bluuebunny/crossref_metadata_2025 huggingface dataset:
Game-Based Augmented Visual Feedback for Enlarging Speech Movements in Parkinson's Disease
Authors: Yunusova Yana , Kearney Elaine , Kulkarni Madhura , Haworth Brandon , Baljko Melanie , Faloutsos Petros
Published: June 2017

Purpose

The purpose of this pilot study was to demonstrate the effect of augmented visual feedback on acquisition and short-term retention of a relatively simple instruction to increase movement amplitude during speaking tasks in patients with dysarthria due to Parkinson's disease (PD).

Method

Nine patients diagnosed with PD, hypokinetic dysarthria, and impaired speech intelligibility participated in a training program aimed at increasing the size of their articulatory (tongue) movements during sentences. Two sessions were conducted: a baseline and training session, followed by a retention session 48 hr later. At baseline, sentences were produced at normal, loud, and clear speaking conditions. Game-based visual feedback regarding the size of the articulatory working space (AWS) was presented during training.

Results

Eight of nine participants benefited from training, increasing their sentence AWS to a greater degree following feedback as compared with the baseline loud and clear conditions. The majority of participants were able to demonstrate the learned skill at the retention session.

Conclusions

This study demonstrated the feasibility of augmented visual feedback via articulatory kinematics for training movement enlargement in patients with hypokinesia due to PD.

Supplemental Materials

https://doi.org/10.23641/asha.5116840
Acoustic and Perceptual Consequences of Speech Cues for Children With Dysarthria
Authors: Levy Erika S. , Chang Younghwa M. , Ancelle Joséphine A. , McAuliffe Megan J.
Published: June 2017

Purpose

Reductions in articulatory working space and vocal intensity have been linked to intelligibility deficits in children with dysarthria due to cerebral palsy. However, few studies have examined the outcomes of behavioral treatments aimed at these underlying impairments or investigated which treatment cues might best facilitate improved intelligibility. This study assessed the effects of cues targeting clear speech (i.e., “Speak with your big mouth”) and greater vocal intensity (i.e., “Speak with your strong voice”) on acoustic measures of speech production and intelligibility.

Method

Eight children with spastic dysarthria due to cerebral palsy repeated sentence- and word-level stimuli across habitual, big mouth, and strong voice conditions. Acoustic analyses were conducted, and 48 listeners completed orthographic transcription and scaled intelligibility ratings.

Results

Both cues resulted in significant changes to vocal intensity and speech rate although the degree of change varied by condition. In a similar manner, perceptual analysis revealed significant improvements to intelligibility with both cues; however, at the single-word level, big mouth outperformed strong voice.

Conclusion

Children with dysarthria are capable of changing their speech styles differentially in response to cueing. Both the big mouth and strong voice cues hold promise as intervention strategies to improve intelligibility in this population.

Supplemental Material

https://doi.org/10.23641/asha.5116843
Nonmonotone conic trust region method with line search technique for bound constrained optimization
Authors: Zhao Lijuan
Published: June 2017

In this paper, we propose a nonmonotone trust region method for bound constrained optimization problems, where the bounds are dealt with by affine scaling technique. Differing from the traditional trust region methods, the subproblem in our algorithm is based on a conic model. Moreover, when the trial point isn’t acceptable by the usual trust region criterion, a line search technique is used to find an acceptable point. This procedure avoids resolving the trust region subproblem, which may reduce the total computational cost. The global convergence andQ-superlinear convergence of the algorithm are established under some mild conditions. Numerical results on a series of standard test problems are reported to show the effectiveness of the new method.
A Concise Synthesis of Isocryptolepine by C–C Cross-Coupling Followed by a Tandem C–H Activation and C–N Bond Formation
Authors: Helgeland Ida , Sydnes Magne
Published: June 2017

Isocryptolepine (1), a potent antimalarial natural product, was prepared in three steps from 3-bromoquinoline and 2-aminophenylboronic acid hydrochloride. The key transformations were a Suzuki–Miyaura cross-coupling reaction followed by a palladium-initiated intramolecular C–H activation/C–N bond formation between an unprotected amine and an aromatic C–H group. The two key reactions can also be performed in one pot.
Controversy in the Determination of Death: Cultural Perspectives
Authors: Potter Katherine
Published: June 2017

The definitions of death have changed throughout recorded history to include not just cardiac death but death by neurological criteria as well. Given the many cultures present in the world, it comes as no surprise that declaring death takes many forms. In the Western world, brain death has gained common acceptance (though not universal), while other cultures and religions have struggled with this issue, especially as it surrounds the controversy of donated organs. There is legal precedent to support death by neurological criteria, as well as support for hospital systems and physicians to terminate somatic support of the brain-dead patient; however, these laws differ greatly from country to country. When dealing with a controversial topic, differing laws, and grief-laden families, it becomes especially crucial that health care staffs are educated regarding varying cultural beliefs surrounding death. In the majority of cases, with kindness and compassion, common ground between science and social perspectives can be found, leading to resolution of care for this group of patients.
Uniportale videoassistiert-thorakoskopische anatomische Lungenresektionen: erste Erfahrungen und ein Vergleich mit dem multiportalen Zugang
Authors: Stamenovic Davor , Messerschmidt Antje , Jahn Tillmann , Schneider Thomas
Published: June 2017

Einleitung Die uniportale videoassistierte Thorakoskopie (UVATS) bei anatomischen Lungenresektionen erfährt zurzeit ein großes Interesse. Das Ziel dieser Untersuchung war es, eventuelle Hindernisse bei der Einführung der uniportalen Methode in die tägliche Routine minimalinvasiver Lungenresektionen darzustellen. Daher untersuchten wir retrospektiv unsere ersten Erfahrungen und ermittelten eine Lernkurve.

Methoden Von Januar bis Mai 2016 erfolgten 24 aufeinanderfolgende anatomische UVATS-Resektionen (UVATS-Gruppe) durch einen Chirurgen ohne vorherige Erfahrung in UVATS-Eingriffen. Diese Eingriffe wurden mit einer Kohorte aus 102 Patienten verglichen, die eine anatomische Resektion in „klassischer“ VATS-Technik (VATS-Gruppe) in den letzten 2 Jahren von demselben Chirurgen erhalten hatten. Die Auswertung erfolgte mittels Propensity Score. Basierend auf einer initialen Analyse, wurde die UVATS-Gruppe weiterhin in 2 Subgruppen unterteilt, UVATS1 und UVATS2, die die ersten 12 und die letzten 12 Fälle beinhalteten.

Ergebnisse Bei keinem Patienten der UVATS-Gruppe war eine Konversion zur Thorakotomie noch ein zusätzlicher Zugang erforderlich. In der VATS-Gruppe war die durchschnittliche Operationsdauer kürzer als in der UVATS1-Subgruppe (MVATS = 152, MUVATS1 = 191; p = 0,019), jedoch nicht in der UVATS2-Subgruppe (MVATS = 152, MUVATS2 = 152; p = 1). Es gab keine Unterschiede in der Menge der angegangenen Lymphknotenstationen (MVATS = 7, MUVATS1 = 7, MUVATS2 = 7;p = 0,92), noch in der durchschnittlichen Anzahl dissezierter Lymphknoten (MVATS = 19, MUVATS1 = 15, MUVATS2 = 18;p = 0,659) oder der Anzahl und der Art postoperativer Komplikationen Unter Verwendung einer standardisierten Schmerzskala (AAS, Audio-Analog-Skala) zeigte sich, dass der Schmerzmittelbedarf insgesamt in der UVATS-Gruppe bis zur Entlassung niedriger war (p < 0,001).

Schlussfolgerung Die Einführung der uniportalen VATS bei anatomischen Eingriffen kann ohne negativen Einfluss auf den operativen Erfolg und klinischen Verlauf erfolgen, sofern diese von einem Chirurgen durchgeführt wird, der bereits auf dem Gebiet der VATS-Chirurgie hinreichend Erfahrungen gesammelt hat. Nach unserer Erfahrung waren weder zusätzliche Operationskurse, Proctor-Unterstützung noch eine Anpassung der chirurgischen Instrumente erforderlich, obwohl die oben erwähnten Optionen die Anpassung erleichtern können.
Potential impact of screening for fatty liver disease by transient elastography with liver stiffness and controlled attenuation parameter measurements: a pilot study
Authors: Peiseler Moritz , Creutzfeldt Anna , Cassens Insa , Glaubke Claudia , Kroll Claudia , Lohse Ansgar , Weiler-Normann Christina
Published: June 2017

Background The prevalence of chronic liver diseases is high in developed countries, and the leading causes are amenable to prevention. The German Lebertag is to increase awareness of the burden of chronic liver diseases in the general public. We performed a pilot study using transient elastography with liver stiffness measurement (LSM) and the controlled attenuation parameter (CAP) as a screening tool for previously unrecognized liver diseases.

Patients and methods LSM and CAP was performed in 60 individuals, and participants filled in a questionnaire reporting basic characteristics and past medical history.

Results Median LSM and CAP values were within the normal range. Participants with self-reported diabetes mellitus had significantly elevated LSM (p = 0.02) and CAP values (p = 0.002). Participants with a BMI > 30 kg/m2 or dyslipidemia had significantly elevated CAP values (p = 0.007 and p = 0.01, respectively) with normal LSM values. Overall, 35 % of participants had elevated CAP values, indicating a high prevalence of hepatic steatosis.

Discussion In a German pilot study, diabetes mellitus was a key risk factor for increased LSM and CAP values. Prevalence of steatosis was high and comparable to other Western countries. Transient elastography is a valuable tool to identify patients with increased risk for metabolic liver diseases. In people without risk factors, LSM and CAP values were within the normal range, indicating that screening for chronic liver injury was not warranted.
Die Bedeutung der Psychoanamnese für die homöopathische Mittelwahl
Authors: Müller H.V.
Published: June 2017

Die Methode der Mittelwahl aufgrund einer durch eine eingehende lebensgeschichtlich-psychoanamnestische Befragung gewonnenen Symptomatik wird an 3 Fällen demonstriert.
Value and Application of Repertory
Authors: Sankaran R.
Published: June 2017

Der Verfasser teilt seine Erfahrungen mit dem Repertorium mit und demonstriert sie in eindrücklichen Falldarstellungen. Ohne Repertorium könnte man viele Fälle nicht lösen, weil wir entweder die Symptome nicht im Kopf haben oder das wahre Mittel nicht genug kennen. Erst beim Repertorisieren ergeben sich gegenüber dem gewöhnlichen Gebrauch oft ungewöhnliche Aspekte des Mittels. Es ist für die Heilung nötig, eine genaue Übereinstimmung der Fallsymptome mit den Rubriken des Repertoriums herzustellen. Dabei können Pannen eintreten, die erst durch erneute Beobachtung des Patienten und einer Neuinterpretation dieser Symptome in ihrer repertoriaien Bedeutung behoben werden. Das Repertorium kann auf verschiedene Arten verwendet werden, abhängig von der Lage des Falls. Die Methode von Bönninghausen wird viel zu wenig benützt. Von ihrem Wert gibt der Verfasser überzeugende Belege. Sie tritt vor allem dann in den Vordergrund, wenn ein hochcharakterisiertes Lokai-symptom nicht unter den Teilsymptomen des Repertoriums angeführt ist und auch nicht seine Fragmente auf einen gemeinsamen Nenner gebracht werden können. Hier führt eine generalisierende Methode zum Erfolg, im Repertorium finden sich auch die Leitsymptome, die zum richtigen Mittel führen, das Mittel muÜ allerdings zum Patienten passen. Kein Repertorium ist vollständig, alle haben ihre Vor-und Nachteile. Wenn der Patient nurSymptome groÜer Rubriken aufweist, läÜt sich kein eindeutiges Mittel repertorisieren. Hier versagt das Repertorium, aber es hilft die Materia medica weiter. Denn dort wurden charakteristische Symptomenkombinationen nicht, wie im Repertorium in für sich uncharakteristische Fragmente aufgeteilt.
Konstitutionelles Ekzem der Kinder
Authors: Gsell H.-O.
Published: June 2017

Der Verfasser zeigt mit 3 Fällen, wie jeweils durch Repertorisation nur eines Mittels chronische Ekzemerkrankungen ausgeheilt werden können.
Developments on a SEM-based X-ray tomography system: Stabilization scheme and performance evaluation
Authors: Gomes Perini L. A. , Bleuet P. , Filevich J. , Parker W. , Buijsse B. , Kwakman L. F. Tz.
Published: June 2017

Recent improvements in a SEM-based X-ray tomography system are described. In this type of equipment, X-rays are generated through the interaction between a highly focused electron-beam and a geometrically confined anode target. Unwanted long-term drifts of the e-beam can lead to loss of X-ray flux or decrease of spatial resolution in images. To circumvent this issue, a closed-loop control using FFT-based image correlation is integrated to the acquisition routine, in order to provide an in-line drift correction. The X-ray detection system consists of a state-of-the-art scientific CMOS camera (indirect detection), featuring high quantum efficiency (∼60%) and low read-out noise (∼1.2 electrons). The system performance is evaluated in terms of resolution, detectability, and scanning times for applications covering three different scientific fields: microelectronics, technical textile, and material science.
Improved performance of latent heat energy storage systems utilizing high thermal conductivity fins: A review
Authors: Dhaidan Nabeel S. , Khodadadi J. M.
Published: June 2017

A review of the analytical, computational, and experimental studies directed at improving the performance of phase change material-based (PCM) latent heat energy storage systems that utilize high thermal conductivity fins is presented. Spanning over many decades, managing of heat generation associated with electronics utilized for early work on aeronautics and space exploration was emphasized, with later extensions to waste heat recovery, passive thermal management of computing platforms, and energy storage for solar thermal applications. The focus of this review is placed on investigations that deal with utilization of non-moving fins/extended surfaces with high conductivity. Aluminum, brass, bronze, copper, iron, mild steel, nickel, and stainless steel were the metal-based fin materials of choice utilized to promote heat transfer, whereas carbon fiber brushes were also used. A variety of phase change materials including pure/commercial paraffins, carbonate mixtures, polyethylene glycol, chloride mixtures, fluorides, asphalt, water, nitrite and nitrate mixtures, stearic acid, dodecanoic acid, and lauric acid, covering melting temperatures in the range of 0–735 °C, was used. Both freezing and thawing of phase change materials within a variety of thermal energy storage container geometries and heat exchange operating conditions were reported. More recent studies have highlighted the important role of convection, particularly in situations involving melting. The formation of thermally unstable fluid layers responsible for improved mixing and expedited thawing of PCM was also highlighted. It was found that the number of fins (or fin-pitch) and fin length have far stronger effects on the performance of the storage system than those caused by fin thickness and fin orientation. At the same time, insertion of fins will weaken buoyancy-driven convection, which is well-known to play an important role in the melting process. Therefore, the conflict between enhancement of the effective thermal conductivity and simultaneous suppression of the buoyancy effect should be considered by the designer through selecting the optimum positions and orientation of the fins. A generalized finding of these studies underlines that in employing fins with high thermal conductivity, minimum-distance conducting pathways that connect the extreme temperature of the heat storage system should be sought.
Wearable near-field communication antennas with magnetic composite films
Authors: Zhan Bihong , Su Dan , Liu Sheng , Liu Feng
Published: June 2017

The flexible near-field communication (NFC) antennas integrated with Fe3O4/ethylene-vinyl acetate copolymer (EVA) magnetic films were presented, and the influence of the magnetic composite films on the performance and miniaturization capability of the NFC antennas was investigated. Theoretical analysis and experimental results show that the integration of the magnetic composite films is conducive to the miniaturization of the NFC antennas. However, the pattern design of the integrated magnetic film is very important to improve the communication performance of NFC antenna. When magnetic film covers whole antenna, the inductance (L) and quality factor (Q) of the NFC antenna at 13MHz are increased by 60% and 5% respectively, but the communication distance of NFC system is decreased by 70%. When the magnetic film is located at the center of the antenna, the L value, Q value and communication distance of the NFC antenna are increased by 16.5%, 15.5% and 20% respectively. It can be seen that the application of the integrated magnetic film with optimized pattern to the NFC antenna can not only reduce the size of the antenna, but also improve the overall performance of the antenna.
Using density functional theory to understand the properties of water
Authors: Hendricks-Sturrup Rachele
Published: June 2017

Researchers analyze mass density fluctuations in water using a revised Perdew-Burke-Ernzerhof plus Grimme’s third generation of dispersion protocol.
Economics and computer science of a radio spectrum reallocation
Authors: Leyton-Brown Kevin , Milgrom Paul , Segal Ilya
Published: June 2017

The recent “incentive auction” of the US Federal Communications Commission was the first auction to reallocate radio frequencies between two different kinds of uses: from broadcast television to wireless Internet access. The design challenge was not just to choose market rules to govern a fixed set of potential trades but also, to determine the broadcasters’ property rights, the goods to be exchanged, the quantities to be traded, the computational procedures, and even some of the performance objectives. An essential and unusual challenge was to make the auction simple enough for human participants while still ensuring that the computations would be tractable and capable of delivering nearly efficient outcomes.
Arabidopsis
ABCG34 contributes to defense against necrotrophic pathogens by mediating the secretion of camalexin
Authors: Khare Deepa , Choi Hyunju , Huh Sung Un , Bassin Barbara , Kim Jeongsik , Martinoia Enrico , Sohn Kee Hoon , Paek Kyung-Hee , Lee Youngsook
Published: June 2017

Significance

Alternaria brassicicola
infection causes dark spots on the leaves of most
Brassica
species, reducing the yield of economically important oilseed crops. In response to
A
.
brassicicola
infection,
Arabidopsis thaliana
and other Brassicaceae produce and secrete camalexin, a major phytoalexin imparting resistance to
A
.
brassicicola
. Because camalexin is toxic to the plant itself, specific transporters are needed for secretion. Here we show that the ABC transporter ABCG34 mediates the secretion of camalexin from the epidermal cells to the surface of leaves and thereby confers resistance to
A
.
brassicicola
infection. This work establishes a complete picture of a plant defense system, consisting of a toxic secondary metabolite, its transporter, and the disease phenotype caused by an economically important pathogen.
Simulation of
Deepwater Horizon
oil plume reveals substrate specialization within a complex community of hydrocarbon degraders
Authors: Hu Ping , Dubinsky Eric A. , Probst Alexander J. , Wang Jian , Sieber Christian M. K. , Tom Lauren M. , Gardinali Piero R. , Banfield Jillian F. , Atlas Ronald M. , Andersen Gary L.
Published: June 2017

Significance

The
Deepwater Horizon
drilling accident was the first major release of oil and natural gases in the deep ocean, and considerable uncertainty remains about the fate of vast amounts of hydrocarbons that never reached the surface. We simulated the deep-sea plumes of dispersed oil microdroplets and measured biodegradation of crude oil components. We successfully reproduced the successive blooms of diverse bacteria observed in the field and obtained near-complete genomes of all major hydrocarbon-degrading species, providing an assessment of the metabolic capabilities of the microbial community responsible for biodegradation. Our results show that rapidly degraded components of oil were consumed by bacteria with highly specialized degradation capabilities and that crude oil alone could explain the microbial dynamics observed in the field.
Exploiting the synthetic lethality between terminal respiratory oxidases to kill
Mycobacterium tuberculosis
and clear host infection
Authors: Kalia Nitin P. , Hasenoehrl Erik J. , Ab Rahman Nurlilah B. , Koh Vanessa H. , Ang Michelle L. T. , Sajorda Dannah R. , Hards Kiel , Grüber Gerhard , Alonso Sylvie , Cook Gregory M. , Berney Michael , Pethe Kevin
Published: June 2017

Significance

New drugs are needed to combat multidrug-resistant tuberculosis. The electron transport chain (ETC) maintains the electrochemical potential across the cytoplasmic membrane and allows production of ATP, the energy currency of any living cell. The ETC of the tubercle bacilli contains two terminal oxidases, the cytochrome
bc

1

:
aa

3

and the cytochrome
bd
oxidase. In this study, we used genetics and chemical biology approaches to demonstrate that simultaneous inhibition of both terminal oxidases stops respiration, kills nonreplicating drug-tolerant
Mycobacterium tuberculosis
, and eradicates infection in vivo at an extraordinarily fast rate. Exploiting this potent synthetic lethal interaction with new drugs promises to shorten tuberculosis chemotherapy.
“We are going to our Portuguese homeland!”
Authors: Simões Marques Isabelle , Koven Michèle
Published: June 2017

This article combines the study of online narratives as social practices and the linguistic anthropological study of imagined communities, to examine a set of non-canonical narrative practices in a Facebook group for the Portuguese diaspora in France. Instead ofreportsofindividualmembers’pastexperiences, these narratives function asinvitationsto other group members to co-telltypical,sharedexperiences. Specifically, we investigate how group members share vacation trips to Portugal with each other in ways that produce a sense of collective and simultaneous experience. They accomplish this through deictically-based narrative strategies that shift the social, spatial, and temporal perspectives of narrating and narrated frames in ways that link the following: individualI’swith collectivewe’s, one-time events with timeless event types, and co-presence online with co-presence on vacation. Through these strategies, participants connect Facebook narrations of vacations to the larger social project of diasporic longing for and return to Portugal.
Multiple selves
Authors: John Aesha , Bailey Lucy E.
Published: June 2017

The paper presents findings from narrative analyses of interviews with 16 Gujarati women caring for a child with an intellectual disability in a midsized city in India. Participants’ mothering narratives articulate the multiple selves (or identities) they have constructed in the context of their child’s disability. In efforts to align with the cultural discourse on good mothering, women in this study sometimes narrate themselves as knowledge bearers and as agents, as people who labor and triumph over difficult circumstances, but at other times vulnerable and victimized as they navigate both their daily responsibilities and the social expectations and discourses regarding mothering. The identity narratives educate the audience of what mothering a child with an intellectual disability means in this unique sociocultural context.
Reduced Acute Care Costs With the ERAS® Minimally Invasive Transforaminal Lumbar Interbody Fusion Compared With Conventional Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Wang Michael Y , Chang Hsuan Kan , Grossman Jay
Published: June 2017

BACKGROUND

Enhancing Recovery After Surgery (ERAS®) programs have been widely adopted throughout the world, but not in spinal surgery. In this report, we review the implementation of a “fast track” surgery for lumbar fusion and its effect on acute care hospitalization costs.

OBJECTIVE

To determine if a “fast track” surgery methodology results in acute care cost savings.

METHODS

Thirty-eight consecutive ERAS patients were compared with patients undergoing conventional minimally invasive transforaminal lumbar interbody fusion. Differences between these groups included the use of endoscopic decompression, injections of liposomal bupivacaine, and performing the surgery under sedation in the ERAS® group.

RESULTS

Patients had similar medical comorbidities (2.02 vs 2 for ERAS® and comparator groups, respectively; P = .458). Body mass index was similar (26.5 vs 27.0; P = .329). ERAS® patients were older (65 vs 59 yr, P = .031). Both groups had excellent clinical results with an improvement of 23% and 24%, respectively. Intraoperative blood loss was less (68 ± 31 cc vs 231 ± 73, P < 0.001). Length of stay was also less with ERAS® surgery, at a mean of 1.23 ± 0.8 d vs 3.9 ± 1.1 d (P = 0.009). When comparing ERAS® surgery to standard minimally invasive transforaminal lumbar interbody fusion, the total cost for the acute care hospitalization was $19 212 vs $22 656, respectively (P < 0.001). This reflected an average of $3444 in savings, which was a 15.2% reduction.

CONCLUSION

ERAS® programs for spinal fusion surgery have the potential to reduce the costs of acute care. This is made possible by leveraging less invasive interventions to minimize soft tissue damage.
Palliative Care: Evolution and Scope of Practice
Authors: Altilio Terry , McKinnon Anna , Rivas Nansi
Published: June 2017

Palliative care is an interdisciplinary specialty that privileges patient-centered, family-focused care and is ideally accessible across ages, settings, and diagnoses. While hospice care is also provided to patients and families of varying ages across setting and diagnosis by an interdisciplinary team, in the United States it is generally available to patients and families with anticipated prognosis of six month or less. Alternatively, palliative care is accessible at any point along the continuum of illness, regardless of prognosis, and is often provided concurrently with disease-modifying or curative therapies. Palliative clinicians often work in collaborative relationships with primary providers toward the shared work of identifying and responding to the goals and needs of patients and their families as illness evolves. Palliative social work brings values and ethics specific to the profession, along with varied skills that begin with a psychosocial-spiritual assessment, that reflect a whole person in environment perspective that naturally coheres with the goals and focus of the specialty of palliative care. As palliative care has evolved to a specialty over the past decades, domains of care, preferred practices, training programs, discipline-specific certifications and competencies, and program certifications have developed, providing definition to the skill sets and program elements that may be expected. The mandate for access to palliative care has been informed by an increasing evidence base that documents the benefit to patients and families, enhanced quality of care, and cost effectiveness. As demand for palliative care increases across countries, diagnoses, and settings, there is a concurrent need to define specialist and primary skills and to create opportunities for practicing health-care clinicians to validate existing skills relevant to palliative practice, and, when necessary, to learn or further integrate palliative principles and practices. This is uniquely relevant to the thousands of social workers who practice across health settings and have a rich opportunity and responsibility to engage their skills in communication, advocacy, family systems, group dynamics, and psychosocial and cultural aspects of experience to enhance patient-centered, family-focused care across ages, settings, and illnesses. It is additionally relevant because the national and international call for palliative care mandates a continuing dialogue within the social work profession related to the imposition of Western values and the need for critical and creative thinking in servicing resource-poor nations.
Thomas Paine
Authors: Dickinson Harry T.
Published: June 2017

Thomas Paine (b. 1737–d. 1809) was born in Thetford, England, the son of Joseph Pain [sic], a Quaker stay-maker. Educated at the local grammar school, he was apprenticed to his father, but soon tried out several other occupations. By mid-1774 he was in financial difficulties and legally separated from his second wife. He took Benjamin Franklin’s advice to seek his fortune in Philadelphia, which he reached in November 1774. By early 1775 Paine was editing and contributing to the Pennsylvania Magazine. In January 1776 he produced a short, but immensely influential, pamphlet, Common Sense, which attacked George III and the British Constitution and encouraged the American colonies to seek their independence. During the War of Independence, he produced essays on the American Crisis, encouraging the colonists that ultimate victory could be theirs. He also wrote in support of Pennsylvania’s new constitution, served for a time as secretary to Congress’s Committee for Foreign Affairs, and even visited France to secure financial assistance for the American cause. After the war, Paine took an interest in scientific and engineering experiments and devised a single-span iron bridge. In 1787 he sailed to Europe to secure backing in either France or Britain to build such a bridge. In both France and Britain, he associated with men seeking political reforms and constitutional changes. In London he produced two widely distributed volumes of the Rights of Man (1791–1792) defending radical reform and advocating improvements in the welfare of the poor. Fearing arrest, he fled to France in September 1792. In France, Paine was elected as a deputy to the newly established National Convention. His pacific views led to his arrest in late December 1793. He narrowly avoided execution, but was finally released in 1795. Arrest and imprisonment did not prevent him producing his Age of Reason, in two parts. This attack on the Bible and the clergy was also widely distributed. After his release, Paine was no longer active in French politics, though he continued to produce political works. His Agrarian Justice (1796) advocated taxes on landed property to fund welfare benefits for the poor. He also wrote attacking the British financial system and castigating George Washington’s conduct. In 1802 Paine returned to America. Although welcomed by President Jefferson and more warmly by radical artisans in New York, he was bitterly attacked by many who deplored his religious and political views and denigrated his moral character. He engaged in a press war with his New York critics until shortly before his death in June 1809. He died neglected and largely friendless. He was denied burial in a churchyard and was interred on his farm in New Rochelle.
Cuba
Authors: Schneider Elena A.
Published: June 2017

Cuba’s past has taken place at the crossroads of Atlantic history. The largest Caribbean island—located at the crux of crucial shipping lanes and trade networks and neighbored by British, French, and later US and Haitian territories—Cuba has been profoundly shaped by both imperial rivalry and the interaction of European, Amerindian, and African societies and cultures on its shores. The site of a landing by Columbus in October of 1492, the island saw violence and disease unleashed on its indigenous Taíno population. Bartolomé de Las Casas took part in Cuba’s wars of “pacification,” an experience reflected in his Brief Account of the Destruction of the Indies (see Las Casas 1992, cited under Contemporary Accounts: Colonial Period to 1820). The island served as a launching pad for the conquest campaigns in Mexico and as a crucial meeting site for the treasure galleons bringing gold and silver from Mexico and Peru back to Spain. For that reason, in the 16th and 17th centuries, French and Dutch corsairs menaced the island, although the British were the principal threat during the 18th century, when they invaded and occupied both Guantánamo Bay and Havana. Throughout that period, settlements of Europeans and Africans, both free and enslaved, helped to construct a society based on logging, cattle ranching, shipbuilding, sugar, and tobacco, as well as a vibrant service economy in the island’s capital of Havana, moved there from Santiago de Cuba in 1592. In the 1790s, almost a century later than its neighbor Jamaica, the island experienced a dramatic boom in sugar production, bolstered by the disruptions of the Haitian revolution and the arrival of exiles from St. Domingue. Fiscal policies that favored Cuba’s sugar elite, the precarious racial hierarchies of plantation society, and a strong Spanish military presence made Cuba generally a bastion of loyalty during the Spanish–American independence wars, despite the Aponte slave rebellion of 1812 and the conspiracy of La Escalera in 1843–1844. Throughout the 19th century, the island drifted more into a US economic orbit, periodically shadowed by talk of annexation. 1868 marked the beginning of a thirty-year revolutionary process, a struggle against both Spanish colonialism and ultimately slavery that reached an ambiguous culmination in the US invasion and occupation of 1898. Given this long and complicated history, this bibliography ranges from the 15th to the 20th centuries, though its coverage is by necessity not comprehensive, given the tremendous volume of scholarly production for the 19th and early 20th centuries. That said, this bibliography aspires, nonetheless, to provide a helpful introduction to the literature on this island, colony, and nation in Atlantic history.
Image Updating for Brain Shift Compensation During Resection
Authors: Fan Xiaoyao , Roberts David W , Olson Jonathan D , Ji Songbai , Schaewe Timothy J , Simon David A , Paulsen Keith D
Published: June 2017

BACKGROUND

In open-cranial neurosurgery, preoperative magnetic resonance (pMR) images are typically coregistered for intraoperative guidance. Their accuracy can be significantly degraded by intraoperative brain deformation, especially when resection is involved.

OBJECTIVE

To produce model updated MR (uMR) images to compensate for brain shift that occurred during resection, and evaluate the performance of the image-updating process in terms of accuracy and computational efficiency.

METHODS

In 14 resection cases, intraoperative stereovision image pairs were acquired after dural opening and during resection to generate displacement maps of the surgical field. These data were assimilated by a biomechanical model to create uMR volumes of the evolving surgical field. A tracked stylus provided independent measurements of feature locations to quantify target registration errors (TREs) in the original coregistered pMR and uMR as surgery progressed.

RESULTS

Updated MR TREs were 1.66 ± 0.27 and 1.92 ± 0.49 mm in the 14 cases after dural opening and after partial resection, respectively, compared to 8.48 ± 3.74 and 8.77 ± 4.61 mm for pMR, respectively. The overall computational time for generating uMRs after partial resection was less than 10 min.

CONCLUSION

We have developed an image-updating system to compensate for brain deformation during resection using a computational model with data assimilation of displacements measured with intraoperative stereovision imaging that maintains TREs less than 2 mm on average.
Efficacy and Safety of Tranexamic Acid in Orthopaedic Fracture Surgery: A Meta-Analysis and Systematic Literature Review
Authors: Amer Kamil M. , Rehman Saqib , Amer Kamal , Haydel Christopher
Published: June 2017

Background:

Tranexamic acid (TXA) is an antifibrinolytic drug that has been shown to be effective in reducing blood loss and the need for transfusions after several orthopaedic surgeries. However, the effectiveness of TXA use in orthopaedic fracture surgeries still remains unclear. The purpose of this meta-analysis was to review existing literature with interest in the effectiveness and safety of TXA treatment in reducing total blood loss and transfusion rates for patients who underwent surgery for fracture repairs.

Methods:

An electronic literature search of PubMed, Embase, OVID, and the Cochrane Library was conducted to identify studies published before December 2016. All randomized controlled trials and cohort studies evaluating the efficacy of TXA during fracture repair surgeries were identified. Primary outcome measures included the number of patients receiving a blood transfusion and perioperative total blood loss. Data were analyzed using Comprehensive Meta-Analysis (CMA) statistical software.

Results:

Seven studies encompassing 559 patients met the inclusion criteria for the meta-analysis. Our meta-analysis indicated that when compared with the placebo control group, the use of TXA in fracture surgeries significantly reduced total blood loss by approximately 330 mL (P = 0.009), reduced the transfusion rate with a relative risk of 0.54 (P < 0.001), and decreased the drop of hemoglobin by 0.76 g/dL (P < 0.001). There was no significant difference between the number of thromboembolic events among the study groups (P = 0.24).

Conclusions:

This study demonstrated that tranexamic acid may be used in orthopaedic fracture surgeries to reduce total blood loss, transfusion rates, and the drop in hemoglobin level, without increasing risk of venous thrombo-embolism. A limitation to these findings is the small number of studies available. Further studies need to be conducted to confirm these findings.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
The Hyperextension Tibial Plateau Fracture Pattern: A Predictor of Poor Outcome
Authors: Gonzalez Leah J. , Lott Ariana , Konda Sanjit , Egol Kenneth A.
Published: June 2017

Objectives:

To assess the outcome of patients with hyperextension bicondylar tibial plateau fractures (HEBTPs) and those with other complex tibial plateau fractures.

Design:

Retrospective cohort design.

Setting:

Academic Medical Center.

Patients:

A total of 84 patients were included in the study. There were 69 patients with 69 knees (82%) that had sustained non-HEBTPs and 15 patients with 15 knees (18%) that had HEBTPs.

Intervention:

Surgical repair of bicondylar tibial plateau fracture.

Main Outcome Measures:

Clinical and functional outcomes included knee range of motion, postoperative alignment, numerical rating scale pain scores, and Short Musculoskeletal Functional Assessment (SMFA) scores at long-term follow-up. Complications were recorded for both cohorts including infection and posttraumatic osteoarthritis.

Results:

There was no difference in knee range of motion at 1-year follow-up between hyperextension and nonhypertension patients. Patients with hyperextension mechanisms did however have higher functional (SMFA) scores and a trend of higher pain scores, indicating worsened functional outcomes and were more likely than their nonhyperextension mechanism counterparts to have associated soft-tissue damage and to develop posttraumatic osteoarthritis.

Conclusions:

Non-HEBTP and HEBTP fracture patients have similar outcomes in terms of range of motion at approximately 1 year of follow-up, however, differ significantly in terms of functional recovery and the types of complications associated with their injuries.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Capecitabine and Celecoxib as a Promising Therapy for Thymic Neoplasms
Authors: Wood Kevin , Byron Elizabeth , Janisch Linda , Salgia Ravi , Sharma Manish R.
Published: June 2017

Objectives:

For patients with unresectable or metastatic thymic epithelial neoplasms, few therapy options are available and outcomes are poor. This case series demonstrates that the combination of capecitabine and celecoxib may be a promising therapeutic option for these patients.

Materials and Methods:

The current report describes the outcomes of 5 patients with thymic neoplasms treated on a drug-drug interaction study of capecitabine and celecoxib in patients with advanced solid malignancies (NCT01705106) conducted at the University of Chicago, plus a sixth patient treated with the same regimen outside of the protocol.

Results:

Six patients with thymic neoplasms were treated with capecitabine 1000 mg/m2 twice daily and celecoxib 200 mg twice daily, day 1 to day 14 on a 21-day cycle. This included 3 patients with thymic carcinoma, 1 with thymic neuroendocrine tumor, and 2 with thymomas. Objective response rates were noted in 3 of 6 patients. Two of the 3 thymic carcinoma patients had complete responses, and the third had a partial response. Best response for the other patients included stable disease for both thymoma patients and progressive disease for the thymic neuroendocrine patient. Other than grade 3 palmar-plantar erythrodysesthesia, which developed in 4 of 6 patients and required dose reductions, the regimen was well tolerated.

Conclusions:

This case series suggests that capecitabine plus celecoxib may be an effective and well-tolerated treatment option for patients with thymic carcinoma. Further studies should be carried out to establish the efficacy of capecitabine plus celecoxib in thymic carcinoma, and to determine whether monotherapy with capecitabine would be similarly effective.
Microcystic Adnexal Carcinoma: A Review of the Literature
Authors: Gordon Shayna , Fischer Caroline , Martin Ann , Rosman Ilana S. , Council M. Laurin
Published: June 2017

BACKGROUND

Microcystic adnexal carcinoma (MAC) is a rare, locally aggressive cutaneous neoplasm that commonly occurs on the face.

OBJECTIVE

The purpose of this article is to comprehensively review the current literature on MAC pertaining to epidemiology, pathogenesis, clinical presentation, histology, immunohistochemistry, prognosis, follow-up, and treatment.

MATERIALS AND METHODS

An extensive literature review was conducted using OVID MEDLINE and PubMed to identify articles relating to MAC.

RESULTS

Microcystic adnexal carcinoma typically presents as a skin-colored nodule on the face. The pathogenesis is mostly related to pilar and eccrine differentiation. Histologically, MAC can mimic syringoma, desmoplastic trichoepithelioma, and infiltrative basal cell carcinoma. Diagnosis is challenging because superficial shave biopsies may reveal only benign findings that do not warrant further management. A deep biopsy is mandatory for the correct diagnosis, and Mohs micrographic surgery provides the highest cure rate.

CONCLUSION

Microcystic adnexal carcinoma is a locally aggressive disease with histological margins that often far surpass what is clinically suspected. Mohs micrographic surgery is the standard of care for removal of these lesions. Patients with a history of MAC should be examined at least every 6 months for recurrence, metastasis, and development of additional skin cancers.
Morphometric Analysis of the Orbital Process of the Palatine Bone and its Relationship to Endoscopic Orbital Apex Surgery
Authors: Mueller Sarina K. , Freitag Suzanne K. , Bleier Benjamin S.
Published: June 2017

Background:

Endoscopic approaches to the orbit improve the ability to directly access apical lesions while minimizing manipulation of normal structures. Inferomedial orbital access is limited by the orbital process of the palatine bone (OPPB) which prevents dissection and retraction in the inferolateral vector.

Objective:

The objective of this study was to examine the morphometric characteristics of the OPPB and quantify the benefit of complete resection to surgical access.

Methods:

Morphometric osteologic measurements of the OPPB were performed in 59 human skulls. A radius subtended by the OPPB was calculated to generate a hemispheric dissection corridor achievable by complete resection of the OPPB. Cadaveric and live surgical dissections were then performed on 15 orbits to develop discreet endoscopic surgical landmarks which could be used to both identify the OPPB and verify complete resection.

Results:

The mean(± SD) radius of the OPPB was 0.47 ± 0.28 cm. Complete OPPB resection provided an additional 0.36 ± 0.42 cm3 of surgical exposure within the inferomedial apex. Relative to the Caucasian (n = 27) skulls, the radii in the Asian (n = 27) and African (n = 5) skulls were significantly smaller (p < 0.001 and p = 0.02, respectively).

Conclusion:

The OPPB significantly limits surgical access to the inferomedial orbital apex during endoscopic approaches. Complete surgical resection of the OPPB improves surgical exposure facilitating retraction of the inferior rectus muscle and circumferential dissection of lesions within this space. Knowledge of the morphology and clinical relevance of this structure provides an opportunity to improve surgical exposure for relevant pathologic assessment and optimize endoscopic surgical outcomes.
A Prospective, Randomized Comparison of Lower Eyelid Retraction Repair With Autologous Auricular Cartilage, Bovine Acellular Dermal Matrix (Surgimend), and Porcine Acellular Dermal Matrix (Enduragen) Spacer Grafts
Authors: Barmettler Anne , Heo Moonseong
Published: June 2017

Purpose:

To compare outcomes of lower eyelid retraction repair with 3 types of spacer grafts: autologous auricular cartilage, bovine acellular dermal matrix (Surgimend, Integra, Plainsboro, NJ), porcine acellular dermal matrix (Enduragen, Stryker, Kalamazoo, MI).

Methods:

A prospective, randomized clinical trial was conducted in patients undergoing lower eyelid retraction repair with spacer graft. Subjects received autologous auricular cartilage, bovine acellular dermal matrix, or porcine acellular dermal matrix between June 2015 and July 2016. Patient demographics, margin to reflex distance 2, conjunctival injection, eyelid swelling, tearing, discomfort, itching, and complications were recorded preoperatively and at postoperative week 1, month 1, month 3, and month 6.

Results:

Of the 49 randomized lower eyelids (39 patients), 42 eyelids (32 patients) completed the study. The preoperative margin to reflex distance 2, conjunctival injection, eyelid swelling, tearing, discomfort, and itching showed no statistical difference. Postoperative week 1 swelling was statistically significantly higher in auricular cartilage, followed by bovine acellular dermal matrix, then porcine acellular dermal matrix (p = 0.04). The mean postoperative month 6 margin to reflex distance 2 trended toward a better outcome from auricular cartilage over bovine acellular dermal matrix (p = 0.029), but after p was adjusted for multiple pairwise comparisons, this was no longer statistically significant (p = 0.088). All other postoperative 6-month measurements showed no statistical difference.

Conclusions:

Among patients randomized to 3 types of spacer grafts for lower eyelid retraction repair, outcomes were not statistically significant different when the 3 groups were compared.