bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Septoplasty on Olfactory Function Evaluated by the Brief Smell Identification Test: A Study of 116 Patients
Authors: Haytoğlu Süheyl , Dengiz Ramazan , Muluk Nuray Bayar , Kuran Gökhan , Arikan Osman Kursat
Published: December 2018

We conducted a prospective study of 116 patients—61 men and 55 women, aged 17 to 64 years (mean: 26.4)— to investigate the effects of septoplasty on olfactory function in patients with septal deviation (SD). The Mladina classification system was used to define SD types, and olfactory function was assessed with the Brief Smell Identification test (BSIT). The BSIT, which includes 12 odorants, was administered preoperatively and at postoperative months 1 and 3. The most common SD types were types 2 (20.7% of patients) and 1 (19.0%), followed by types 3 and 5 (both 16.4%). At postoperative month 1, the mean BSIT score was significantly higher in men than in the women. For patients with types 1 and 2 SD, BSIT scores at 1 month were significantly lower than the scores preoperatively and 3 months postoperatively. For types 3 and 4, BSIT values were significantly higher at 3 months than preoperatively or at 1 month. For type 3 SD, the pre-operative mean score was significantly lower than those for types 1, 4, 5, 6, and 7; for type 2 SD, the BSIT score was significantly lower than those of types 5 and 6 only. At 1 month, the scores for types 2 and 3 were significantly lower than those for types 4, 5, 6, and 7. At 3 months, the BSIT score for type 2 was significantly lower than those of types 1, 3, 4, 5, and 6; the type 3 SD score at 3 months was significantly higher than those for types 1, 2, 5, 6, and 7. We conclude that septoplasty surgery for patients with a type 3 SD may improve olfactory function. In contrast, we found that olfactory function in patients with a type 2 SD did not improve to a satisfactory degree, even when good nasal patency was achieved with a corrected septum and an enlarged intranasal volume. Our findings should be investigated further in future studies.
Use of the Microdebrider in the Surgical Management of Rhinophyma
Authors: Chow Winsion , Jeremic Goran , Sowerby Leigh
Published: December 2018

Rhinophyma is a disfiguring end-stage manifestation of acne rosacea. It is characterized by a painless hyperplasia of the sebaceous glands and connective tissues of the nose. Numerous surgical modalities—including scalpel surgery, dermabrasion, CO2 laser ablation, and electrocautery—have been reported with varying results. We describe our experience with using a microdebrider to treat 2 patients—a 65-year-old man and a 74-year-old man—who presented with rhinophyma. The instrument we used was the Medtronic Straight-shot M4 Microdebrider. Using a low revolution speed, we easily excised the bulky superficial tissue. At higher revolution speeds with the use of a small shaver tip, we were able to achieve delicate contouring of the nasal tip and ala without causing scarring. Postoperatively, both patients exhibited an excellent cosmetic outcome and expressed a high degree of patient satisfaction. We conclude that the microdebrider is an excellent surgical tool for treating rhinophyma lesions. Its ease of use and its availability at most surgical centers makes it a favorable surgical option.
Comparison of Anterior Palatoplasty and Uvulopalatal Flap Placement for Treating Mild and Moderate Obstructive Sleep Apnea
Authors: Haytoğlu Süheyl , Arikan Osman Kürşat , Muluk Nuray Bayar , Tuhanioğlu Birgül , Çörtük Mustafa
Published: December 2018

We prospectively compared the efficacy of anterior palatoplasty and the uvulopalatal flap procedure for the treatment of patients with mild and moderate obstructive sleep apnea syndrome (OSAS). Our study group was made up of 45 patients who had been randomly assigned to undergo one of the two procedures. Palatoplasty was performed on 22 patients—12 men and 10 women, aged 28 to 49 years (mean: 39.2)—and the flap procedure was performed on 23 patients—14 men and 9 women, aged 28 to 56 years (mean: 41.3). Our primary outcomes measure was the difference in pre- and postoperative apnea-hypopnea index (AHI) as determined by polysomnography at 6 months after surgery. Surgical success was observed in 18 of the 22 palatoplasty patients (81.8%) and in 19 of the 23 flap patients (82.6%). Compared with the preoperative values, mean AHIs declined from 17.5 to 8.1 in the former group and from 18.5 to 8.6 in the latter; the improvement in both groups was statistically significant (p < 0.001). In addition, significant postoperative improvements in both groups were seen in mean visual analog scale (VAS) scores for snoring, in Pittsburgh Sleep Quality Index values, and in Epworth Sleepiness Scale scores (p < 0.001 for all). VAS scores for pain at rest were significantly lower in the palatoplasty group than in the flap group at 2, 4, and 8 hours postoperatively and on postoperative days 4 through 7 (p < 0.002). Likewise, VAS scores for pain during swallowing were significantly lower in the palatoplasty group at 2, 4, 8, and 16 hours and on days 4 through 7 (p < 0.009). We conclude that both anterior palatoplasty and uvulopalatal flap procedures are effective for the treatment of mild and moderate OSAS in patients with retropalatal obstruction. However, our comparison of postoperative pain scores revealed that anterior palatoplasty was associated with significantly less morbidity.
Psoriasis, Chronic Tonsillitis, and Biofilms: Tonsillar Pathologic Findings supporting a Microbial Hypothesis
Authors: Allen Herbert B. , Jadeja Saagar , Allawh Rina M. , Goyal Kavita
Published: December 2018

Group A Streptococcus has been identified as a possible etiologic agent in psoriasis in epidemiologic, immunologic, immunopathologic, medical, and surgical studies. Tonsillectomy has been shown to provide considerable relief to 75% of patients with plaque psoriasis. Even with the substantial evidence supporting group A Streptococcus as a causative pathogen in psoriasis, it is an elusive pathogen because it is not culturable, nor does it exhibit any positive serologic evidence of its presence. One possible reason for the negative cultures and negative serology findings with group A Streptococcus is the development of biofilms. We conducted a pathologic study to determine whether biofilms were present in the tonsillar tissues of 10 patients with psoriasis—6 men and 4 women, aged 25 to 64 years (mean: 48)—and in 10 age- and sex-matched controls with chronic tonsillitis who did not have psoriasis. We found that biofilms were present in every tonsillectomy specimen we examined, including those of the controls. Whereas psoriasis has been considered a “double hit” phenomenon, we believe that the development of skin lesions is likely attributable to the presence of the gene PSORS together with the biofilm in psoriasis patients rather than to the biofilm itself. Biofilms have been identified in both extra- and intracellular locations. We believe our findings add further evidence supporting a microbial pathogenesis of this disease.
Study of Steroid Effects on Graft and Inner ear Outcomes in Tympanoplasty: Randomized Controlled Trial
Authors: Kouhi Ali , Dabiri Sasan , Amali Amin , Yazdani Nasrin , Baroodabi Mahboubeh , Kouchakinejad Taha , Mohseni Alireza
Published: December 2018

More studies are needed to investigate the side effects of steroids in tympanoplasty, owing to the paucity of such studies in the literature. This randomized, controlled clinical trial included 59 patients with chronic otitis media who underwent tympanoplasty and were randomized after surgery to a systemic steroid or no steroid treatment. Patients were randomized into two groups. Perforation size, graft outcome, and complications such as tinnitus and hearing loss were compared between the two groups. Postsurgical steroid injection had no effect on graft outcome ( p = 0.927) or tinnitus ( p = 0.478). Tympanic membrane perforation ( p = 0.92), plaque size ( p = 0.94), bleeding amount ( p = 0.38), and mucosal status ( p = 0.96) during surgery had no effect on graft outcome after the tympanoplasty. In conclusion, administration of steroids after tympanoplasty failed to improve outcome and may put the patient at risk of side effects.
Fourth Branchial Pouch Sinus: A Report of 7 Cases and Review of the Literature
Authors: Pal Indranil , Kumar Saumitra , Mukherjee Ankur , Mondal Bibhas , Babu Anindita Sinha
Published: December 2018

A fourth branchial pouch sinus often manifests quite late in life as a recurrent neck abscess, suppurative thyroiditis, or pseudothyroiditis. Demonstration of the sinus opening in the piriform fossa by hypopharyngoscopy in combination with ultrasonography of the neck provides adequate information to justify proceeding to surgery. The sinus tract usually courses through the thyroid cartilage. The most effective treatment is surgical excision of the tract up to the piriform fossa through the cartilage. This procedure is associated with very low complication and recurrence rates. A fourth branchial pouch sinus is an uncommon condition. Even so, it is still underdiagnosed as a result of poor awareness of its existence by medical practitioners, including otolaryngologists. Part of the reason is a lack of adequate coverage of this topic in otolaryngology and surgery textbooks. In this article, we add to the literature by describing our experience with 7 patients—4 males and 3 females, aged 5 to 45 years (mean: 25.6)—who were diagnosed with a fourth branchial pouch sinus over a 6-year period. The diagnosis was confirmed by identifying the sinus opening at the apex of the piriform sinus during hypopharyngoscopy. Definitive treatment consisted of surgical exploration of the neck and excision of the tract.
Analysis of the Audiogram Shape in Patients with Idiopathic Sudden Sensorineural Hearing Loss using a Cluster Analysis
Authors: Watanabe Tetsuo , Suzuki Masashi
Published: December 2018

We performed a cluster analysis to classify the audiogram shape in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). We also investigated whether the audiogram shape is a prognostic indicator in the management of ISSNHL. A total of 115 inpatients with ISSNHL treated between 2001 and 2010 were analyzed. The data collected included age, sex, duration of hearing loss at the time of treatment, and the presence or absence of tinnitus, vertigo, diabetes, nystagmus, and canal paresis. A hierarchical cluster analysis was performed using the hearing threshold for each frequency on audiograms as variables. A logistic regression model was used for the prognostic analysis. The audiogram shape was classified into four clusters: (1) crossing horizontally pattern of all tones; (2) up-sloping pattern of low-tone loss; (3) deaf pattern; and (4) down-sloping pattern of high-tone loss. The age of the patient, presence of canal paresis, and audiogram shape showed statistically significant relationships with hearing improvement. The audiogram shape based on the cluster analysis demonstrated a significant relationship with hearing improvement in patients with ISSNHL. Further studies are needed to elucidate the underlying etiology of each audiogram shape.
Late Free Flap Failure in Head and Neck Reconstruction: A Systematic Review
Authors: Forner David , Williams Blair A. , Makki Fawaz M. , Trites Jonathan R.B. , Taylor S. Mark , Hart Robert D.
Published: December 2018

Our objectives were to review all reported cases of late flap failure in head and neck surgery and describe any relevant patterns. We conducted a systematic review of all published cases of free flap failure after postoperative day 7 in head and neck surgery from January 1990 to January 2018. Data were collected with respect to flap type, site of reconstruction, reason for failure, and time to failure. A total of 45 cases of late free flap failure in the head and neck were identified. Among the 34 cases in which the necessary data were available for analysis, 50% of late failures occurred between postoperative day 7 and 14. Common reasons for failure were abscess and vascular compromise. We conclude that most late flap failures occur in the second postoperative week. In patients with risk factors for flap failure, close monitoring for up to 14 days after surgery could detect flap compromise before the flap is lost.
Chronic Otitis Media with Effusion in Chronic Sinusitis with Polyps
Authors: Daval Mary , Picard Hervé , Bequignon Emilie , Bedbeder Philippe , Coste André , Ayache Denis , Escabasse Virginie
Published: December 2018

The relationship between otitis media with effusion (OME) and chronic rhinosinusitis with nasal polyposis (CRSwNP) remains unclear. We conducted a cross-sectional study of 80 consecutively presenting patients—42 males and 38 females, aged 15 to 76 years (median: 48)—who were diagnosed with CRSwNP. Our aim was to ascertain the prevalence of OME in CRSwNP patients, to determine whether the severity of CRSwNP affected OME, and to identify risk factors for OME in CRSwNP patients. The severity of CRSwNP was assessed on the basis of nasal symptoms, endoscopic nasal examinations, and Lund-Mackay staging scores. In addition to demographic data, we obtained information on each patient's history of otitis, otoscopic findings, and the results of pure-tone audiometry and tympanometry. We then compared the data between CRSwNP patients with OME (n = 20) and those without (n = 60). In the OME group, a conductive hearing loss was present in 16 patients (80.0%); all patients in the control group had normal hearing. With regard to symptoms, only rhinorrhea appeared to be more common in patients with OME than in those without, although the difference was not statistically significant. We found no significant difference in nasal polyposis grades between the two groups. Also, we found no correlations between the risk of OME and previous surgical treatment, asthma, allergy, aspirin intolerance, aspirin and/or NSAID intolerance, aspirin and/or sulfite intolerance, and aspirin-exacerbated respiratory disease. Based on our findings, we conclude that OME occurs frequently during the evolution of CRSwNP, even when the nasal disease is well controlled. This finding suggests the possible presence, in OME and/or CRSwNP, of a global inflammatory process that involves the epithelium in both the middle ear and upper airway.
Age-Related Changes Affecting the Cricoarytenoid Joint Seen on Computed Tomography
Authors: Ziade Georges , Semaan Sahar , Assaad Sarah , Hamdan Abdul Latif
Published: December 2018

We conducted a retrospective chart review to compare four characteristics—cricoarytenoid joint ankylosis, narrowing, erosion, and density increases—in patients younger and older than 65 years. Our study population was made up of 100 patients, who were divided into two groups on the basis of age. The younger group (<65 yr) comprised 49 patients (27 men and 22 women), and the older group (≥65 yr) was made up of 51 patients (25 men and 26 women). Findings on computed tomography (CT) of the neck were used to determine whether each of the four characteristics was present or absent. Overall, we found only one statistically significant difference between the two groups: ankylosis was significantly more common in the older group (p = 0.036). When we looked further at the side of these anatomic changes, we found that the older group had significantly more right-sided and left-sided ankylosis than did the younger group (p = 0.026 for both), as well as significantly more left-sided narrowing (p = 0.028) (some patients had bilateral involvement). When we analyzed age as a continuous variable, older age was again associated with significantly more ankylosis (p = 0.047) and narrowing (p = 0.011). We conclude that CT can be useful for assessing radiologic changes in the cricoarytenoid joint in elderly patients during the workup of dysphonia and abnormal movement of the vocal folds.
Bilateral Spontaneous Temporomandibular Joint Herniation: A Case Report and Literature Review
Authors: O'Brien Daniel C. , Purpura Kaylee R. , Cassis Adam M.
Published: December 2018

In this article we report the case of a 41-year-old man with bilateral aural fullness and hearing loss. On examination he was found to have bilateral, dehiscent anterior canal walls with herniation of the mandibular condyle. This herniation partially obstructed the canals and contributed to his symptoms. To the best of our knowledge, this is only the third reported case of bilateral spontaneous temporomandibular joint herniation, and only 28 cases of unilateral spontaneous herniation can be found in the English language literature. While it is a rare phenomenon, it should be considered when evaluating a patient with fluctuating ear symptoms.
Mucocele Development after Endoscopic Sinus Surgery for Nasal Polyposis: A Long-Term Analysis
Authors: Benkhatar Hakim , Khettab Idir , Sultanik Philippe , Laccourreye Ollivier , Bonfils Pierre
Published: December 2018

The aim of the present study was to determine the prevalence of long-term mucocele development after functional endoscopic sinus surgery (FESS) for nasal polyposis, to search for a statistical relationship with preoperative variables and to analyze the management of this complication. A retrospective analysis of 153 patients who underwent FESS for nasal polyposis, with a minimum of 7 years of follow-up, was performed. Mucocele diagnosis was based on regular clinical and radiologic evaluation. Univariate and multivariate statistical analysis was performed. The postoperative mucocele rate was 13.1% (20 patients). The mean delay between surgery and mucocele diagnosis was 6.25 years. A high preoperative Lund-Mackay score (>19) was a risk factor for postoperative mucocele (p = 0.04). Asthma and aspirin intolerance did not increase the risk of this complication. Endoscopic marsupialization of mucoceles was successful in 19 patients, with only one recurrent frontal mucocele. One patient required external approaches for two frontal mucoceles. In conclusion, mucocele risk after FESS for nasal polyposis is significant, especially in case of a high preoperative Lund-Mackay score (>19). Long-term clinical follow-up is recommended, imaging being prescribed based on symptoms or abnormal findings on clinical examination. Endoscopic marsupialization is very effective, but frontal mucoceles are more likely to recur.
Long-term Use of Le Fort I Osteotomy for the Management of Nasopharyngeal Rhinosporidiosis: A Case Series
Authors: Shetty Vikram , Kulkarni Akshaya , Banerjee Suman
Published: December 2018

Rhinosporidiosis is a rare, chronic, granulomatous infection of the mucous membranes that mainly involves the nose and nasopharynx; it occasionally involves the pharynx, conjunctiva, larynx, trachea and, rarely, the skin. The characteristic clinical features of this disease include the formation of painless polyps in the nasal mucosa or the nasopharynx that bleed easily on touch. At our center, excision of the lesion with a Le Fort I osteotomy is carried out in patients (1) in whom two or more previous attempts at excision of biopsy-proven rhinosporidiosis arising from the nasal mucosa was carried out or (2) in whom the rhinosporidiosis arises from the nasophayrngeal mucosa and/or extranasal sites. In this article we retrospectively present 7 cases in which, according to our inclusion criteria, complete excision of the lesion was carried out with a Le Fort I osteotomy. Excellent visualization of the entire maxillary and ethmoidal air cells after the down-fracture of the maxilla helped in the total removal of the lesions. Most of these lesions had multiple points of origin through the nasal, maxillary, and ethmoidal mucosa; the excellent visualization enabled direct cauterization of all these points of origin. The mean follow-up period was 7.96 years, and all patients were disease-free by the time the study was prepared. This article presents details of the treatment protocol and technique followed at our center for the treatment of nasopharyngeal rhinosporidiosis and the details of long-term follow-up. Through this study we hope to prove the efficacy of Le Fort I osteotomy in the definitive management of nasopharyngeal rhinosporidiosis.
Nurses’ Safety Motivation: Examining Predictors of Nurses’ Willingness to Report Medication Errors
Authors: Farag Amany , Lose Daniel , Gedney-Lose Amalia
Published: December 2018

Medication errors are common in health care settings. Safety motivation, such as willingness to report error, is needed to contain medication errors. Limited evidence exists about measures to enforce nurses’ safety motivation. The purpose of this study was to test a proposed model explaining the mechanism by which organizational and social factors influence nurses’ safety motivation. Survey for this cross-sectional study was mailed to a random sample of 500 acute care nurses. Data collection started in January 2014 and lasted 6 months. Path analysis results showed a good fitting final model with 15% of explained variance on nurses’ safety motivation. Safety climate dimensions of error feedback (β = .38, p ⩽ .00) and nonpunitive response to errors (β = .22, p = .01) significantly predicted the outcome. There is a need for both organizational and social factors to motivate nurses to report errors. Leadership practices emphasizing safety as a priority is needed to enhance nurses’ safety motivation.
Understanding physical activity behavior in patients with bladder cancer before and after radical cystectomy: a qualitative interview study
Authors: Rammant Elke , Fonteyne Valérie , Decaestecker Karel , Bultijnck Renée , Deforche Benedicte , Pieters Ronny , Ost Piet , Verhaeghe Sofie , Van Hecke Ann
Published: December 2018

Objective:

To explore the determinants of physical activity in patients with bladder cancer before and after radical cystectomy.

Design:

A qualitative research design using semi-structured face-to-face interviews.

Setting and subjects:

A total of 30 interviews were conducted with people diagnosed with bladder cancer and treated with radical cystectomy at Ghent University Hospital.

Main measures:

The interviews were audiotaped and transcribed verbatim. Framework analysis with constant comparison between and within interviews was applied until final topics were derived from interpreting the data.

Results:

Physical activity behavior in patients with bladder cancer is determined multifactorial with condition-related (e.g. urinary symptoms, comorbidities), therapy-related (e.g. fatigue, diarrhea), patient-related (e.g. outcome expectations, coping skills, definitions of physical activity), social/economic-related (e.g. social support, attractive environment) and health system–related (e.g. physicians’ advice, information) factors.

Conclusion:

The results of this study can guide the development of theory-based behavior change interventions to increase physical activity in bladder cancer patients.
Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study
Authors: Paul Lorna , Renfrew Linda , Freeman Jennifer , Murray Heather , Weller Belinda , Mattison Paul , McConnachie Alex , Heggie Robert , Wu Olivia , Coulter Elaine H
Published: December 2018

Objective:

To examine the feasibility of a trial to evaluate web-based physiotherapy compared to a standard home exercise programme in people with multiple sclerosis.

Design:

Multi-centre, randomized controlled, feasibility study.

Setting:

Three multiple sclerosis out-patient centres.

Participants:

A total of 90 people with multiple sclerosis (Expanded Disability Status Scale 4–6.5).

Interventions:

Participants were randomized to a six-month individualized, home exercise programme delivered via web-based physiotherapy ( n = 45; intervention) or a sheet of exercises ( n = 45; active comparator).

Outcome measures:

Outcome measures (0, three, six and nine months) included adherence, two-minute walk test, 25 foot walk, Berg Balance Scale, physical activity and healthcare resource use. Interviews were undertaken with 24 participants and 3 physiotherapists.

Results:

Almost 25% of people approached agreed to take part. No intervention-related adverse events were recorded. Adherence was 40%–63% and 53%–71% in the intervention and comparator groups. There was no difference in the two-minute walk test between groups at baseline (Intervention-80.4(33.91)m, Comparator-70.6(31.20)m) and no change over time (at six-month Intervention-81.6(32.75)m, Comparator-74.8(36.16)m. There were no significant changes over time in other outcome measures except the EuroQol-5 Dimension at six months which decreased in the active comparator group. For a difference of 8(17.4)m in two-minute walk test between groups, 76 participants/group would be required (80% power, P > 0.05) for a future randomized controlled trial.

Conclusion:

No changes were found in the majority of outcome measures over time. This study was acceptable and feasible by participants and physiotherapists. An adequately powered study needs 160 participants.
Anticipatory prescribing of injectable medications for adults at the end of life in the community: A systematic literature review and narrative synthesis
Authors: Bowers Ben , Ryan Richella , Kuhn Isla , Barclay Stephen
Published: December 2018

Background:

The anticipatory prescribing of injectable medications to provide end-of-life symptom relief is an established community practice in a number of countries. The evidence base to support this practice is unclear.

Aim:

To review the published evidence concerning anticipatory prescribing of injectable medications for adults at the end of life in the community.

Design:

Systematic review and narrative synthesis. Registered in PROSPERO: CRD42016052108, on 15 December 2016 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=52108 ).

Data sources:

Medline, CINAHL, Embase, PsycINFO, Web of Science, Cochrane Library, King’s Fund, Social Care Online, and Health Management Information Consortium databases were searched up to May 2017, alongside reference, citation, and journal hand searches. Included papers presented empirical research on the anticipatory prescribing of injectable medications for symptom control in adults at the end of life. Research quality was appraised using Gough’s ‘Weight of Evidence’ framework.

Results:

The search yielded 5099 papers, of which 34 were included in the synthesis. Healthcare professionals believe anticipatory prescribing provides reassurance, effective symptom control, and helps to prevent crisis hospital admissions. The attitudes of patients towards anticipatory prescribing remain unknown. It is a low-cost intervention, but there is inadequate evidence to draw conclusions about its impact on symptom control and comfort or crisis hospital admissions.

Conclusion:

Current anticipatory prescribing practice and policy is based on an inadequate evidence base. The views and experiences of patients and their family carers towards anticipatory prescribing need urgent investigation. Further research is needed to investigate the impact of anticipatory prescribing on patients’ symptoms and comfort, patient safety, and hospital admissions.
Pectoralis major myocutaneous flap in salvage reconstruction following free flap failure in head and neck cancer surgery
Authors: Wei Wei , Qiu Yongsheng , Fang Qigen , Jia Yingping
Published: December 2018

Objective

This study aimed to compare the results of the pectoralis major myocutaneous (PMM) flap in primary and salvage head and neck cancer surgery.

Methods

A total of 160 patients were enrolled in this study. The salvage group consisted of 30 patients who received immediate PMM flap surgery following free flap failure. In the primary group, the PMM flap was primarily chosen for 130 patients. Related information was collected and analysed. The University of Washington (UW)-Quality of Life questionnaire, version 4, was mailed to every patient.

Results

Partial necrosis was significantly lower in the primary group (n = 13, 10.0%) than in the salvage group (n = 7, 23.3%). Surgical site infection was found in 10 (7.8%) patients in the primary group and in six (20.0%) patients in the salvage group. The mean composite quality of life scores were 66.8 ± 20.5 and 66.2 ± 22.1 in the two groups, respectively. Differences in scores for domains of activity, mood, and anxiety were significant. Disease-specific survival and recurrence-free survival rates were not different between the two groups.

Conclusion

PMM flap salvage reconstruction has a higher complication rate and poorer functional results, but similar survival prognosis, compared with primary surgery.
Irinotecan toxicity during treatment of metastatic colorectal cancer: focus on pharmacogenomics and personalized medicine
Authors: Paulík Adam , Nekvindová Jana , Filip Stanislav
Published: December 2018

Colorectal cancer, one of the most frequent types of cancer worldwide, has a high mortality rate. Irinotecan (CPT-11) has been approved for the treatment of advanced or metastatic disease either as a single agent or, more commonly, as part of combined chemotherapeutic regimens. Treatment with irinotecan is often accompanied by severe toxicity (e.g. neutropenia and diarrhea) that can result in treatment interruption or cessation, thus jeopardizing the patient’s prognosis and quality of life. Irinotecan is bioactivated into its metabolite SN-38, which is subsequently detoxified by uridine diphosphate-glucuronosyl transferases (mainly UGT1A1). Further, ABC transporters (i.e. ABCB1, ABCC1–ABCC6, and ABCG2) are responsible for drug efflux into bile and urine whereas OATP transporters (SLCO1B1) enable its influx from blood into hepatocytes. Genetic polymorphisms in these enzymes/pumps may result in increased systemic SN-38 level, directly correlating with toxicity. Contemporary research is focused on the clinical implementation of genetic screenings for validated gene variations prior to treatment onset, allowing tailored individual doses or treatment regimens.
Feminist Experiences of ‘Studying Up’: Encounters with International Institutions
Authors: Holmes Georgina , Wright Katharine A. M. , Basu Soumita , Hurley Matthew , Martin de Almagro Maria , Guerrina Roberta , Cheng Christine
Published: December 2018

This article makes the case for feminist IR to build knowledge of international institutions. It emerges from a roundtable titled ‘Challenges and Opportunities for Feminist IR: Researching Gendered Institutions’ which took place at the International Studies Association Annual Convention in Baltimore in 2017. Here, we engage in self-reflexivity, drawing on our conversation to consider what it means for feminist scholars to ‘study up’. We argue that feminist IR conceptions of narratives and the everyday make a valuable contribution to feminist institutionalist understandings of the formal and informal. We also draw attention to the value of postcolonial approaches and multi-site analyses of international institutions for creating a counter-narrative to hegemonic accounts emerging from both the institutions themselves, and scholars studying them without a critical feminist perspective. In so doing, we draw attention to the salience of considering not just what we study as feminist International Relations scholars but how we study it.
Scared or Attached? Unraveling Important Links in Strain–Crime Relationships Among School Students
Authors: Kuptsevych-Timmer Anastasiia , Antonaccio Olena , Botchkovar Ekaterina V. , Smith William R.
Published: December 2018

Drawing on general strain theory of crime, the study employs the survey data from a random sample of 600 school students in Lviv, Ukraine, to examine how sanction risks and social bonds mediate and moderate the relationship between strain and adolescent delinquency. Findings from negative binomial regressions and the KHB decomposition procedure demonstrate that fear of sanctions and levels of social control mediate the relationships between strain and delinquency to a different degree, depending on the type of strain experienced. Results concerning conditioning effects are mixed, with only parental monitoring found to be a moderator of the strain–delinquency link. However, the direction of the interaction effect is unexpected. Future research needs to improve the specification of strain models and evaluate them in other sociocultural contexts.
‘Haciendas and Plantations’: History and limitations of a 60-year-old taxonomy
Authors: Edelman Marc
Published: December 2018

In 1957, Eric R Wolf and Sidney W Mintz published ‘Haciendas and Plantations in Middle America and the Antilles’ in the Jamaican journal Social and Economic Studies. This article discusses the production of the Wolf and Mintz article, its analytical framework and the theoretical tensions it contains, and its subsequent influence, mainly though not exclusively on anthropological and historical scholarship about large landed properties in Latin America and the Caribbean. ‘Haciendas and Plantations’ appeared at a time when anthropologists such as Elman Service, Charles Wagley, and Marvin Harris were trying to make sense of agrarian Latin America by developing typologies of labour relations, rural populations, and forms of property. These efforts never successfully resolved the inherent tension between ethnographic or historical content, on the one hand, and Weberian ideal type definitions, on the other, although Wolf and Mintz’s article came closer to doing this than the other works in the typological genre. In part, this was because it analysed discrete dimensions of large landed estates – capital, labour, land, markets, technology, sumptuary patterns, and so on – in a manner intended to stimulate cross-regional, cross-national, and trans-historical comparisons. ‘Haciendas and Plantations’, however, saw these elements as largely determining local-level outcomes on the ground and left little analytical room for contingency or rural class struggle in driving historical processes or shaping property relations and land use. Despite the article’s scant historical content, it nonetheless continues to serve as a point of departure in early twenty-first-century agrarian studies and the analytical tensions it embodied are still significant in comparative social scientific research.
‘A Conference That Didn’t’: African Diaspora Studies and an episode in anthropology’s identity politics of representation
Authors: Yelvington Kevin A
Published: December 2018

In 1968, the Social Science Research Council of the United States established the Committee on Afro-American Societies and Cultures which lasted until 1975 and which was initially chaired by the anthropologist Sidney W Mintz. In April, 1970, the committee held a conference on ‘Continuities and Discontinuities in Afro-American Societies and Culture’ at the University of the West Indies in Mona, Jamaica. The conference occurred in the context of civil rights struggles and the prominence of the Black Power movement in the United States, the near-simultaneous rise of the Black Power movement in Jamaica, Trinidad and Tobago, and elsewhere in the Caribbean, and on the heels of protests by black and African scholars and students at the African Studies Association meetings in Montreal in 1969, and similar protests at other scholarly venues. A number of prominent white Caribbeanist anthropologists and other social scientists were invited to present papers at the Social Science Research Council conference. When black academics, such as the anthropologist St Clair Drake and the sociologist Joyce A Ladner, were invited, seemingly as an afterthought, they refused to participate, citing the lack of representation of scholars of colour on the committee and in the conference program. And at the conference itself, there were subtle conflicts and misunderstandings over styles of presentation and argumentation. This article develops a theoretical model appropriate for the history of science to illustrate anthropology’s contested identity politics of representation.
Money’s micro and macro qualities: Slaves, colonies, regions, and markets in the historical Caribbean – and beyond
Authors: Guyer Jane I
Published: December 2018

This article reconsiders Sidney W Mintz’s classic 1964 chapter ‘Currency problems in eighteenth century Jamaica and Gresham’s Law' in light of the forms and uses of money in the colonial Caribbean slave economies and the utility of Mintz’s approach to understand today’s globalizing multicurrency economy. In considering Gresham’s Law that ‘bad money drives out good', Mintz showed how, in colonial Jamaica, money’s four functions – medium of exchange, means of payment, unit of account, and store of value – were transformed by the enslaved themselves as they worked with and in currencies circulating locally and via colonial financial networks. Further, Mintz’s ethnographic work suggests an approach to the financial practices of the poor and marginalized that highlights how their uses of money, paralleled in other arenas of their lives, confront and complicate dominating political–economic power. Directions provided by Mintz’s insights are used to analyze creative uses of money in the present world economic order.
Picturing Preservation and Renewal: Photographs as Planning Knowledge in Society Hill, Philadelphia
Authors: Ammon Francesca Russello
Published: December 2018

This history of postwar Society Hill, Philadelphia illuminates the role of photographs as planning knowledge and the relationship between historic preservation and urban renewal practice. Photographs both reflect and shape shifting values, preferences, and power dynamics among stakeholders in the built environment. Four photographic categories make this clear: “before images” selectively sample pre-renewal wrongs; “counter-images” picture planning alternatives; “process images” show the messy nature of renewal in progress; and “after images” document the completed neighborhood, while obscuring the destructive character of even preservation-oriented renewal. This case illustrates the significance of culturally constructed qualitative data to both past and present planning practice.
Indigenous model of care to health and social care workforce planning
Authors: Pepler Eileen , Martell Rebecca C.
Published: December 2018

Indigenous people have always had the end in mind—a long range vision for the health and wellbeing of their families and communities. Creating Indigenous solutions-oriented approaches to strategic health and social care workforce planning is an essential component to the realization of self-determination and empowerment, accessible health services, community participation, and flexible approaches to care. This article suggests using an Indigenous “models of care” population health approach to health and social care workforce planning that takes a critical thinking, systems thinking, and design thinking approach using digital tools (eg, scenario planning and population health simulation). It also proposes to increase the number of Indigenous professionals through Indigenous partnership initiatives with professional groups and academic institutions. This article is written to encourage discussion on the use of a whole system approach to developing Indigenous models of health delivery and to inform strategic services and workforce planning.
The beneficial differentiation within entrepreneurship of self-employed, business owner and entrepreneur
Authors: Østergaard Annemarie
Published: December 2018

This study explores the diversity among entrepreneurs to identify the innate factors behind the variation. The intention is to explain why some entrepreneurs prefer to be self-employed in one-person businesses, while others build enterprises with numerous employees. A factor analysis of the personality traits of active entrepreneurs reveals nine entrepreneurial factor types, which are further subjected to psychological analysis. Based on leadership, innovation, social and efficiency skills, the psychological interpretation reveals three categories in entrepreneurship: the self-employed, the business owner and the entrepreneur. The categories exhibit inherent dissimilarities and similarities that clearly explain the discrepancies in entrepreneurs’ preferences on a profoundly personal level. The concept of entrepreneur, commonly used to refer to a variety of individuals, accurately describes only one category. Instead, the concepts of self-employed and business owner better explain the related activity and outcomes of the other two categories. Accordingly, the results suggest that the quality of support, expected outcomes and consequently socio-economic growth will improve with a thorough consideration by authorities of each individual’s personality or at least by consideration of which category best describes the target group of, for example, teaching and financial support.
Assembly variation analysis of complicated products based on rigid–flexible hybrid vector loop
Authors: Liu Zhenyu , Zhou Shien , Qiu Chan , Tan Jianrong
Published: December 2018

The performance of mechanical products is closely related to their key feature errors. It is essential to predict the final assembly variation by assembly variation analysis to ensure product performance. Rigid–flexible hybrid construction is a common type of mechanical product. Existing methods of variation analysis in which rigid and flexible parts are calculated separately are difficult to meet the requirements of these complicated mechanical products. Another methodology is a result of linear superposition with rigid and flexible errors, which cannot reveal the quantitative relationship between product assembly variation and part manufacturing error. Therefore, a kind of complicated products’ assembly variation analysis method based on rigid–flexible vector loop is proposed in this article. First, shapes of part surfaces and sidelines are estimated according to different tolerance types. Probability density distributions of discrete feature points on the surface are calculated based on the tolerance field size with statistical methods. Second, flexible parts surface is discretized into a set of multi-segment vectors to build vector-loop model. Each vector can be orthogonally decomposed into the components representing position information and error size. Combining the multi-segment vector set of flexible part with traditional rigid part vector, a uniform vector-loop model is constructed to represent rigid and flexible complicated products. Probability density distributions of discrete feature points on part surface are regarded as inputs to calculate assembly variation values of products’ key features. Compared with the existing methods, this method applies to the assembly variation prediction of complicated products that consist of both rigid and flexible parts. Impact of each rigid and flexible part’s manufacturing error on product assembly variation can be determined, and it provides the foundation of parts tolerance optimization design. Finally, an assembly example of phased array antenna verifies effectiveness of the proposed method in this article.
Steering law design for a magnetically suspended control and sensitive gyro cluster considering rotor tilt saturation
Authors: Xia Changfeng , Cai Yuanwen , Ren Yuan
Published: December 2018

To effectively reject the influence of rotor tilt saturation in a magnetically suspended control and sensitive gyro cluster, an adaptive nonlinear pseudo-inverse steering law is developed in this study. Based on the working principle of a Lorentz force magnetic bearing–rotor system in a single magnetically suspended control and sensitive gyro, the dynamical model of a rigid spacecraft equipped with a magnetically suspended control and sensitive gyro cluster is established. Because of the monotonicity and symmetric properties of the chosen nonlinear function, an adaptive nonlinear weighting matrix is incorporated with the pseudo-inverse steering law for the magnetically suspended control and sensitive gyro cluster. The steering law adjusts the weighting matrix elements according to saturation penalty functions so that the rotors generate control torques consistent with the limited rotor tilting domain. The effectiveness and superiority of this steering law are verified by numerical simulations. The simulation results demonstrate that the proposed steering law not only imposes control torques on the carrier spacecraft with three degrees of freedom but also avoids rotor tilt saturation, ensuring rapid attitude control of agile maneuvering spacecraft.
Confidence intervals for the Mann–Whitney test
Authors: Perme Maja Pohar , Manevski Damjan
Published: December 2018

The Mann–Whitney test is a commonly used non-parametric alternative of the two-sample t-test. Despite its frequent use, it is only rarely accompanied with confidence intervals of an effect size. If reported, the effect size is usually measured with the difference of medians or the shift of the two distribution locations. Neither of these two measures directly coincides with the test statistic of the Mann–Whitney test, so the interpretation of the test results and the confidence intervals may be importantly different. In this paper, we focus on the probability that random variable X is lower than random variable Y. This measure is often referred to as the degree of overlap or the probabilistic index; it is in one-to-one relationship with the Mann–Whitney test statistic. The measure equals the area under the ROC curve. Several methods have been proposed for the construction of the confidence interval for this measure, and we review the most promising ones and explain their ideas. We study the properties of different variance estimators and small sample problems of confidence intervals construction. We identify scenarios in which the existing approaches yield inadequate coverage probabilities. We conclude that the DeLong variance estimator is a reliable option regardless of the scenario, but confidence intervals should be constructed using the logit scale to avoid values above 1 or below 0 and the poor coverage probability that follows. A correction is needed for the case when all values from one sample are smaller than the values of the other. We propose a method that improves the coverage probability also in these cases.
Size, Aspect Ratio and Anatomic Location of Ruptured Intracranial Aneurysms: Consecutive Series of 415 Patients from a Prospective, Multicenter, Observational Study
Authors: Zheng Y. , Zhou B. , Wang X. , Chen H. , Fang X. , Jiang P. , Yang H. , He C. , Yang G. , Song Y. , An Q. , Leng B.
Published: December 2018

To analyze the size and location distribution of ruptured intracranial aneurysms (IAs) helps to provide evidence for clinical treatment of unruptured IAs using this feature of aneurysms. In this study, 415 patients who presented with an acute subarachnoid hemorrhage caused by IAs were enrolled from eight tertiary referral centers between June 2016 and March 2018. The size, aspect ratio and anatomic location of ruptured IAs were defined and reported by patient sex. In the study cohort of 415 patients (60.5% women) with saccular ruptured IAs, the three most common locations of ruptured IAs were posterior communicating artery (32.0%), anterior communicating artery (28.7%), and middle cerebral artery (13.5%). The mean size of all ruptured IAs was 5.3±3.1 mm (range 1.1–28.5 mm), but the size varied considerably by location. For example, ruptured IAs of the posterior communicating artery had a mean size of 5.8±3.1 mm, whereas the mean size of ruptured anterior communicating artery aneurysms was 4.6±1.7 mm. The mean AR in all ruptured IAs was 1.66±0.76. Of those aneurysms, 243 (58.6%) had an AR smaller than 1.6 and 318 (76.6%) had an AR smaller than 2.0. Our results suggested that the size of the most ruptured IAs are smaller than 7 mm or even 5 mm. The size and AR varied by sex and location. With the knowledge of size, location and AR, multiplicity should be considered for treatment strategies of unruptured IAs.