bluuebunny/crossref_metadata_2025 huggingface dataset:
A Sonographically Guided In-Plane Distal-to-Proximal Transligamentous Approach to Carpal Tunnel Injections
Authors: Jurbala Brian M. , Burbank Troy A.
Published: August 2017

Background: Several sonographically guided injection methods have been described to treat carpal tunnel syndrome. In most cases, the medication diffuses through the carpal tunnel to the site of maximum compression of the nerve after being injected proximally. In this article, we describe a novel method of sonographically guided carpal tunnel injection that utilizes a distal-to-proximal, in-plane, and transligamentous approach. This novel method may provide ergonomic as well as safety advantages to both clinicians and patients, and should be considered by those performing carpal tunnel injections. Methods: A distal-to-proximal transligamentous approach is taken, utilizing high-resolution ultrasound guidance. Once the median nerve is sonographically visualized longitudinally within the carpal tunnel, an ulnar shift is made with the transducer. With the median nerve out of view, the needle is inserted in-line and distal to the transducer on the palmar side of the hand, at the ulnar portion of Kaplan’s cardinal line. Following a trajectory that is nearly parallel to the median nerve, the needle is sonographically guided to the site of maximum nerve compression. Conclusions: This novel method provides an alternative to previous carpal tunnel injections. The use of ultrasound guidance allows the clinician to visualize and avoid the neurovascular structures near the median nerve and guide the needle to the site of maximum nerve compression. It is possible that this parallel trajectory with the median nerve will provide a lower risk of damage to the nerve.
Reliability and Validation of the Greek Version of the Boston Carpal Tunnel Questionnaire
Authors: Bougea Anastasia , Zambelis Thomas , Voskou Panagiota , Katsika Paraskevi Zacharoula , Tzavara Chara , Kokotis Panagiotis , Karandreas Nikolaos
Published: August 2017

Background: The Boston Carpal Tunnel Questionnaire (BCTQ) is an easy, brief, self-administered questionnaire developed by Levine et al for the assessment of severity of symptoms and functional status of patients with carpal tunnel syndrome. The aim of our study was to develop and validate the Greek version of BCTQ. Methods: We conducted a cross-sectional study of 90 patients with idiopathic carpal tunnel syndrome. The original English version of BCTQ was adapted into Greek using forward and backward translation. Reliability was assessed by internal consistency (Cronbach α and item-total correlation) and reproducibility. Validity was examined by correlating the Boston Questionnaire scores to Canterbury severity scale for electrodiagnostic severity grading. Results: The Greek version showed high reliability (Cronbach α 0.89 for Symptom Severity Scale and 0.93 for Functional Status Scale) and construct validity (Pearson correlation coefficient 0.53 for Symptom Severity Scale and 0.68 for Functional Status Scale). Test-retest were 0.75 for Symptom Severity Scale and 0.79 for Functional Status Scale ( P < .05). Receiver operating characteristic curve analysis showed that the optimal cutoff of Symptom Severity Scale for the discrimination of subjects with low electrodiagnostic severity grading than subjects with high electrodiagnostic severity grading was 1.95 with sensitivity equal to 75.5% and specificity equal to 68.3%. Conclusions: The Greek version of the BCTQ is a valid, reliable screening tool for assessment in daily practice of symptoms and functional status in patients with carpal tunnel syndrome.
The Incidence of Arthroplasty After Initial Arthroscopy for Trapeziometacarpal Arthrosis
Authors: Wilkens Suzanne C. , Vissers Frederique L. , Nazzal Adam , Chen Neal
Published: August 2017

Background: It remains unclear how many patients undergo secondary surgery after initial arthroscopy for trapeziometacarpal (TMC) arthrosis. We studied the factors related to secondary TMC arthroplasty after TMC arthroscopy. We also examined secondary questions of: (1) what percentage of patients underwent secondary TMC arthroplasty; and (2) how much time elapsed from initial arthroscopy to arthroplasty. Methods: In this retrospective study, we included all adult patients who were treated with arthroscopy of the TMC joint at 2 level I hospitals and affiliates. Factors were assessed for their independent association with secondary TMC arthroplasty using bivariate and multivariable analyses. Results: Fourteen of 84 (17%) thumbs underwent secondary TMC arthroplasty an average of 11 months after the initial arthroscopy. Synovectomy alone and smoking tobacco were independently associated with secondary TMC arthroplasty when compared with arthroscopic (partial) trapeziectomy with additional tendon interposition or allograft. Conclusions: This study demonstrated that 1 in 6 thumbs underwent secondary TMC arthroplasty, an average of 11 months after the initial arthroscopy. Coupling arthroscopy with partial trapeziectomy, interposition, or extension osteotomy may be a preferable strategy to isolated synovectomy. In addition, smoking tobacco is associated with inferior outcomes regardless of surgical procedure.
Arthroscopic Wrist Debridement and Radial Styloidectomy for Advanced Scapholunate Advanced Collapse Wrist: Long-term Follow-up
Authors: Noback Peter C. , Seetharaman Mani , Danoff Jonathan R. , Birman Michael , Rosenwasser Melvin P.
Published: August 2017

Background: Symptomatic stage 2 or 3 scapholunate advanced collapse (SLAC) wrist is aggressively treated with salvage procedures, such as proximal row carpectomy or partial wrist fusion with resultant pain relief but limited motion. We hypothesize that arthroscopic synovectomy, radial styloidectomy, and neurectomy will preserve wrist motion, relieve pain, and delay or avoid salvage procedures. Methods: We evaluated outcomes in 13 wrists through questionnaires and 11 of these through additional physical examination at a mean follow-up of 5.0 years. Eight wrists were stage 2 and 5 were stage 3. Data at final follow-up included mobility/strength measurements, subjective outcome scores (Disabilities of the Arm, Shoulder, and Hand [DASH] and visual analog scale [VAS] pain), patient satisfaction, and return to work statistics. Results: Patients had an average flexion-extension arc of 88.0° in the treated wrist and an average grip strength that was 95.0% of the contralateral side. No patients required revision surgery at follow-up. The 13 wrists reported an average DASH score of 16.4 and mean VAS pain score at rest and with activity of 17.9 and 31.6, respectively. All patients working prior to the procedure (n = 8) were able to immediately return to work. In all, 84.6% of patients were satisfied. Conclusions: The procedure studied may have advantages in relieving pain, while preserving wrist motion for SLAC stage 2 or 3 disease. This procedure does not preclude future salvage procedures in those patients with severe disease who prefer to maintain wrist motion for the short term. Patients experience good functional outcomes with the majority experiencing a reduction in pain with the ability to return to work.
Performance and Return to Sport After Forearm Fracture Open Reduction and Internal Fixation in National Football League Players
Authors: Sochacki Kyle R. , Jack Robert A. , Hirase Takashi , McCulloch Patrick C. , Lintner David M. , Liberman Shari R. , Harris Joshua D.
Published: August 2017

Background: Forearm fractures are one of the most common upper extremity injuries requiring surgery in professional football. Surgical fixation of forearm fractures may speed recovery and decrease games missed in football. Methods: National Football League (NFL) players who underwent forearm fracture open reduction and internal fixation (ORIF) were identified. Matched controls (position, age, experience, performance) were identified. Control and case performance scores were calculated using a standardized scoring system. Return to sport (RTS) in the NFL was defined as playing in a single NFL game after surgery. Comparisons between case and control groups and preoperative and postoperative time points were made using paired-samples Student t tests. Results: Thirty-six surgeries were analyzed following ORIF. Thirty-three were able to RTS in the NFL at an average of 152.1 + 129.8 days. Controls had a significantly longer NFL career ( P < .001) and played in significantly more games per season ( P = .026) than players who underwent surgery. There was a significant ( P = .013) decrease in games/season for DBs following surgery. No significant difference was seen in postoperative performance scores compared with preoperative scores among any positions, nor in postoperative and postindex performance scores compared with matched controls. Conclusion: There is a high rate of RTS in the NFL following forearm fracture ORIF. Following surgery, players’ careers were 1 year shorter and played nearly 2 fewer games per season than matched controls. Games per season following surgery was significantly lower among DBs when compared with presurgery. Postoperative performance scores were not significantly different compared with preoperative and when compared with matched controls.
Endovascular strategies for treatment of posterior communicating artery aneurysm according to angiographic architecture: Preservation vs. sacrifice of posterior communication artery
Authors: Ko Jung Ho , Kim Young-Joon
Published: August 2017

We report ischemic complications related to obstruction of the posterior communicating artery (PcomA) and suggest treatment strategies according to the angiographic characteristics of the PcomA and the posterior cerebral artery (PCA). Twenty-one patients with PcomA aneurysm who had initially undergone endovascular treatment and had an identifiable PcomA occlusion on immediate or follow-up angiography were enrolled. We classified PcomA aneurysm according to the characteristics of the PcomA and PCA (P1) on baseline angiography, as follows: type I was defined as PcomA aneurysm with an absent PcomA and a normal-sized P1. Type II was defined as a hypoplastic PcomA and a normal-sized P1. Type III was defined as a normal-sized PcomA and an absent P1. Type IV was defined as a normal-sized PcomA and a hypoplastic P1. Type V was a normal-sized PcomA and a normal-sized P1. Among all cases of PcomA obstruction, 15 (71.4%) were type II PcomA aneurysms, four were type IV, one was type III, and one was type V. Ischemic events related to PcomA obstruction occurred in three cases (type II, III and VI), which included two tuberothalamic infarctions (type III and IV) and one cortical infarction in the territory of the PCA (type II). Follow-up angiographies showed flow change in the PcomA in 14 cases. It is relatively safe to sacrifice type II PcomA if necessary. However, physicians should pay attention to unexpected flow changes, such as recanalization or occlusion of the PcomA, which are possible after treatment.
The increase in circulating myeloid-derived suppressor cells correlated with clinical stage of cervical carcinoma
Authors: Du Ting , Shen Yu , Qu Qiu-Xia , Huang Qin
Published: August 2017

The myeloid-derived suppressor cells (MDSCs) are important tumor-induced immune suppression cells which have gained great attention in recent years. In this study, the levels of MDSCs in peripheral blood of cervical carcinoma (CC) patients, cervical intraepithelial neoplastic (CIN) patients, and healthy donors were analyzed by flow cytometry. It was shown that the proportion of circulating MDSCs was elevated in CC and CIN patients compared to that in healthy donor (HD). Further analyses revealed that the percentage of MDSCs is increased along with the stage of CC, but has no difference among other clinicopathological factors, including age, tumor grade, lymph node invasion, and histopathology. Taken together, our results suggested that MDSC levels are indicative of suppressive functions within the tumor environment of CC. Therefore, large validation studies could help to develop new immunotherapeutic strategies for CC patients by inhibiting or eliminating MDSC functions.
Active stability observer using artificial neural network for intuitive physical human–robot interaction
Authors: Sassi Mohamed Amir , Otis Martin J-D , Campeau-Lecours Alexandre
Published: August 2017

Physical human–robot interaction may present an obstacle to transparency and operations’ intuitiveness. This barrier could occur due to the vibrations caused by a stiff environment interacting with the robotic mechanisms. In this regard, this article aims to deal with the aforementioned issues while using an observer and an adaptive gain controller. The adaptation of the gain loop should be performed in all circumstances in order to maintain operators’ safety and operations’ intuitiveness. Hence, two approaches for detecting and then reducing vibrations will be introduced in this study as follows: (1) a statistical analysis of a sensor signal (force and velocity) and (2) a multilayer perceptron artificial neural network capable of compensating the first approach for ensuring vibrations identification in real time. Simulations and experimental results are then conducted and compared in order to evaluate the validity of the suggested approaches in minimizing vibrations.
Capillary water absorption by a porous cylinder
Authors: Hall Christopher
Published: August 2017

Capillary absorption (imbibition) of water by a porous cylinder is described by means of a Sharp-Front model. The cumulative absorption increases as (time)1/2 at early times, but more slowly as the wet front approaches the cylinder axis. Results are given in terms of dimensionless variables. Experimental data on plaster cylinders are in good agreement with theory. Estimates of the sorptivity and effective porosity of the material can be obtained. The model may be useful in testing drilled cores and may also be applied to radial flow through the wall of a porous tube (hence to conduits and arches).
Intraoperative electroacupuncture relieves remifentanil-induced postoperative hyperalgesia via inhibiting spinal glial activation in rats
Authors: Shi Changxi , Liu Yue , Zhang Wei , Lei Yishan , Lu Cui’e , Sun Rao , Sun Yu’e , Jiang Ming , Gu Xiaoping , Ma Zhengliang
Published: August 2017

Background

Accumulating studies have suggested that remifentanil, the widely-used opioid analgesic in clinical anesthesia, can activate the pronociceptive systems and enhance postoperative pain. Glial cells are thought to be implicated in remifentanil-induced hyperalgesia. Electroacupuncture is a complementary therapy to relieve various pain conditions with few side effects, and glial cells may be involved in its antinociceptive effect. In this study, we investigated whether intraoperative electroacupuncture could relieve remifentanil-induced postoperative hyperalgesia by inhibiting the activation of spinal glial cells, the production of spinal proinflammatory cytokines, and the activation of spinal mitogen-activated protein kinases.

Methods

A rat model of remifentanil-induced postoperative hyperalgesia was used in this study. Electroacupuncture during surgery was conducted at bilateral Zusanli (ST36) acupoints. Behavior tests, including mechanical allodynia and thermal hyperalgesia, were performed at different time points. Astrocytic marker glial fibrillary acidic protein, microglial marker Iba1, proinflammatory cytokines, and phosphorylated mitogen-activated protein kinases in the spinal cord were detected by Western blot and/or immunofluorescence.

Results

Mechanical allodynia and thermal hyperalgesia were induced by both surgical incision and remifentanil infusion, and remifentanil infusion significantly exaggerated and prolonged incision-induced pronociceptive effects. Glial fibrillary acidic protein, Iba1, proinflammatory cytokines (interleukin-1β and tumor necrosis factor-α), and phosphorylated mitogen-activated protein kinases (p-p38, p-JNK, and p-ERK1/2) were upregulated after surgical incision, remifentanil infusion, and especially after their combination. Intraoperative electroacupuncture significantly attenuated incision- and/or remifentanil-induced pronociceptive effects, spinal glial activation, proinflammatory cytokine upregulation, and phosphorylated mitogen-activated protein kinase upregulation.

Conclusions

Our study suggests that remifentanil-induced postoperative hyperalgesia can be relieved by intraoperative electroacupuncture via inhibiting the activation of spinal glial cells, the upregulation of spinal proinflammatory cytokines, and the activation of spinal mitogen-activated protein kinases.
Post-discharge hyperpolarization is an endogenous modulatory factor limiting input from fast-conducting nociceptors (AHTMRs)
Authors: Boada M Danilo , Ririe Douglas G , Eisenach James C
Published: August 2017

Peripheral somatosensory neurons are frequently exposed to mechanical forces. Strong stimuli result in neuronal activation of high-threshold mechanosensory afferent neurons, even in the absence of tissue damage. Among these neurons, fast-conducting nociceptors (A-fiber high-threshold mechanoreceptors (AHTMRs)) are normally resistant to sustained activation, transiently encoding the mechanical stimulus intensity but not its full duration. This rapidly adapting response seems to depend on changes in the electrical excitability of the membrane of these afferent neurons during sustained stimulation, a restraint mechanism that disappears following sensitization. Here, we examine the mechanism by which strong peripheral activation of mechanoreceptors elicits this control process in the absence of tissue injury and temporally silences afferent neurons despite ongoing stimulation. To study this, mechanoreceptors in Sprague–Dawley rats were accessed at the soma in the dorsal root ganglia from T11 and L4/L5. Neuronal classification was performed using receptive field characteristics and passive and active electrical properties. Sustained mechanical nociceptive stimulation in the absence of tissue damage of AHTMRs induces a rapid membrane hyperpolarization and a period of reduced responsiveness to the stimuli. Moreover, this phenomenon appears to be unique to this subset of afferent neurons and is absent in slow-conducting C-mechanonociceptors (C-fiber high-threshold mechanoreceptors) and rapidly adapting fast-conducting low-threshold mechanoreceptors. Furthermore, this mechanism for rapid adaptation and reducing ongoing input is ablated by repeated strong stimuli and in sensitized AHTMRs after chronic neuropathic injury. Further studies to understand the underling molecular mechanisms behind this phenomenon and their modulation during the development of pathological conditions may provide new targets to control nociceptive hyperexcitability and chronic pain.
Practitioner perspectives on learning for social change through non-formal global citizenship education
Authors: Brown Eleanor J
Published: August 2017

This article engages with debates about transformative learning and social change, exploring practitioner perspectives on non-formal education activities run by non-governmental organisations. The research looked at how global citizenship education practitioners met their organisation’s goals of change for social justice through educational activities. This education is sometimes criticised for promoting small individual changes in behaviour, which do not ultimately lead to the social justice to which it pertains to aim. Findings suggest that this non-formal education aims to provide information from different perspectives and generate critical reflection, often resulting in shifts in attitudes and behaviour. While the focus is often on small actions, non-formal spaces opened up by such education allow for networks to develop, which are key for more collective action and making links to social movements. Although this was rarely the focus of these organisations, it was these steps, often resulting from reflection as a group on personal actions, which carried potentially for social change.
The effect of manipulating task constraints on game performance in youth field hockey
Authors: Timmerman Ewout A , Farrow Damian , Savelsbergh Geert JP
Published: August 2017

The purpose of this study was to examine the influence of manipulating game constraints on match performance in youth field hockey. A total of 25 participants aged 10.6–14.6 years old played four different 25-min games where density (228 m2 or 158 m2 per player) and/or number of players (11 per side or 8 per side) was manipulated. Match performance was determined by using notational analysis and physical demands were determined by using GPS analyses. Manipulating the number of players led to an increase in a successful passes (+2.68 passes), skilled actions (+3.73 skilled actions) and successful actions (+3.77 successful actions) performed per player and also created a more advantageous environment to enhance decision making. Increasing the density led to a decrease in unsuccessful dribbles (−0.59 unsuccessful dribbles) made by players and an increase in high intensity running (+38 m) and sprinting (+21.2 m). The findings of this study provide an insight into the effect of manipulating task constraints in skilled junior field hockey and the findings highlight that all types of constraints influence emergent performance in their unique way and that coaches should consider these interactions to promote specific playing behaviour.
Rolling bearing fault severity identification using deep sparse auto-encoder network with noise added sample expansion
Authors: Chen Renxiang , Chen Siyang , He Miao , He David , Tang Baoping
Published: August 2017

This article presents a rolling bearing fault severity identification methodology that aims to adaptively extract fault severity features and intelligently identify the fault severity. The presented method is developed based on a deep sparse auto-encoder network trained with noise added sample expansion. A sparse auto-encoder is a learning algorithm that is capable of performing unsupervised learning of the inner structure and characters of source data. However, even though the original shallow structure of the sparse auto-encoders is capable of extracting the features, they do not have the capability for fault and severity classification. By stacking multiple sparse auto-encoders with a classifier layer, a deep sparse auto-encoder network with the ability of fault severity feature extraction and intelligent severity identification can be obtained. After unsupervised layer-wise self-learning and supervised fine-tuning, the designed deep sparse auto-encoder network can perform severity identification with automatically extracted fault features. Also, to overcome the issue of overfitting caused by limited number of training samples and stacked structure with numerous neurons and layers in a deep sparse auto-encoder network, Gaussian noises are added into the training samples to train the deep sparse auto-encoder network. Using deep sparse auto-encoder network for rolling bearing fault severity identification, the overfitting phenomenon can be retrained to increase the robustness of the network. The performance of the presented method is validated using bearing fault datasets that contain different levels of bearing severity and bearing life stages and compared with other methods. In comparison with recent solutions developed using deep learning approaches, the advantages of the presented method are that it does not require any pre-processing of the vibration data and provides a more robust diagnostic performance.
Media memorial discourses and memory struggles in Slovenia: Transforming memories of the Second World War and Yugoslavia
Authors: Pušnik Maruša
Published: August 2017

The radical break between two national contexts in 1991, when Slovenia seceded from Yugoslavia, and Slovenia’s integration into the European Union in 2004, has brought changes to the collective memory of the Slovenian nation. In this article, I investigate how Delo, a major Slovenian daily newspaper, has been involved in memory struggles to present new memorial discourses that are in accordance with the new national politics. A large part of the common Yugoslav past has been reinvented for the present political and ideological purposes of European integration, whereby the Second World War and the Partisan movement, which once signified a common Yugoslav life, have become a contested issue. The focus of the critical narrative analysis is put on those general narrative templates that underlie specific news narratives about the Second World War and socialist Yugoslavia. Over the last 25 years, dominant media have strengthened memory struggles in the Slovenian public realm and have created revisionist narratives of the Second World War and the post-war past.
Rising incidence of scaphoid fracture surgery in Finland
Authors: Raittio Lauri T. , Jokihaara Jarkko , Huttunen Tuomas T. , Leppänen Olli V. , Launonen Antti P. , Mattila Ville M.
Published: August 2017

The aim of the present study was to investigate the incidence of scaphoid fracture surgery by obtaining data from the national discharge register in Finland, a country of 5 million inhabitants, for the period from 1997 to 2014. A total of 1380 patients with scaphoid fracture were treated surgically. Half of the patients were aged under 28 years and 84% were men. The surgical treatment of scaphoid fractures was classified into two groups. There were 640 (46%) primary fracture fixations and 740 (54%) treatments of fracture nonunion. The overall incidence of all scaphoid fixations increased twofold (from 14.8 to 30.1 per 1,000,000 person-years) and threefold in the primary fixation group (from 5.5 to 17.8 per 1,000,000 person-years) during the study period.

Level of evidence: III
Relationship between plate removal and Soong grading following surgery for fractured distal radius
Authors: Selles Caroline A. , Reerds Sam T.H. , Roukema Gert , van der Vlies Kees H. , Cleffken Berry I. , Schep Niels W.L.
Published: August 2017

The aim of this study was to determine the relationship between volar plate removal and the Soong classification following fixation for fractured distal radius. In this retrospective cohort study, all consecutive patients who had volar plate fixation for a distal radius fracture in 2011–2015 were reviewed. Differences in Soong classification between patients who had plate removal and those who did not were analysed. The total incidence of plate removal was calculated and the indications analysed. A total of 323 patients were included. The incidence of plate removal in all patients was 17%. Soong classification was significantly higher in patients who had plate removal compared with those who did not. For patients with plate placement classified as Soong grade 2, the incidence of plate removal was almost six times higher than those classified as Soong grade 0. The relationship between volar plate removal and a higher Soong grading stresses the importance of accurate plate positioning.

Level of evidence: IV
Muscle-specific endurance of the trapezius muscles using electrical twitch mechanomyography
Authors: McCully Kevin K. , Prins Payton , Mistry Kajal , Willingham T. Bradley
Published: August 2017

Background

Symptoms of fatigue and pain are often reported for the trapezius muscle in the shoulder. The present study evaluated endurance in the trapezius muscles of healthy participants using electric twitch mechanomyography (ETM).

Methods

Surface electrodes and a tri-axial accelerometer were placed over the left trapezius muscle. Muscles were stimulated for 3 min each at 2 Hz, 4 Hz and 6 Hz. Maintenance of acceleration during muscle twitches was used to calculate an endurance index (EI). Subjects (n = 9) were tested on two separate days to assess reproducibility of the trapezius EI measurements. The endurance measurements were made on the wrist flexor and vastus lateralis muscles for comparison. Near infrared spectroscopy was used to measure muscle oxygenation (HbO2) during the stimulation protocol (n = 8).

Results

Mean (SD) EI was 84.9% (8.7%), 63.3% (19.1%) and 41.7% (20.0%) for 2 Hz, 4 Hz and 6 Hz, respectively. The coefficients of variation were 7.4%, 11.3% and 24.0% for 2 Hz, 4 Hz and 6 Hz, respectively. EI values were significantly lower in the trapezius compared to arm and leg muscles (p < 0.05). HbO2 values were unchanged from resting values with electrical stimulation.

Conclusions

The EI as measured by ETM may provide a reproducible method of evaluating function in trapezius muscles that is not influenced by oxygen saturation.
A pilot study of lymph node mapping with indocyanine green in robotic gastrectomy for gastric cancer
Authors: Lan Yuan-Tzu , Huang Kuo-Hung , Chen Ping-Hsien , Liu Chien-An , Lo Su-Shun , Wu Chew-Wun , Shyr Yi-Ming , Fang Wen-Liang
Published: August 2017

Objectives:

Robotic gastrectomy has become increasingly popular in the treatment of gastric cancer, especially in Asian countries. The use of indocyanine green fluorescence has been reported in lymphatic mapping for gastric cancer in laparoscopic gastrectomy; however, there have been few reports regarding the use of indocyanine green in robotic gastrectomy.

Methods:

From January 2011 to March 2016, a total of 79 patients underwent robotic gastrectomy for gastric cancer. Among them, intraoperative subserosal injection (n = 9) or preoperative submucosal injection (n = 5) of indocyanine green with near-infrared imaging was performed in 14 patients, and the other 65 patients underwent robotic gastrectomy without the use of indocyanine green.

Results:

There was no significant difference in the operative time, total number of retrieved lymph nodes, operative blood loss, and postoperative hospital stay between the patients who underwent robotic gastrectomy with or without indocyanine green fluorescence. For each lymph node station, there was significantly more number of retrieved lymph nodes in the indocyanine green group than in the no-indocyanine green group at the greater curvature side of the low body (#4d) to the infrapyloric region (#6) of the stomach. Five of the 14 patients who received an indocyanine green injection for lymphatic mapping had lymph node metastasis, and metastatic lymph nodes were located in the lymph node stations as detected by indocyanine green fluorescence during surgery.

Conclusion:

Indocyanine green fluorescence with near-infrared imaging is feasible and is a promising method of lymphatic mapping in robotic gastrectomy for gastric cancer. In future studies, larger patient numbers and long-term follow-up are required.
When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report
Authors: Tijssen Janice A. , Filler Guido
Published: August 2017

Background:

Continuous renal replacement therapy (CRRT) is an excellent method used to remove fluid and solutes. It may also reduce the systemic inflammatory response for patients on extracorporeal membrane oxygenation (ECMO) support. The objective of this report is to describe a case where CRRT in combination with ECMO was insufficient to control hyperkalemia.

Methods:

We report the case of an adolescent patient with refractory symptomatic hyperkalemia due to substantial rhabdomyolysis in which CRRT insufficiently cleared the patient’s excess potassium.

Results:

Intermittent hemodialysis (IHD) was added and proved successful. The patient was weaned off ECMO, CRRT, and IHD, and his cardiac and renal function eventually normalized.

Conclusions:

Two important lessons can be learned from this case report: (1) If CRRT is insufficient in achieving a desirable potassium balance, additional IHD should be considered and (2) separate IHD access should be considered to improve efficacy.
Ascending Aortic Aneurysm in a Case of Arterial Tortuosity Syndrome: A Rare Tortuous Disorder
Authors: Siddiqui Sumbul , Rana Yashpal , Patel Hardik , Malhotra Amber , Mishra Amit
Published: August 2017

Aortic aneurysms are a common entity among adults but very rare in the pediatric age-group. Association with autosomal inheritance is well established. We describe the unusual clinical presentation of a large ascending aortic aneurysm in a young child who was ultimately found to have severe diffuse arterial tortuosity.
A Case of Persistent Left Superior Vena Cava and Left Pulmonary Venous Drainage to the Coronary Sinus
Authors: Rabinowitz Edon J. , Misra Nilanjana , Meyer David B.
Published: August 2017

We report a case of a persistent left superior vena cava draining to the right atrium via the coronary sinus in conjunction with partial anomalous pulmonary venous return of the left pulmonary veins to the coronary sinus. Although a persistent left superior vena cava is typically of little clinical consequence, in this case, it complicated surgical repair of the congenital heart disease. Successful repair of this unusual combination of systemic and pulmonary venous anomalies required a combination of two well-described surgical techniques.
Minimally Invasive Approach to Correct Anomalous Inferior Vena Cava Connection to the Left Atrium
Authors: Pace Napoleone Carlo , Marini Davide , Baronetto Andrea , Deorsola Luca , Agnoletti Gabriella , Rinaldi Mauro
Published: August 2017

Anomalous drainage of the inferior vena cava into the left atrium is a rare congenital condition. A 20-year-old girl was referred for recurrent transient ischemic attacks. Transthoracic echocardiography revealed a large ostium secundum atrial septal defect, and computed tomography showed anomalous drainage of the inferior vena cava into the left atrium. Through a right mini-thoracotomy, the opening of the inferior vena cava into the atrium was identified under the inferior edge of the interatrial septum, draining into the left atrium, and redirected to the right atrium, using a pericardial patch to reconstruct the atrial septum. Postoperative course was uneventful. Right mini-thoracotomy approach was effective in correcting the anomalous drainage of the inferior vena cava into the left atrium.
The Chiari Network—Only an Embryonic Remnant or a Confusing Finding?
Authors: Figueras-Coll Marc , Sabaté-Rotés Anna , Cañete-Abajo Noemí , Domènech-Ximenos Blanca
Published: August 2017

Chiari network is an embryonic remnant of valves of the sinus venosus, which can be observed in several locations in the right atrium. Although it is usually considered a normal anatomic variant, when associated with certain clinical conditions, the Chiari network may become a confusing finding, and a careful differential diagnosis is required. It should be differentiated from a tricuspid valve disruption, vegetation, thrombus, or tumoral mass. In this case report, we describe a singular case of endocarditis over a Chiari network in a seven-year-old boy that was successfully managed in a conservative fashion.
Cavopulmonary Anastomosis in a Patient With Arrhythmogenic Right Ventricular Cardiomyopathy With Severe Right Ventricular Dysfunction
Authors: Vaidyanathan Swaminathan , Kothandam Sivakumar , Kumar Rajesh , Indrajith Sujatha Desai , Agarwal Ravi
Published: August 2017

A 26-year-old lady presented with exertional dyspnea, palpitations, central cyanosis, and oxygen saturations of 80% in room air. Her electrocardiogram, echocardiogram, and cardiac magnetic resonance were diagnostic of arrhythmogenic right ventricular dysplasia. There was no documented ventricular arrhythmia or syncopal episodes and Holter recordings were repeatedly normal. Cardiac hemodynamics showed right to left shunt through atrial septal defect, low pulmonary blood flow, normal atrial pressures, and minimally elevated right ventricular end-diastolic pressures. Since her presenting symptoms and cyanosis were attributed to reduced pulmonary blood flow, she underwent off-pump cavopulmonary anastomosis between right superior vena cava and right pulmonary artery. As we intended to avoid the adverse effect of extracorporeal circulation on the myocardial function and pulmonary vasculature, we did not attempt to reduce the size of the atrial septal defect. Her postoperative period was uneventful; oxygen saturation improved to 89% with significant improvement in effort tolerance. At 18-month follow-up, there were no ventricular arrhythmias on surveillance. The clinical presentation of this disease may vary from serious arrhythmias warranting defibrillators and electrical ablations at one end to right ventricular pump failure warranting cardiomyoplasty or right ventricular exclusion procedures at the other end. However, when the presentation was unusual with severe cyanosis through a stretched foramen ovale leading to reduced pulmonary blood flows, Glenn shunt served as a good palliation and should be considered as one of the options in such patients.
Why Fans Act That Way
Authors: Brown-Devlin Natalie , Devlin Michael B. , Vaughan Phillip W.
Published: August 2017

The purpose of the study was to examine whether personality traits predict one’s likelihood of basking in reflected glory (BIRGing) and cutting off reflected failure (CORFing) and to what extent team identification would mediate those effects. A path analysis was conducted to empirically test relationships between personality, team identity, and BIRGing/CORFing behaviors using the Honesty-Humility emotionality extraversion agreeableness conscientiousness openness to experience (HEXACO)-Personality Inventory (HEXACO-PI), Sport Spectator Identification Scale, and BIRGing and CORFing scales. The HEXACO-PI provides a theoretical framework to examine the degree to which six broad personality domains and several underlying personality traits influence behavior. A survey utilizing a national sample of 715 participants indicates several narrow underlying personality traits predict BIRGing and CORFing behaviors. Using this personality framework presents a new area of research for sport communication theories. The practical applications and future research examining the role of personality in sport communication and sport marketing is offered in conclusion.
Positive Peer Relationships Facilitate Adjustment in the Transition to University for Emerging Adults With ADHD Symptoms
Authors: Khalis Adri , Mikami Amori Yee , Hudec Kristen L.
Published: August 2017

Many emerging adults, particularly those with attention-deficit/hyperactivity disorder (ADHD) symptoms, struggle to manage the developmental and contextual changes that accompany the transition to university. We examined new students’ formation of positive peer relationships as facilitators of their good university adjustment and as buffers of their ADHD symptom levels. Participants were 571 new university students who had moved away from home to attend university. Sociometric procedures indexed participants’ social acceptance and reciprocated friendships with university peers. Participants completed questionnaires on ADHD symptoms, internalizing difficulties, and attachment to university. Academic transcripts were obtained from the registrar. Students with high ADHD symptoms displayed poorer adjustment overall. However, peer acceptance and reciprocated friendships incrementally predicted better attachment to university, while peer acceptance predicted higher year-end grade point average. Buffering effects of friendships on internalizing difficulties and attachment to university were strongest for those with high ADHD symptoms. Implications for service provision are discussed.
Do Medical Comorbidities Affect Outcomes in Patients With Rotator Cuff Tears?
Authors: Gagnier Joel J. , Allen Benjamin , Watson Scott , Robbins Christopher B. , Bedi Asheesh , Carpenter James E. , Miller Bruce S.
Published: August 2017

Background:

The effects of medical comorbidities on clinical outcomes in patients with rotator cuff tears (RCTs) have not been fully elucidated. This study investigates the association between medical comorbidities, as measured by the Functional Comorbidity Index (FCI), and clinical outcomes in patients treated surgically or nonsurgically for symptomatic, full-thickness RCTs.

Hypothesis:

Patients with RCTs who have more comorbidities will have worse outcome scores.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We collected the following outcome measures at baseline and at regular intervals up to 64 weeks in all patients: FCI, the Western Ontario Rotator Cuff Index (WORC), and the American Shoulder and Elbow Surgeons (ASES) score. Changes in outcomes were compared separately for surgical and nonsurgical patients using paired t tests. The relationship of the FCI and all outcomes of interest at baseline, at 64-week follow-up, and for changes from baseline was explored using linear regression modeling.

Results:

Of the 222 study patients (133 males; mean age, 60.0 ± 9.6 years), 140 completed the 64-week WORC and 120 completed the 64-week ASES. Overall, 128 patients underwent RCT repair, and 94 patients were treated nonsurgically. Both treatment groups improved compared with baseline at 64 weeks on the ASES score and WORC. At 64 weeks, patients with higher baseline FCI scores had worse WORC score (by 74.5 points; P = .025) and ASES score (by 3.8 points; P < .01). A higher FCI score showed a trend toward predicting changes in the WORC and ASES scores at 64 weeks compared with baseline, but this did not reach statistical significance (WORC change, P = .15; ASES change, P = .07).

Conclusion:

Patients with higher FCI scores at baseline reported worse baseline functional scores and demonstrated less improvement with time. The magnitude of this change may not be clinically significant for single comorbidities.
Diversity Regimes and Racial Inequality: A Case Study of Diversity University
Authors: Thomas James M.
Published: August 2017

Despite record investment in diversity infrastructure, racial inequality persists in higher education. This article examines, through a case study of diversity’s articulation process, how diversity is defined, organized, and implemented within an American public flagship university. My findings reveal what I characterize as a diversity regime: a set of meanings and practices that institutionalizes a benign commitment to diversity, and in doing so obscures, entrenches, and even intensifies existing racial inequality by failing to make fundamental changes in how power, resources, and opportunities are distributed. My concept of a diversity regime helps explain how and why organizational commitments to multiculturalism and diversity often fall short in practice. The concept of a diversity regime also helps us better understand the underlying processes that perpetuate racial inequality.
Exploring Culturally Sustaining Writing Pedagogy in Urban Classrooms
Authors: Woodard Rebecca , Vaughan Andrea , Machado Emily
Published: August 2017

We examine how culturally sustaining pedagogy that fosters linguistic and cultural pluralism might be taken up in writing instruction. Using data collected through semistructured interviews with nine urban elementary and middle school writing teachers, we document teachers’ conceptualizations and enactments of culturally sustaining writing pedagogy. Findings indicate that these teachers tended to make space for explicit discussions of language, culture, and power in the writing curriculum and to problematize expressions of dominant culture, such as an emphasis on official languages. We also explore the tensions that these teachers experienced in their pedagogy while engaging in culturally sustaining methods; for example, we documented teachers’ sense that writing needed to be more formal than speech and instances where their critical practices put them at odds with stakeholders in their schools. This work represents an emerging understanding of how culturally sustaining literacy pedagogy might be implemented in practice.
Why People Apply to Medical School in Iraq?
Authors: Al-Hemiary Nesif , Al-Nuaimi Ahmed Sameer , Al-Saffar Hilal , Randall Ian
Published: August 2017

Background:

The motivations behind why people choose to study medicine in Iraqi medical schools are unknown. Such information could help school pupils to make more informed career decisions and assist medical schools in enhancing the student selection process.

Aims:

To investigate why people choose to study medicine in Iraq.

Subjects and methods:

The first-year students admitted on the academic year 2015-2016 to Baghdad College of Medicine, University of Baghdad, were invited to complete a structured questionnaire, which was administered through the college electronic education portal. The data were analyzed using IBM SPSS version 21 software.

Results:

A total of 152 (50% response rate) students responded. Women constituted 69.1% of respondents. Most students (61.8%) had made their choice by themselves without family pressure. The most frequent reasons that affected this choice were “humanitarian reasons and a wish to provide help to others” as well as “childhood dream,” “positive community appraisal of doctors,” and “ready availability of work for physicians.” About three-quarters (73.6%) of the students made some inquiry about medical school before making their choice, and the people asked were most frequently a medical student or a doctor. Information provided by the consulted parties was regarded as satisfactory by 64.2% of the surveyed students, had a positive value in 47.2%, and affected their decision in 34.9%. The highest proportion (42.2%) of the study sample was thinking about studying medicine since primary school. In addition, students with personal preference made their choice at a significantly younger age.

Conclusions:

Reasons to apply for medical schools in Iraq are similar to those in many countries. Most of the students who inquired about studying medicine had not contacted the medical school itself.
The reliability of microseismic moment-tensor solutions: Surface versus borehole monitoring
Authors: Eyre Thomas S. , van der Baan Mirko
Published: August 2017

Source mechanisms of microseismic events, resolved as moment-tensor solutions, usually are obtained using either surface monitoring arrays, which appear to obtain mechanisms with high shear components, or borehole arrays, which tend to constrain more variable mechanisms with higher tensile components; however, the corresponding reliability of the solutions remains unclear. Synthetic tests are therefore conducted to compare the reliability of moment-tensor solutions from surface and two- and three-well borehole arrays based purely on geometry. Moment-tensor inversion is carried out for synthetically generated amplitudes with added random noise, and the bias and variance in the solutions are calculated. For the surface array, all inversions are able to constrain reliable results (with negligible bias and low variance), whereas borehole geometries with two wells produce reliable results only when including P- and S-wave amplitudes recorded on three components in the inversion (as is usual). Surface array inversion results show less bias and variance in the results compared with borehole results, and the three-borehole geometry shows significantly lower biases and estimation variances than the two-borehole geometry, most likely due to a greater sampling of the focal sphere. These results may explain in part why downhole moment-tensor inversion studies tend to resolve more variable mechanisms than surface arrays. Nonetheless, as well as geometry, other influences (e.g., signal-to-noise ratio) will influence the reliability of the solutions in real settings and different amplitude strengths of pure shear or tensile mechanisms combined with different path lengths, and thus energy dissipation for borehole or surface acquisitions also may play a role. Nonetheless, tests such as those in this study are useful to help design appropriate monitoring geometries and/or understand possible sources of bias and uncertainty in moment-tensor interpretations.