bluuebunny/crossref_metadata_2025 huggingface dataset:
Public awareness of audiology, hearing and hearing health in the Limpopo Province, South Africa
Authors: Joubert Karin , Sebothoma Ben , Kgare Khomotjo S.
Published: October 2017

Background: The burden of hearing loss is on the increase, especially in low-income countries such as South Africa. The need for urgent action to prevent ear and hearing problems is a priority, especially as in many cases permanent hearing loss is preventable. In South Africa, as in other developing countries, there is a limited number of hearing health professionals and audiological resources. The lack of hearing health services may impact the general public’s awareness of hearing and hearing health. Limited information is available on the South African public’s knowledge of audiologists and the services they provide, especially in underserved rural communities.Aim: The aim of this study was to describe individuals’ awareness of the audiology profession, hearing and hearing loss, and hearing health in a rural area of the Limpopo Province.Method: A cross-sectional survey design was employed for the purpose of this study. Using a random sampling strategy, 297 households in four rural villages were selected and a selfdeveloped questionnaire was administered to one individual (18 years and older) per household. The questionnaire consisted of 23 questions targeting awareness of the audiology profession, as well as knowledge of hearing, hearing loss and hearing health.Results: Only 14% of participants were aware of the audiology profession, indicating that individuals living in rural communities are not aware of the role of audiologists and the services they provide. Doctors and nurses were identified by participants as the individuals who assist them with hearing-related problems. Although most participants (87%) acknowledged that it is very important to undergo a hearing test, only 5% have previously visited an audiologist. Most participants were aware that ear infections and excessive noise exposure can cause hearing loss. The majority also believed that ears must be kept clean at all times and used cotton buds to maintain ear hygiene.Conclusion: There is a general lack of public awareness of audiologists and the services they offer. This study highlighted the need for the National Department of Health in collaboration with professional associations and hearing health professionals to develop and implement effective strategies to increase the South African public’s awareness of the profession and the services they provide. South African universities can also play a significant role in teaching students to develop context-relevant strategies to increase awareness of the profession.
The mediation role of motivation between leadership and public sector performance
Authors: Mavhungu Dzivhuluwani , Bussin Mark H.R.
Published: October 2017

Orientation: As a result of poor performance in 2013, five departments in the Limpopo province were placed under administration in terms of Section 100 (1) (b) of the Constitution of the Republic of South Africa.Research purpose: The main purpose of this study was to investigate the importance of the individual level of performance when diagnosing performance issues in the public sector by focusing on the mediatory role of motivation in the relationship between leadership and public sector performance.Motivation for the study: The diagnosis conducted focused more on the analysis of administrative and operational systems. The solutions were based on normalising financial statements and systems to improve performance.Research design, approach and method: The study took a positivist approach as the philosophy of the study. Using quantitative methods, a cross-sectional survey was used to collect data from 65 employees working in one of the departments that were affected by the intervention.Main findings: The study confirmed the existence of a relationship between leadership and performance in the public sector. It was also found that Public Sector Motivation plays a mediatory role between Perceived Leadership Styles and Individual Job Performance.Practical/managerial implications: The findings imply that it is important that the Limpopo Provincial Government makes an effort to employ and retain employees who are readily showing high levels of Public Sector Motivation.Contribution or value additions: The study focused on an overlooked area in the study of performance in the public sector. The study was able to produce a tool that should be able to provide information to assist managers to make better performance improvement strategy decisions.
Dynamic ultrasound evaluation of the syndesmosis ligamentous complex and clear space in acute ankle injury, compared to magnetic resonance imaging and surgical findings
Authors: Van Niekerk Chantelle , Van Dyk Barbara
Published: October 2017

Background: Syndesmosis injuries are often more serious than an injury to the lateral ligament complex of the ankle, with double the recovery time, chronic discomfort and joint instability. Although magnetic resonance imaging (MRI) is considered as the best imaging modality to assess the integrity of the syndesmotic ligamentous complex and clear space, a dynamic ultrasound evaluation may provide an alternative imaging option worthy of exploring.Aim: The aim of this article is to compare the sensitivity and specificity of musculoskeletal ultrasound and MRI, in the diagnosis of syndesmosis pathology, with surgical findings as the reference point.Method: MRI was performed on 114 participants presenting with pain over the lateral aspect of the ankle after injury. This was followed by a dynamic ultrasound examination during which the anterior tibiofibular ligament (ATiFL) was assessed for continuity, contour and haematoma. The tibiofibular clear space was measured with the ankle in a neutral position, followed by internal and external rotation.Results: The Fisher’s exact test was used to determine non-random associations between variables and compute statistical significance (p < 0.05). Ultrasound achieved a sensitivity of 86.3%, specificity of 97% with a false-positive rate of 3%. The sensitivity of MRI is similar to that of ultrasound (86%) with a specificity of 100%.Conclusion: Although both imaging tests performed very well, MRI was slightly better at excluding pathology while both tests performed equally in demonstrating pathology. As a simple, inexpensive and reproducible test, dynamic ultrasound can thus be considered as an alternative to MRI in acute ankle pathology.
First presentation of Crohn’s disease complicated with hepatic portal venous gas and pylephlebitis
Authors: Lee Beom Jun , Krim Ahmed O. A. , Samson Paul
Published: October 2017

The authors present a rare case where radiological findings provided an important diagnostic and prognostic role in a surgical patient with abdominal sepsis. The case in interest describes an extremely rare surgical complication of intestinal Crohn’s disease (CD), namely, pylephlebitis and hepatic portal venous gas (HPVG). Key radiological findings and their clinical significance are described to further add to the limited published data available on CD with pylephlebitis and HPVG.
Van laboratoriumbank tot siekbed: Genetiese bevindings in skisofrenie
Authors: Roos Johannes L.
Published: October 2017

Die komplekse genetiese argitektuur van skisofrenie word kortliks omskryf deur na twee kontrasterende (maar konseptueel verbandhoudende) hipoteses te verwys. Bevindings van die lokus van genoomwye assosiasiestudies (GWAS) en die major-histoversoenbaarheidskompleks (MHK) op chromosoom 6 en skisofrenie word aangehaal. Klassieke aanvullingskaskade verbonde hieraan word betrek in die eliminering, of ‘snoei van sinapse’ as deel van die patogenese van skisofrenie. Daar word nader aan die siekbed van skisofreniepasiënte beweeg deur te kyk na die volgende navorsingsbevindings in pasiënte met skisofrenie in die Afrikanerbevolking:mikro-uitwissing by die 22q11.2 chromosoom as ’n spesifieke tipe skisofrenie;fenotipiese kenmerke van skisofreniepasiënte wat spontane geenmutasies dra;skisofrenie wat verwant is aan die vaderlike ouderdom (VOVS) en sosiale funksionering vroeg en later in die lewe van die pasiënte;verhoogde selfdoodrisiko in skisofreniepasiënte met koppeling aan chromosoom 13q en hoe mortaliteit in die pasiënte verlaag kan word.
Becoming good in Africa: A critical appraisal of Stanley Hauerwas’ ecclesial ethic in the sub-Saharan context
Authors: Bafinamene Charles K.
Published: October 2017

The present article examines the appropriateness of Stanley Hauerwas’ ecclesial ethic for the sub-Saharan African churches. Thus, it consists in a Christian ethical assessment of the metaethical foundational categories of his ecclesial ethic. In brief, his proposal is eclectic and pluri-disciplinarily applicable to the churches of various denominations. It reflects the marks of the Aristotelian ethical tradition endorsed by Thomas Aquinas and recovered by several communitarian philosophers. It also includes some discernible ecclesio-centric and postliberal theological accents. The promising insights of this proposal include: (1) the necessity to ordain the church’s worship, polity and its entire way of life to the spiritual and moral formation of church members; (2) the stress on Christian virtuous life, identity formation, witness and non-conformism in social ethics. However, essentially designed against the background of a Western, liberal, autonomous and individualist self, Hauerwas’ ecclesial ethic is not a definitive answer for the holistic, normative and communalist moral self, characteristic of the traditional African ethos and influencing a large majority in Africa. Moreover, it stresses the purity of the church in a way that restricts cooperation between Christians and nonChristians for socio-economic justice and the common good.Intradisciplinary and/or interdisciplinary implications: Therefore, Hauerwas’ virtue, narrative, community and social ethics provide some valuable insights for moral formation in African churches as it explores the interplay between ecclesiology, Christian ethics, practical theology and philosophical ethics. For sure, other relevant resources should come from African spirituality, developmental psychology and sociology of religion.
Comparison between ventriculosubgaleal shunt and extraventricular drainage to treat acute hydrocephalus in adults
Authors: Nee Low , Harun Rahmat , Sellamuthu Pulivendhan , Idris Zamzuri
Published: October 2017

Context: Hydrocephalus, due to subarachnoid or intraventricular hemorrhage (IVH), meningitis, or tumor compression, is usually transient and may resolve after treatment. There are several temporary methods of cerebrospinal fluid (CSF) diversion, none of it is superior to the other, and the decision is based on its various etiologies and factors. Ventriculosubgaleal shunt (VSGS) is one of those temporary measures, which is a simple and rapid CSF decompression method without causing electrolyte and nutritional losses. Aims: The aim is to study the efficacy of VSGS for temporary CSF diversion, compared to extraventricular drainage (EVD) in adult hydrocephalus patients; to evaluate the outcome in terms of avoiding a permanent shunt, and to look for incidences of their complications. Settings and Design: This was a retrospective observational study. Subjects and Methods: The data were acquired from case notes of fifty patients with acute hydrocephalus: 26 secondary to IVH, 10 from aneurysm rupture, 8 posttrauma, and 6 from infection. All these patients had undergone CSF diversion in Hospital Queen Elizabeth II, Sabah, Malaysia, between 2013 and 2015. The patients were followed up from the date of treatment until the resolution of hydrocephalus, where parameters such as shunt dependency and complications were documented. Statistical Analysis Used: All analyses were carried out using Statistical Packages for the Social Sciences Version 22.0. Chi-squared test or Fisher's exact test is used for univariate analysis of categorical variables. Results: A total of 21 (42%) patients underwent EVD insertion and 29 (58%) underwent VSGS insertion. Thirty-seven (74%) patients did not require a permanent shunt; 24 (64.8%) of them were from the VSGS group (P = 0.097). EVD had more intracranial complications (44.1%) compared with VSGS (23.5%), with a statistically significant P = 0.026. Conclusions: VSGS is a safe and viable option for adult hydrocephalus patients, with the possibility of continuation of the treatment for such patients in nonneurosurgical centers, as opposed to patients with EVDs. Furthermore, even though this method had no statistical difference in avoiding a permanent ventriculoperitoneal shunt, VSGS has statistically significant less intracranial complications compared with EVD.
Predictive value of motor evoked potential monitoring during surgery of unruptured anterior circulation cerebral aneurysms
Authors: Yamada Yasuhiro , Kato Yoko , Nouri Mohsen , Ganaha Tsukasa , Oheda Motoki , Ishihara Kohei , Moriya Shigeta , Sadato Akiyo , Inamasu Joji , Hirose Yuichi
Published: October 2017

Objective and Background: Surgery of unruptured aneurysms is always a great challenge to neurovascular surgeons because no postoperative neurological deficits should be expected postoperatively as the patients are fully asymptomatic before the surgery. Here, we present our experience with selective motor evoked potential (MEP) monitoring of our patients in a 2-year time window. Patients and Methods: From 2012 to 2014, 27 patients with unruptured intracranial aneurysms were operated in our institute with the help of MEP monitoring. All patients underwent endoscope-assisted microsurgery with pre- and post-clipping indocyanine green angiography. Results: In this period, no mortality was observed, but 18.5% of the patients developed postoperative deficits which showed good recovery in all cases. Overall, MEP showed about 90% accuracy in predicting postoperative deficits. Conclusions: MEP as a part of multimodality monitoring of aneurysm surgeries is a valuable tool to improve the outcome. However, we should know its limitations as its results are not always consistent with the outcome.
Subependymal giant cell astrocytoma: Associated hyperproteinorrhachia causing shunt failures and nonobstructive hydrocephalus - Report of successful treatment with long-term follow-up
Authors: Kasper Ekkehard , Laviv Yosef , Sebai Mohammed-Adeeb , Lin Ning , Butler William
Published: October 2017

Subependymal giant cell astrocytomas (SEGAs) are histologically benign tumors most frequently associated with tuberous sclerosis complex (TSC). Despite their benign histopathological appearance, they may cause unfavorable outcomes due to their intraventricular location. Rarely, SEGA may be associated with hyperproteinorrhachia (high levels of proteins in the cerebrospinal fluid [CSF]), which causes malresorptive, communicating hydrocephalus; certainly, this scenario makes shunt obstruction likely in this patient population. In this report, we illustrate the case of hyperproteinorrhachia in an SEGA patient with known TSC, who presented repeatedly with shunt failure from proteinaceous shunt obstruction. Subsequent surgical resection of the main intraventricular lesion resulted in a dramatic drop in the CSF protein levels and has since prevented further shunt failures. Different treatment concepts and possible pathophysiology are discussed and the pertinent literature is reviewed.
Outcomes of minimally invasive surgery compared to open posterior lumbar instrumentation and fusion
Authors: Lee Low , Idris Zamzuri , Beng Tan , Young Teo , Chek Wong , Abdullah Jafri , Hieng Wong
Published: October 2017

Introduction: Degenerative spine disease is increasingly common. There are many spinal fusion techniques used to treat degenerative spine disease. This study aims to compare the functional outcome of open versus minimally invasive surgery (MIS) technique in posterior lumbar instrumentation and fusion in degenerative spine disease and to evaluate the perioperative outcome and complications between MIS and open surgery. Materials and Methods: This is an observational cross-sectional study conducted on all degenerative spine disease patients who underwent both methods of posterior lumbar instrumentation and fusion from 2010 to 2014 by the Orthopedic and Neurosurgery Department, Sarawak General Hospital. The analyzed variables were method of surgery and the levels involved, demographic data, estimated blood loss, duration of operation, length of hospitalization, visual analog scale of back pain and radicular pain preoperative, postoperative 1 month, 3 months, 6 months, 1 year, and functional outcome. Results: One hundred and twenty-two patients underwent posterior lumbar instrumentation and fusion from 2010 to 2014. Seventy patients were subjected to MIS transforaminal lumbar interbody fusion (TLIF) and 52 open TLIF. Total 89 patients underwent single level of lumbar fusion with sixty patients in MIS group and 29 in open surgeries. MIS TLIF has less estimated blood loss and shorter hospitalization and longer operation time compared to open TLIF, which were statistically significance. MIS TLIF has statistically significance better functional outcome based on Oswestry disability index, Modified NASS score, and RAND 36-item Health Survey 1.0 score. Complications such as infection, new onsets of neurological, and dural tear are equal in both methods of surgery. Conclusion: This study concluded that MIS has better functional outcome compared to open TLIF with shorter hospitalization, faster return to work, and less estimated blood loss.
Profiling cognitive deficits in intra-axial and extra-axial tumors using addenbrooke's cognitive examination as a screening tool: An Indian experience
Authors: Cherkil Sandhya , Panikar Dilip , Soman Deepak
Published: October 2017

Background: Tumors of the brain, whether intra- or extra-axial, results in cognitive deficits. The aim of the present study was to profile cognitive deficits using Addenbrooke's Cognitive Examination-Malayalam (ACE-M) as a screen and to determine the sensitivity and specificity of the same. Methods: Seventy-four drug naïve patients diagnosed to have brain tumors were assessed for cognitive functioning using ACE-M before surgery. Results: Patients with high-grade intra-axial tumors showed a significant association on the cognitive domains of registration (0.04), recall (0.01), and visuospatial functioning (0.02). Gender showed an association between registration (0.02) and verbal fluency (0.02) with females performing better while education was significantly associated with retrograde or remote memory (0.00) with college-educated sample performing better. Significance was assumed at P < 0.05. In extra-axial tumors, laterality had a single association with recall (0.02). Males showed a significant cognitive decline on the cognitive domains of attention (0.02), recall (0.05), naming (0.02), and language functions (0.01). College educated group performed better on registration (0.01), recall (0.09), naming (0.00), and visuospatial functioning (0.00). The area under the receiver operating characteristic curve was estimated as 0.75, which indicates fairly good discriminative ability with a cut off of 71/100; sensitivity at 77.3 and specificity fixed at 67. Conclusions: ACE-M is capable of bringing out cognitive deficits along with a number of cognitive domains in patients with intra- and extra-axial tumors in the capacity of a screen, with fairly good levels of sensitivity and specificity.
A method for reconstruction of severely damaged spinal cord using autologous hematopoietic stem cells and platelet-rich protein as a biological scaffold
Authors: Ammar Ahmed , Osman Yasser , Hendam Ahmed , Hasen Mohammed , Al Rubaish Fatma , Al Nujaidi Danya , Al Abbas Faisal
Published: October 2017

Introduction: There have been attempts to alter the prognosis of severe spinal cord injury in different centers, but none of which have reliably altered the outcome. Some trials use stem cells (SCs) that produced widely differing results. We hereby add our experience in our center of a surgical reconstruction of the damaged spinal cord using a mixture of SCs and Platelet-Rich Protein (PRP) with fibrin coated as a biological scaffold. Materials and Methods: Four cases of severely damaged spinal cord have been operated for neurolysis and reconstruction of the spinal cord using SCs and platelet-rich protein (PRP) with fibrin coated harvested from the peripheral circulation of the patient. PRP serves to maintain the position of the SCs. One milliliter suspension contains an average of 2.8 × 106 of autologous hematopoietic SCs. Patients were intraoperatively monitored by somatosensory evoked potential, motor evoked potentials, and delta wave. They are clinically followed postoperatively and electromyogram was repeated every 2 weeks. Magnetic resonance imaging (MRI) was repeated regularly. The patients are followed up for a period between 2 and 3 years. Results: One patient demonstrated motor and objective sensory improvement (P = 0.05), two other patients reported subjective sensory improvement, and the fourth one remained without any improvement (P = 0.1). None of these patients demonstrated any sign of deterioration or complication either on the surgery or on implanting of the SCs. MRI clearly proved that the inserted biological scaffold remained in place of reconstruction. Conclusion: SCs may play a role in restoring spinal cord functions. However, the unsolved problems of the use of SCs and related ethical issues should be addressed.
Tumor recurrence in a glioblastoma patient after discontinuation of prolonged temozolomide treatment
Authors: Tseng Wei-Lung , Hsu Hsu-Hsien , Chen Yun , Tseng Sheng-Hong
Published: October 2017

There is no consensus regarding the duration of temozolomide (TMZ) treatment for glioblastoma multiforme (GBM). We report a 53-year-old woman who had a left frontal GBM. The tumor showed good response to TMZ treatment, which was discontinued after 5.5 years with recurrence of tumor at the posterior fossa 6 months later, although there was no definite tumor recurrence in the left frontal region. The tumor failed to respond to the reinstitution of TMZ therapy. Continuous TMZ treatment may be necessary in GBM patients on prolonged TMZ treatment despite improved neurological condition and imaging studies revealing marked tumor regression.
A new isoperimetric inequality for the elasticae
Authors: Bucur Dorin , Henrot Antoine
Published: October 2017

For a smooth curve

\gamma

, we define its elastic energy as

E(\gamma)= \frac {1}{2} \int_{\gamma} k^2 (s) ds

where

k(s)

is the curvature. The main purpose of the paper is to prove that among all smooth, simply connected, bounded open sets of prescribed area in

\mathbb R^2

, the disc has the boundary with the least elastic energy. In other words, for any bounded simply connected domain

\Omega

, the following isoperimetric inequality holds:

E^2(\partial \Omega)A(\Omega)\ge \pi ^3

. The analysis relies on the minimization of the elastic energy of drops enclosing a prescribed area, for which we give as well an analytic answer.
Conical structure for shrinking Ricci solitons
Authors: Munteanu Ovidiu , Wang Jiaping
Published: October 2017

It is shown that a shrinking gradient Ricci soliton must be smoothly asymptotic to a cone if its Ricci curvature goes to zero at infinity.
On sup-norms of cusp forms of powerful level
Authors: Saha Abhishek
Published: October 2017

Let

f

be an

L^2

-normalized Hecke–Maass cuspidal newform of level

N

and Laplace eigenvalue

\lambda

. It is shown that

\|f\|_\infty \ll_{\lambda, \epsilon} N^{-1/12 + \epsilon}

for any

\epsilon > 0

. The exponent is further improved in the case when

N

is not divisible by "small squares". Our work extends and generalizes previously known results in the special case of

N

squarefree.
Неавтономные гамильтоновы квантовые системы, операторные уравнения и представления упорядоченного по Вейлю базиса Бендера-Данна при зависящих от времени канонических преобразованиях
Authors: Gianfreda Maria , Landolfi G
Published: October 2017

С использованием зависящих от времени канонических преобразований решена проблема интегрирования операторных уравнений, описывающих динамику неавтономных квантовых систем. Исследуемые операторные уравнения в сущности воспроизводят на квантовом уровне классические условия интегрируемости для основных случаев одномерных неавтономных динамических систем. Решения ищутся в виде операторных рядов в базисе псевдодифференциальных операторов Бендера-Данна. Наряду с данной проблемой рассмотрены квантовые канонические преобразования. Минимальное решение операторного уравнения в представлении данного базиса при фиксированном времени соответствует наименьшему порядку вклада от решения, полученного в результате применения канонического линейного преобразования к элементам базиса.
Преобразования Лапласа хюльтеновской функции Грина и их применение к задаче потенциального рассеяния
Authors: Laha Ujjwal , Ray S , Panda S , Bhoi J
Published: October 2017

Выведены и записаны в максимально редуцированном виде замкнутые представления одно- и двукратного преобразований Лапласа хюльтеновской функции Грина уходящей волны, умноженной на потенциал Ямагучи. Выражения для двукратного преобразования используются при вычислении низкоэнергетического фазового сдвига при упругом рассеянии в системах $\alpha$-нуклон, $\alpha$-$He^3$ и $\alpha$-$H^3$. Результаты расчета хорошо согласуются с экспериментальными данными.
Об асимптотике спектра комбинационного рассеяния на стоксовских фононах
Authors: Aptekarev Alexander Ivanovich , Lapik Mariya Aleksandrovna , Orlov Yurii Nikolayevich
Published: October 2017

Для некоторого класса полиномиальных квантовых гамильтонианов, используемых в моделях комбинационного рассеяния в квантовой оптике, в представлении вторичного квантования получена асимптотика спектра при больших числах заполнения. Диагонализация гамильтонианов этого класса осуществляется с помощью специальной системы полиномов, задаваемых рекуррентными соотношениями с коэффициентами, зависящими от параметра (числа заполнения). Для этой системы полиномов определяется асимптотика дискретной меры, относительно которой они ортогональны. Получаемые предельные меры интерпретируются как равновесные меры в экстремальных задачах логарифмического потенциала во внешнем поле и с ограничениями на меру. Общий случай иллюстрируется точно решаемым примером, когда гамильтониан можно диагонализовать каноническим преобразованием Боголюбова, а специальные ортогональные полиномы вырождаются в классические дискретные полиномы Кравчука.
Assessing the Impact of Leveraging Traditional Leadership on Access to Sanitation in Rural Zambia
Authors: Tiwari Amy , Russpatrick Scott , Hoehne Alexandra , Matimelo Selma M. , Mazimba Sharon , Nkhata Ilenga , Osbert Nicolas , Soloka Geoffrey , Winters Anna , Winters Benjamin , Larsen David A.
Published: October 2017

Open defecation is practiced by more than one billion people throughout the world and leads to significant public health issues including infectious disease transmission and stunted growth in children. Zambia implemented community-led total sanitation (CLTS) as an intervention to eliminate open defecation in rural areas. To support CLTS and the attainment of open defecation free communities, chiefs were considered key agents of change and were empowered to drive CLTS and improve sanitation for their chiefdom. Chiefs were provided with data on access to sanitation in the chiefdom during chiefdom orientations prior to the initiation of CLTS within each community and encouraged to make goals of universal sanitation access within the community. Using a survival regression, we found that where chiefs were orientated and mobilized in CLTS, the probability that a village would achieve 100% coverage of adequate sanitation increased by 23% (hazard ratio = 1.263, 95% confidence interval = 1.080–1.478, P = 0.003). Using an interrupted time series, we found a 30% increase in the number of individuals with access to adequate sanitation following chiefdom orientations (95% confidence interval = 28.8–32.0%). The mobilization and support of chiefs greatly improved the uptake of CLTS, and empowering them with increased CLTS knowledge and authority of the program in their chiefdom allowed chiefs to closely monitor village sanitation progress and follow-up with their headmen/headwomen. These key agents of change are important facilitators of public health goals such as the elimination of open defecation in Zambia by 2020.
Development and Evaluation of a Loop-Mediated Isothermal Amplification Assay for the Detection of Treponema pallidum DNA in the Peripheral Blood of Secondary Syphilis Patients
Authors: Xiao Yongjian , Xie Yafeng , Xu Man , Liu Shuangquan , Jiang Chuanhao , Zhao Feijun , Zeng Tiebing , Liu Zhuoran , Yu Jian , Wu Yimou
Published: October 2017

Secondary syphilis (SS) has always been puzzling for the clinicians because of the similarity of the appearance of skin rashes with other dermatoses. Serological assays are useful, but less sensitive at an early stage of SS or when patients are immunodeficient. Therefore, there is an urgent need to develop a rapid and effective tool for the diagnosis of SS, which may play an important role in the control of epidemic syphilis outbreaks. In this study, we evaluated a loop-mediated isothermal amplification (LAMP) assay, targeting gene encoding the basic membrane protein of Treponema pallidum, to detect the presence of circulating T. pallidum DNA in the blood of SS patients. The specificity of LAMP was validated using three strains of Spirochaetales and six common clinical bacteria. The clinical applicability of LAMP assay was assessed using 642 blood samples from clinically suspected SS patients and 80 samples from healthy blood donors, showing a sensitivity of 82.1% and a specificity of 100.0% in the diagnosis of SS. Thus, our results indicate that the LAMP can be used as a supplementary method for the diagnosis of SS.
Case Report: Cysticercosis: Sonographic Diagnosis of a Treatable Cause of Epilepsy and Skin Nodules
Authors: Heller Tom , Wallrauch Claudia , Kaminstein Daniel , Phiri Sam
Published: October 2017

A case of disseminated cysticercosis of brain, muscle subcutaneous tissue is reported and the use of musculoskeletal ultrasound in the diagnosis of the condition emphasized.
Case Report: Primary Tuberculosis of the Bilateral Breast
Authors: Li Qiang , Huang Yin-Xia , Yang Qing , Dong Yu-Jie , Gao Meng-Qiu , Ma Li-Ping
Published: October 2017

Primary breast tuberculosis is rare. We report a case of bilateral primary breast tuberculosis. The patient received incisional drainage and debridement of both breasts. Histopathology of the breast tissues revealed chronic granulomatous inflammation and positive acid-fast stain. The patient received antitubercular therapy for 18 months, and she achieved complete resolution.
Distribution of Mutations Associated with Antifolate and Chloroquine Resistance among Imported Plasmodium vivax in the State of Qatar
Authors: Bansal Devendra , Acharya Anushree , Bharti Praveen K. , Abdelraheem Mohamed H. , Elmalik Ashraf , Abosalah Salem , Khan Fahmi Y. , ElKhalifa Mohamed , Kaur Hargobinder , Mohapatra Pradyumna K. , Sehgal Rakesh , Idris Mohammed A. , Mahanta Jagadish , Singh Neeru , Babiker Hamza A. , Sultan Ali A.
Published: October 2017

Plasmodium vivax is the most prevalent parasite worldwide, escalating by spread of drug resistance. Currently, in Qatar, chloroquine (CQ) plus primaquine are recommended for the treatment of P. vivax malaria. The present study examined the prevalence of mutations in dihydrofolate reductase (dhfr), dihydropteroate synthase (dhps) genes and CQ resistance transporter (crt-o) genes, associated with sulphadoxine-pyrimethamine (SP) and chloroquine resistance, among imported P. vivax cases in Qatar. Blood samples were collected from patients positive for P. vivax and seeking medical treatment at Hamad General Hospital, Doha, during 2013–2016. The Sanger sequencing method was performed to examine the single nucleotide polymorphisms in Pvdhfr, Pvdhps, and Pvcrt-o genes. Of 314 examined P. vivax isolates, 247 (78.7%), 294 (93.6%) and 261 (83.1%) were successfully amplified and sequenced for Pvdhfr, Pvdhps, and Pvcrt-o, respectively. Overall, 53.8% (N = 133) carried mutant alleles (58R/117N) in Pvdhfr, whereas 77.2% (N = 227) and 90% (N = 235) isolates possessed wild type allele in Pvdhps and Pvcrt-o genes, respectively. In addition, a total of eleven distinct haplotypes were detected in Pvdhfr/Pvdhps genes. Interestingly, K10 insertion in the Pvcrt-o gene was observed only in patients originating from the Indian subcontinent. The results suggested that CQ remains an acceptable treatment regimen but further clinical data are required to assess the effectiveness of CQ and SP in Qatar to support the current national treatment guidelines. In addition, limited distribution of genetic polymorphisms associated with CQ and SP resistance observed in imported P. vivax infections, necessitates regular monitoring of drug resistant P. vivax malaria in Qatar.
Preliminary Evaluation of Percutaneous Treatment of Echinococcal Cysts without Injection of Scolicidal Agent
Authors: Firpo Giovanni , Vola Ambra , Lissandrin Raffaella , Tamarozzi Francesca , Brunetti Enrico
Published: October 2017

Puncture, Aspiration, Injection of scolicidal agent, Re-aspiration is the most widely used percutaneous treatment of cystic echinococcosis (CE). Among its perceived risks is chemical sclerosing cholangitis, a serious complication due to the caustic effect of the scolicidal solution on the biliary tree, when a patent cystobiliary fistula occurs. To simplify the protocol, we decided to omit injection and reaspiration of the scolicidal agent and to implement a full course of albendazole (ABZ) therapy instead of the routine 1-month ABZ prophylaxis. We searched our databases for patients with CL (Cystic Lesion, suspected for CE), CE1, and CE3a cysts treated between October 2007 and January 2017 with percutaneous aspiration followed by at least 1 month of oral ABZ and with an ultrasound follow-up of at least 6 months. Fifteen patients matched our inclusion criteria. Follow-up ranged from 7 to 75 months. The oral ABZ course after the aspiration procedure ranged from 1 to 18 months. Eleven subjects (73.3%) had undergone a course of ABZ before the percutaneous procedure (min 15 days, max 16 months). Ten cysts (62.5%) had reached solidification (stage CE4) in 3 to 69 months. Four other cysts (26.7%) remained stable in stage CE3a, whereas two cysts (13.3%) reactivated to stage CE3b. Procedural perioperative complications occurred in 13.3% of patients, whereas complications during the follow-up occurred in 20% of patients. These proof-of-concept preliminary results are overall comparable with those reported in the literature for other percutaneous treatments, both in terms of response rate, relapse rate, and morbidity.
Presence of Burkholderia pseudomallei in Soil and Paddy Rice Water in a Rice Field in Northeast Thailand, but Not in Air and Rainwater
Authors: Ong Catherine E. L. , Wongsuvan Gumphol , Chew Janet S. W. , Kim Tan Yian , Teng Low Hwee , Amornchai Premjit , Wuthiekanun Vanaporn , Day Nicholas P. J. , Peacock Sharon J. , Cheng Tan Yoke , Yap Eric P. H. , Limmathurotsakul Direk
Published: October 2017

Environmental Burkholderia pseudomallei has been postulated to be aerosolized during ploughing and heavy rain, and could result in inhalational melioidosis. Here, we determined the presence of B. pseudomallei in soil, paddy field water (PFW), air, and rainwater samples in a single rice paddy field in Ubon Ratchathani, northeast Thailand. In 2012, we collected 100 soil samples during the dry season, 10 PFW samples during the monsoon season, 77 air samples during ploughing (N = 31) and heavy rains (N = 46), and 60 rainwater samples during 12 rain events. We found that 32 soil samples (32%), six PFW samples (60%), and none of the air and rainwater samples were culture positive for B. pseudomallei. Other soil bacteria were isolated from air and rainwater samples. Mean quantitative count of B. pseudomallei estimated from two culture-positive PFW samples was 200 colony forming units/mL. Our findings suggest that the risk of melioidosis acquisition by inhalation in Thailand might be low.
The Multifactorial Epidemiology of Blackwater Fever
Authors: Shanks G. Dennis
Published: October 2017

Blackwater fever is a massive hemolytic event usually occurring in the context of repeated falciparum malaria infections and intermittent quinine use. Its etiology is poorly understood, and it is rarely seen today. Historical epidemiological observations from the 20th century demonstrated variable patterns in prisoners in Andaman Islands, refugees in Macedonia, canal workers in Panama, expatriates in Rhodesia, and Second World War soldiers. Rates of blackwater fever per 1,000 malaria cases varied over two orders of magnitude. Islands, such as the Andaman Islands and New Guinea, had lower blackwater fever rates than continental areas. During the Second World War, blackwater fever rates in British soldiers in West Africa and Australian soldiers in New Guinea differed by a factor of 40 despite similar treatment regimens and falciparum malaria transmission risks. Blackwater fever is a complex interaction between host erythrocyte, falciparum malaria, and antimalarial drugs which remains poorly understood.
Case Report: A Cluster of Three Leptospirosis Cases in a New York City Abattoir and an Unusual Complication in the Index Case
Authors: Kupferman Tania , Coffee Megan P. , Eckhardt Benjamin J.
Published: October 2017

We report the case of a 46-year-old male abattoir worker who developed myalgias, shortness of breath, and irritability 2 weeks after sustaining a laceration to the hand with a knife at work. During his hospital evaluation for septic shock he was noted to be febrile, hypotensive, profoundly jaundiced with aseptic meningitis, and renal failure, and was diagnosed with Leptospirosis interrogans infection confirmed by serum and urine polymerase chain reaction. After standard antibiotic therapy and recovery from severe clinical illness, he developed unilateral orchitis with pyuria secondary to leptospirosis, a well-established complication in the veterinary literature, but of which we offer the first report in humans in the English literature. The case presented was also the index case that uncovered a cluster outbreak of leptospirosis in New York City during the winter of 2016–2017, involving a total of three patients who lived or worked within a block of the abattoir. Two patients survived whereas the third died of pulmonary hemorrhage shortly after seeking medical care.
Refugees in Europe, 1919–1959
Authors: Frank Matthew , Reinisch Jessica
Published: October 2017

Refugees in Europe, 1919-1959 offers a new history of Europe’s mid-20th century as seen through its recurrent refugee crises. By bringing together in one volume recent research on a range of different contexts of groups of refugees and refugee policy, it sheds light on the common assumptions that underpinned the history of refugees throughout the period under review.

The essays foreground the period between the end of the First World War, which inaugurated a series of new international structures to deal with displaced populations, and the late 1950s, when Europe's home-grown refugee problems had supposedly been ‘solved’ and attention shifted from the identification of an exclusively European refugee problem to a global one. Borrowing from E. H. Carr’s The Twenty Years’ Crisis, first published in 1939, the editors of the volume test the idea that the two post-war eras could be represented as a single crisis of a European-dominated international order of nation states in the face of successive refugee crises which were both the direct consequence of that system and a challenge to it.

Each of the chapters reflects on the utility and limitations of this notion of a ‘forty years’ crisis’ for understanding the development of specific national and international responses to refugees in the mid-20th century. Contributors to the volume also provide alternative readings of the history of an international refugee regime, in which the non-European and colonial world are assigned a central role in the narrative.
La educación galerística como campo emergente de la educación artística en contextos no formales
Authors: Ortega Inés , Marín Lola
Published: October 2017

En este artículo se aborda la posibilidad de realizar actividades didácticas, dirigidas a un público amplio, en galerías españolas de arte contemporáneo. Como referente inmediato, se contempla la función educativa de los museos y, para profundizar en el análisis, se estudian galerías de Gran Bretaña que ya llevan a cabo acciones didácticas como parte de su programación habitual. El objetivo es detectar rasgos comunes en las actividades que realizan, observar los colectivos a los que se dirigen y tratar de desvelar el pensamiento subyacente que rige su funcionamiento, además de determinar diferencias sustanciales entre la educación en galerías y la educación en museos. Finalmente, y a partir de los datos extraídos, se establece una comparación con las galerías de arte nacionales y se determinan las características fundamentales de lo que hemos denominado “didáctica galerística”, concluyendo que las galerías de arte contemporáneo que aúnan una función comercial, junto con labores de difusión y educación, constituyen un contexto emergente para la educación artística.
El minotauro escondido en la trilogía de J. A. Bayona
Authors: Martinez-García María A.
Published: October 2017

El cine de J. A. Bayona pertenece a ese grupo de producciones que en el nuevo milenio ha llevado al cine español fuera de sus fronteras. Con solo tres películas en su haber, todas han batido récords de taquilla y le han valido a su director la etiqueta de “universal”. En este artículo analizamos algunas de las razones por las cuales estas películas han triunfado, desde el punto de vista que marcan la mitocrítica y el mitoanálisis propuestos por G. Durand. Tanto El orfanato (2007), como Lo imposible (2012) o Un monstruo viene a verme (2016) forman una “trilogía improvisada”, bautizada así por el propio Bayona, que tiene en común un triángulo profundo: madre – hijo – muerte. En todas ellas los personajes tienen que enfrentarse a la verdad del sufrimiento y ello les conducirá a un proceso de transformación personal que a su vez conectará con el yo más íntimo del espectador. En este texto veremos los mecanismos que se ponen en funcionamiento para que este proceso se lleve a cabo, basado en la actualización de temas antiguos en obras nuevas.
Reconciliación pragmática entre arte y vida cotidiana
Authors: García-Sánchez Rafael
Published: October 2017

Uno de los rasgos que otorgaron fisonomía propia a la Postmodernidad fue la tecnificación y democratización en la producción y consumo de arte. La indiferenciación indolente y la vulgarización artística fueron los riesgos a los que se expuso. Con ella se mantuvo en vigor la escisión existente entre la experiencia estética refinada y la vida cotidiana vinculada a lo útil. Intentaremos mostrar la incapacidad de la propuesta postmoderna técnico-democrática, más política que artística, para resolver esa discontinuidad. Se propondrá, como alternativa, la rehabilitación del marco pragmático, con la intención de articular recíprocamente y dar continuidad al arte culto y al arte popular, a lo estético y lo útil, superando el aislamiento del primero y desviaciones vulgares del segundo. Desde una concepción pragmática de la experiencia estética podrá disolverse el dualismo entre arte y vida cotidiana que la Postmodernidad cultural no logró disolver.
Dressing Symkyn's Wife: Chaucer's Reeve's Tale and Bad Taste
Authors: Bertolet Craig E.
Published: October 2017

Chaucer's Reeve describes the entrance of the miller Symkyn and his wife into church on a holy day as a “sighte.” Why is Symkyn's wife in a red dress, and why does the Reeve consider it a spectacle? To answer these questions, this article examines Chaucer's use of the term sighte in the Canterbury Tales, the nature of fashion codes during the later Middle Ages, and what the choice of wearing a red dress says about an individual in a late medieval English village. Using Pierre Bourdieu's notion of distinction or taste, this article shows that the Reeve's description of Symkyn's wife in a red dress is one of the earliest renditions of tastelessness in English-language literature.
Management in higher education: an overview of public universities practices in the United States
Authors: Bodah Eliane Thaines , Bodah Brian William
Published: October 2017

A gestão no ensino superior é um tema que vem ganhando mais atenção nas últimas décadas devido ao aumento do número de novas faculdades, especialmente nos Estados Unidos da América (EUA). O sistema norte-americano é único e difere da maioria dos países da América Latina principalmente pela descentralização do poder governamental, que pode ter contribuído para um sistema de gestão autônoma e local. Além disso, há uma comunidade estudantil altamente diversificada e multicultural nos EUA. Assim sendo, este trabalho apresenta uma abordagem sobre a gestão do ensino superior norte-americano, bem como alguns desafios e perspectivas dessa. A metodologia foi uma pesquisa documental realizada na web durante os anos de 2015 e 2016, com o objetivo de contextualizar o ensino básico no cenário preparatório para o ensino superior. Em seguida, uma análise descritiva dos diferentes níveis de ensino superior foi apresentada, avaliando as recomendações e as normativas federais que contribuíram para um sistema classificatório de acreditação acadêmica. Os resultados indicaram que, na ausência de um ministério federal regulamentador como o Ministério da Educação (MEC) no Brasil, rankings e sistemas de acreditação, como o Carnegie, tornam-se muito importantes como indicadores de qualidade. Entre os aspectos exclusivos do ensino superior dos EUA também está a adoção de conselhos universitários compostos por diferentes membros da comunidade acadêmica que contribuem para a tomada de decisões.
Participação, educação não escolar e problematização de práticas: uma perspectiva em elaboração
Authors: Dalpiaz Luiza Helena
Published: October 2017

Neste trabalho, apresento elementos de uma abordagem exploratória da participação que venho realizando, desde dois pontos de vista distintos, cuja articulação se encontra em elaboração. Por um lado, trato da participação como constitutiva da noção de educação não escolar. A abordagem do tema é realizada por meio da orientação para elaboração de dissertações de mestrado; do levantamento da produção sobre o tema em periódicos qualificados, do campo da educação; de estudos exploratórios sobre indícios socio-históricos referentes à construção social do termo. A principal evidência é a característica híbrida e polissêmica da educação não escolar. Por outro lado, trabalho a participação como elemento estruturante de um método para problematização de práticas profissionais singulares, pelo qual problematizo políticas públicas. O objetivo é mostrar que a prática desse dispositivo de pesquisa-formação evidencia elementos pertinentes para o debate sobre a gestão democrática, em particular, sobre condições para a materialização desse princípio da política educacional na escola pública.