bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the U.S. domestic computer science Ph.D. pipeline
Authors: Hambrusch Susanne , Libeskind-Hadas Ran , Aaron Eric
Published: July 2015

Two studies provide insights into how to increase the number of domestic doctoral students in U.S. computer science programs.
Structural Health Monitoring of Wind Turbine Blades: Acoustic Source Localization Using Wireless Sensor Networks
Authors: Bouzid Omar Mabrok , Tian Gui Yun , Cumanan Kanapathippillai , Moore David
Published: July 2015

Structural health monitoring (SHM) is important for reducing the maintenance and operation cost of safety-critical components and systems in offshore wind turbines. This paper proposes anin situwireless SHM system based on an acoustic emission (AE) technique. By using this technique a number of challenges are introduced due to high sampling rate requirements, limitations in the communication bandwidth, memory space, and power resources. To overcome these challenges, this paper focused on two elements: (1) the use of anin situwireless SHM technique in conjunction with the utilization of low sampling rates; (2) localization of acoustic sources which could emulate impact damage or audible cracks caused by different objects, such as tools, bird strikes, or strong hail, all of which represent abrupt AE events and could affect the structural health of a monitored wind turbine blade. The localization process is performed using features extracted from aliased AE signals based on a developed constraint localization model. To validate the performance of these elements, the proposed system was tested by testing the localization of the emulated AE sources acquired in the field.
The Anthropometric Measurement of Schober’s Test in Normal Taiwanese Population
Authors: Yen Yong-Ren , Luo Jin-Fan , Liu Ming-Li , Lu Fung-Jou , Wang Soo-Ray
Published: July 2015

The measurement of lower back mobility is essential in the assessment of lower back pain including ankylosing spondylitis. Original Schober’s test (OST) and modified Schober’s test (MST) are popularly conducted in daily rheumatology and orthopedics clinical practices. To our knowledge, this report is the only anthropometric reference study in a normal oriental population. The OST declined with age from 5.0 cm in the youngest (20–30 years old) to 3.1 cm in the aged (70–80 years old) male subjects and from 3.6 cm to 2.4 cm in the female subjects. The male OST was significantly more than the female OST. There was a good correlation between OST and MST in each of the three age groups of both sexes.
GDF-15 as a Target and Biomarker for Diabetes and Cardiovascular Diseases: A Translational Prospective
Authors: Adela Ramu , Banerjee Sanjay K.
Published: July 2015

Growth differentiation factor-15 (GDF-15) is a stress responsive cytokine. It is highly expressed in cardiomyocytes, adipocytes, macrophages, endothelial cells, and vascular smooth muscle cells in normal and pathological condition. GDF-15 increases during tissue injury and inflammatory states and is associated with cardiometabolic risk. Increased GDF-15 levels are associated with cardiovascular diseases such as hypertrophy, heart failure, atherosclerosis, endothelial dysfunction, obesity, insulin resistance, diabetes, and chronic kidney diseases in diabetes. Increased GDF-15 level is linked with the progression and prognosis of the disease condition. Age, smoking, and environmental factors are other risk factors that may increase GDF-15 level. Most of the scientific studies reported that GDF-15 plays a protective role in different tissues. However, few reports show that the deficiency of GDF-15 is beneficial against vascular injury and inflammation. GDF-15 protects heart, adipose tissue, and endothelial cells by inhibiting JNK (c-Jun N-terminal kinase), Bad (Bcl-2-associated death promoter), and EGFR (epidermal growth factor receptor) and activating Smad, eNOS, PI3K, and AKT signaling pathways. The present review describes the different animal and clinical studies and patent updates of GDF-15 in diabetes and cardiovascular diseases. It is a challenge for the scientific community to use GDF-15 information for patient monitoring, clinical decision-making, and replacement of current treatment strategies for diabetic and cardiovascular diseases.
Mild Cognitive Impairment in Early Parkinson's Disease Using the Movement Disorder Society Task Force Criteria: Cross-Sectional Study in Hoehn and Yahr Stage 1
Authors: Stefanova Elka , Žiropadja Ljubomir , Stojković Tanja , Stanković Iva , Tomić Aleksandra , Ječmenica-Lukić Milica , Petrović Igor , Kostić Vladimir
Published: July 2015

Background: Mild cognitive impairment (MCI) in Parkinson's disease (PD) is common and confers a higher risk for developing dementia. Methods: In this cross-sectional study of MCI in PD conducted at a university hospital, a comprehensive neuropsychological battery covering five domains (attention/working memory, executive, verbal, and visual memory, language, and visuospatial) was administered to 111 nondemented PD patients in Hoehn and Yahr stage 1 and to 105 healthy matched control subjects (HC). MCI was diagnosed according to level 2 of the Movement Disorder Society Task Force criteria. Results: Criteria for MCI associated with PD (PD-MCI) were fulfilled by 24% of PD patients in the initial stage of the disease at the z cutoff scores of -1.5 SD in contrast to 7% of HC fulfilling criteria for MCI. Memory and visuospatial domains were the most commonly affected at -1.5 SD. PD-MCI patients mostly had a multiple-domain MCI subtype (78%). They presented a more severe bradykinesia and higher mood and apathy scores in comparison with cognitively normal PD patients. Basic motor scores predicted performance on some cognitive tests and specific cognitive-motor relationships emerged. Conclusions: MCI, predominantly of a multiple-domain subtype, was quite prevalent even in the initial stage of PD.
Effects of Wind Chill Factor, Temperature and Other Meteorological Parameters on the Incidence of Bell's Palsy: Results Based on a Retrospective, 7-Year Long, Greek Population Study
Authors: Kokotis Panagiotis , Katsavos Serafeim
Published: July 2015

Background: The etiology of Bell's palsy (BP), the most common type of dysfunction of the facial nerve, remains unclear despite vigorous research. Data concerning the effects of meteorological factors (MFs) on its appearance are inconclusive. The aim of our study was to examine the demographics of a convenience sample of patients with BP and to determine the effects of several MFs in the recorded number of cases per month (cpm). Methods: We retrospectively reviewed 568 files of BP patients and concomitant data of MFs during an 84-month observation period. Information collected included age, gender, diabetic status, number of cpm (months further categorized as winter or summer), mean daily and monthly temperatures and wind speeds and monthly values of wind chill factor (WCF), a measure dependent on both temperature and wind speed. Potential correlations were estimated by univariate analyses (p = 0.05). Results: Demographics were in line with previous research regarding age and diabetic status, but indicative of slight male preponderance. Summer months and mean monthly temperatures showed significant negative correlations with cpm (p = 0.002 and <0.000, respectively) and strong positive correlation with WCF (p < 0.000). Conclusions: MFs can substantially influence the possibility for BP appearance. We propose WCF as a novel, reliable estimator of the overall MF-derived risk.
Waist Circumference as a Predictor of Failure of Sonographic Estimation of Fetal Birth Weight
Authors: Gultekin Ismail Burak , Altinboga Orhan , Ozkaya Enis , Gultekin Serap , Mahmutoglu Selma , Kara Osman Fadil , Kucukozkan Tuncay
Published: July 2015

Objective: Several factors may interfere with the success of fetal birth weight (BW) prediction. In this study we tried to determine the most probable factors that may lead to unsuccessful BW estimation. Methods: 200 consecutive pregnancies between 34 and 41 weeks of gestation were enrolled for the study. All subjects underwent sonographic fetal BW estimation before membrane rupture or engagement of presented part. Sonography was performed by the same sonographer blinded to the study design. Failure of estimation was determined when deviation was found to be >15%. Results: Both amniotic fluid index (AUC = 0.768, p < 0.001) and maternal waist circumference (AUC = 0.698, p = 0.004) were significant predictors for failure of estimation. Optimal cut-off values were 80 mm for amniotic fluid index (77% sensitivity, 65% specificity) and 105 cm for maternal waist circumference (70% sensitivity, 61% specificity). The number of pregnancies with anteriorly located placenta was significantly higher in the group with failed estimation (12/20 vs. 39/180, p = 0.001). Conclusion: Amniotic fluid volume, body mass index, maternal waist circumference and placental location may all cause failure of fetal weight estimation and may need to be adjusted. Moreover, our results indicate that waist circumference may be a more reliable predictor of failure of fetal weight estimation compared to body mass index.
The Reliability and Validity of the Norwegian Version of the Quality of Life in Late-Stage Dementia Scale
Authors: Røen Irene , Selbæk Geir , Kirkevold Øyvind , Engedal Knut , Lerdal Anners , Bergh Sverre
Published: July 2015

Aim: To translate the Quality of Life in Late-Stage Dementia (QUALID) Scale into Norwegian, and to evaluate the test-retest reliability and validity of the scale. Method: QUALID was translated according to standardised procedures. Residents with dementia living in nursing homes were included in the study and assessed using QUALID, Cornell Scale for Depression in Dementia, Neuropsychiatric Inventory, Physical Self-Maintenance Scale and Clinical Dementia Rating Scale. Results: Cronbach's α of QUALID was 0.79. In the reliability study, the intra-class correlation was 0.83. The validity study showed a strong association between depressive symptoms and QUALID, and a moderate association between QUALID and assessments of level of functioning and agitation. Conclusions: The Norwegian version of QUALID is a reliable and valid scale for assessing quality of life in nursing home residents with dementia.
Crinoids of the stalked family Hyocrinidae (Echinodermata) collected by the USNS Eltanin in the Southern Ocean
Authors: ROUX MICHEL
Published: July 2015

Rare species only known from one or a few specimens, mainly collected from abyssal and hadal zones in the Southern Ocean are represented in a collection of stalked crinoids attributed to the family Hyocrinidae (Crinoidea, Echinodermata). The species studied here include Belyaevicrinus latipinnulus Mironov & Sorokina, 1998, Feracrinus heinzelleri Bohn, 2012, Ptilocrinus brucei Vaney, 1908 and Thalassocrinus clausus Mironov & Sorokina, 1998. This collection, mainly collected during the 1960s USNS Eltanin cruises, is housed at the Smithsonian Institution National Museum of Natural History in Washington DC. A detailed study of this material using SEM observations of ossicle articular facets and pinnule architecture allows the emendation of species diagnoses, and a better description of intraspecific variation and of changes in characters through ontogeny. Geographical and depth range extension of species are reported. A gonad with submature ovocytes of 100–150 µm was exceptionally preserved at the base of a genital pinnule of P. brucei. This species likely has a lecithotrophic larval development.
Antitrust in Context
Authors: Kovacic William E.
Published: July 2015

Well before he founded the American Antitrust Institute, Bert Foer directed the Office of Special Projects in the Bureau of Competition of the Federal Trade Commission. Among other contributions, Bert led the preparation of a pathbreaking exploration of the history of U.S. competition law. Bert engaged some of the country’s leading business historians to discuss economic, political, and social forces that shaped the adoption and implementation of U.S. antitrust laws. In convening the historians’ workshop, Bert illuminated how the study of history provides vital context for a competition agency’s formation of modern antitrust policy.
Labour’s legal resources after 2004
Authors: Drahokoupil Jan , Myant Martin
Published: July 2015

This article investigates the influence of the European Union (EU) on legal resources available to labour to tackle labour market challenges in Central and Eastern European countries after their accession to the EU in 2004 and 2007. Its conclusion is that the EU’s impact has been complex and contradictory, with differences between countries and time periods. The EU has to varying degrees encouraged social partnership and supported a model of employment relations giving high levels of legal and collective protection to employees. Since 2008, the EU has advocated reductions in protection for employees on standard contracts and a very substantial reduction in collective bargaining coverage in one case, only partially balanced by advocacy for improving the lot of those on less secure employment relationships. However, the EU agenda has in practice been largely irrelevant to the widespread informalization and casualization of employment relations in the region.
Lobular breast cancer - the most common special subtype or a most special common subtype?
Authors: Lehmann Ulrich
Published: July 2015

Lobular breast cancer is not only the second most common breast cancer subtype, known for decades, but also a tumour entity that still poses many unresolved questions. These include questions about the targets and cooperation partners of E-cadherin, the best model systems for translational research, and the best tools for detection, surveillance and therapy. Leading experts review the molecular and cellular bases, the model systems, the histopathology and profiling approaches, risk factors, imaging tools and therapeutic options for lobular breast cancer.
Report from the Alzheimer’s Research UK Conference 2015
Authors: Sancho Rosa M. , Cox Carla J. , Ridley Simon H. , Phipps Laura E. , Karran Eric
Published: July 2015

On 10–11 March 2015 University College London hosted the annual Alzheimer’s Research UK Conference. This report provides an overview of the presentations and discussions that took place.
Activity Of Companies In Innovation Networks
Authors: Dolińska Małgorzata
Published: July 2015

Innovation networks can be understood as an organization in which two or more independent firms aim at joint research, development or spreading of innovations. In such a relatively stable and cooperative collaboration, the partner firms find support during one or more activities of the innovation process, which may increase their innovation performance (Dilk, Gleich, Wald 2008, p. 693). Relationships of innovative companies with partners in networks are based on development and transfer knowledge, which is used in innovation processes. With development of innovations in the network, knowledge and other resources are multiplied. The objective of this work is to explore cooperative relationships of companies with partners during innovation process execution within the network’s framework. This paper analyzes the impact of these relationships on the development of innovative companies, as well as also attempts to describe synergy effects of cooperation between partners in innovation networks. Questionnaire research on this subject was conducted in Lubelskie region in 2009. Summary results of these research are described in this work.
Laparoscopic splenectomy is emerging ‘gold standard’ treatment even for massive spleens
Authors: Somasundaram SK , Massey L , Gooch D , Reed J , Menzies D
Published: July 2015

Introduction

Since its first description by Delaitre and Maignien in 1991, laparoscopic splenectomy (LS) has evolved as treatment of choice for mild-to-moderately-enlarged spleens and for benign haematological disorders. LS is a challenge if massive spleens or malignant conditions necessitate treatment, but we report our method and its feasibility in this study.

Methods

We undertook a retrospective study of prospectively collected data of all elective splenectomies carried out in our firm of upper gastrointestinal surgeons from June 2003 to June 2012. Only patients opting for elective LS were included in this study.

Results

From June 2003 to June 2012, elective splenectomy was carried out in 80 patients. Sixty-seven patients underwent LS and 13 underwent open splenectomy (OS). In the LS group, there were 38 males and 29 females. Age ranged from 6 years to 82 years. Spleen size in the LS group ranged from ≤11cm to 27.6cm. Twelve patients had a spleen size of >20cm. Weight ranged from 35g to 2,400g. Eighteen patients had a spleen weight of 600–1,600g and eight had a spleen weight >1,600g. Operating times were available for 56 patients. Mean operating time for massive spleens was 129.73 min. There was no conversion to OS. There were no major complications.

Conclusions

With improved laparoscopic expertise and advancing technology, LS is safe and feasible even for massive spleens and splenic malignancies. It is the emerging ‘gold standard’ for all elective splenectomies and has very few contraindications.
Acute afferent loop syndrome in the early postoperative period following pancreaticoduodenectomy
Authors: Nageswaran H , Belgaumkar A , Kumar R , Riga A , Menezes N , Worthington T , Karanjia ND
Published: July 2015

Introduction

Afferent loop syndrome (ALS) is a recognised complication of foregut surgery caused by mechanical obstruction at the gastrojejunostomy anastomosis itself or at a point nearby. Acute ALS has only been reported following pancreaticoduodenectomy (PD) after several years due to recurrence of malignancy at the anastomotic site. We report five cases of acute ALS in the first postoperative week.

Methods

The presentation, clinical findings and successful management of the 5 patients with ALS were obtained from a prospectively collected database of 300 PDs. All five patients with early acute ALS presented with signs and symptoms of a bile leak. Since the fifth patient, the surgical technique has been modified with the creation of a larger window in the transverse mesocolon and a Braun enteroenterostomy.

Results

There have been no further incidents of ALS since the adoption of these modifications to the standard technique of PD and there has also been a reduction in postoperative bile leaks (6.4% vs 3.6%, p=0.416).

Conclusions

Acute ALS is a rare but important complication in the immediate postoperative period following PD and causes disruption to adjacent anastomoses, resulting in a bile leak. A prophylactic Braun anastomosis and wide mesocolic window may prevent this complication and subsequent deterioration.
The two-port laparoscopic retroperitoneal approach for minimal access pancreatic necrosectomy
Authors: Cresswell AB , Nageswaran H , Belgaumkar A , Kumar R , Menezes N , Riga A , Worthington TR , Karanjia ND
Published: July 2015

Introduction

Despite advances in surgery and critical care, severe pancreatitis continues to be associated with a high rate of mortality, which is increased significantly in the presence of infected pancreatic necrosis. Controversy persists around the optimal treatment for such cases, with specialist units variously advocating open necrosectomy, simple percutaneous drainage or one of several minimal access approaches. We describe our technique and outcomes with a two-port laparoscopic retroperitoneal necrosectomy (2P-LRN).

Methods

Thirteen consecutive patients with proven infected pancreatic necrosis were treated by 2P-LRN over a three-year period in the setting of a specialist hepatopancreatobiliary unit. The median patient age was 46 years (range: 28–87 years) and 10 of the patients were male.

Results

The median number of procedures required to clear the necrosis was 2 (range: 1–5), with a median time to discharge following the procedure of 44 days (range: 10–135 days). There was no 90-day mortality and the morbidity rate was 38%, consisting of pancreatic fistula (31%) and bleeding (23%).

Conclusions

Two-port laparoscopic retroperitoneal necrosectomy has been demonstrated to confer similar or better outcomes to other techniques for necrosectomy. It carries the additional advantages of better visualisation, leading to fewer procedures and the opportunity to deploy simple laparoscopic instruments such as diathermy or haemostatic clips.
Brunner’s gland hamartoma of the duodenum
Authors: Sedano J , Swamy R , Jain K , Gupta S
Published: July 2015

Brunner’s gland hamartoma (BGH) is a rare benign tumour of the duodenum. We present a case of duodenal obstruction caused by a BGH, which required surgical resection after a failed attempt at endoscopic removal.
A two-year follow-up observational study of the T-14 paediatric throat disorders outcome measure in tonsillectomy and adenotonsillectomy
Authors: Konieczny KM , Biggs TC , Pringle MB
Published: July 2015

Introduction

The T-14 questionnaire is a validated patient reported outcome measure used to assess the value of paediatric tonsillectomy from the patient’s perspective. There are currently limited data revealing the long-term postoperative effects of tonsillectomy on quality of life in the paediatric population. A previously published study was therefore extended to provide additional data at 12 and 24 months following surgery.

Methods

A prospective uncontrolled observational study was undertaken examining 54 paediatric patients undergoing tonsillectomy at Portsmouth Hospitals NHS Trust. Parents of children having surgery were invited to complete a T-14 questionnaire preoperatively as well as at 3, 6 (previously published), 12 and 24 months postoperatively.

Results

The questionnaire was completed for 50 of the 54 patients preoperatively as well as at 3, 6 and 12 months postoperatively, with 44 being completed at 24 months. The mean difference between the preoperative T-14 scores and the scores at 3, 6, 12 and 24 months following surgery were highly statistically significant (p<0.001).

Conclusions

This is the first study published in the literature to assess the T-14 questionnaire at 12 and 24 months following paediatric tonsillectomy, providing evidence of the ongoing benefit of patient reported outcome measures. This further confirms the value of tonsillectomy in the paediatric population and demonstrates its ongoing positive effects on quality of life.
The Emergency Surgical Team – The Way Forward in Emergency Care?
Authors: Tincknell Laura , Burton Sarah , Cooke Claire , Black Stephen , Andreani Stefano , Jourdan Iain , Gudgeon Mark
Published: July 2015

INTRODUCTION

With reduced working hours and shift patterns, surgical training and continuity of patient care is being put at risk. We have devised a system for managing the emergency surgical patients in an effort to counteract these perceived problems. This study describes the emergency surgical team and audits its activity.

PATIENTS AND METHODS

The emergency surgery team concept is described in detail. Over a 2-week period, general surgical referral data, patient management and operative activity were audited.

RESULTS

A total of 229 patients were referred to the emergency surgical team with 159 treated conservatively, 45 underwent operative intervention and 25 were discharged without admission. Of the emergency surgical team referrals, 58% had gallstone pathology, appendicitis or constipation/non-specific abdominal pain. Average daily number of patients under the care of the emergency surgical team was 26 (range, 10–40).

CONCLUTIONS

The consultant-led emergency surgical team look after many of the acutely sick surgical patients. Our system not only provides good teaching opportunities but ensures optimal continuity of patient care in a busy district general hospital. Such an approach to emergency surgical care has been successfully developed to optimise training opportunities and improve patient care in a setting of reduced working hours and shift systems in our hospital.
An assessment of fine-needle sampling techniques
Authors: Titoria Puneet , Siva Thiru M , Malik Tass
Published: July 2015

INTRODUCTION

Fine-needle cytology sampling, when adequate, is highly sensitive and specific for tissue-type diagnosis, with figures of 94% and 88%, respectively. This study explores the technique of sampling to reduce interoperator variability and ensure maximal tissue yield.

MATERIALS AND METHODS

Apple cortical tissue was sampled as a proxy of human lymph node. A total of 200 samples, by four methods, with 50 by each sampling method, were taken using blue venepuncture needles and weighed to assess tissue yield. Results were analysed using one-way analysis of variance and Tukey's HSD test. Comparable yields, by mass, were achieved by both straight lance and coring techniques (P > 0.05). Significantly greater yield was achieved with a multiplanar technique (P < 0.05).

CONCLUSIONS

Multiplanar sampling increases mass yield of tissue in fine-needle sampling. Coring appears to have little bearing on yield.
Diverticular fistulation is associated with nicorandil usage
Authors: McDaid James , Reichl Claire , Hamzah Ihsan , Fitter Samantha , Harbach Laura , Savage Adrian P
Published: July 2015

INTRODUCTION

We observed that a number of patients presenting to our clinic with diverticular fistulation were taking nicorandil for angna. Recognised side effects of nicorandil include gastrointestinal and genital ulceration. The aim of our study was to determine whether nicorandil is an aetiological agent in diverticular fistulation.

PATIENTS AND METHODS

We conducted a case-control study of patients with diverticular disease related enteric fistulae. Two patient groups were identified: a study group of patients with diverticular fistulae, and a control group with uncomplicated diverticular disease. The proportion of patients who had ever used nicorandil was compared between the two groups.

RESULTS

A total of 153 case notes were analysed, 69 patients with fistulae and 84 control patients with uncomplicated diverticular disease. Female to male ratio in both groups was 2:1. The mean age was 71 years in the fistula group and 69 years in the control diverticular disease group (P = ns). Of those with colonic fistulae, 16% were taking nicorandil compared with 2% of the control group (odds ratio 7.8; 95% confidence interval 1.5–39.1; P = 0.008). There was no significant difference in rates of ischaemic heart disease between fistula and control groups.

CONCLUSIONS

Nicorandil is associated with fistula formation in diverticular disease.
Postoperative haemorrhage following transurethral resection of the prostate (TURP) and photoselective vaporisation of the prostate (PVP)
Authors: Lynch Mark , Sriprasad Seshadri , Subramonian Kesavapillai , Thompson Peter
Published: July 2015

INTRODUCTION

Intractable haemorrhage after endoscopic surgery, including transurethral resection of the prostate (TURP) and photoselective vaporisation of the prostate (PVP), is uncommon but a significant and life-threatening problem. The knowledge and technical experience to deal with this complication may not be wide-spread among urologists and trainees. We describe our series of TURPs and PVPs and the incidence of postoperative bleeding requiring intervention.

PATIENTS AND METHODS

We retrospectively reviewed 437 TURPs and 590 PVPs over 3 years in our institution. We describe the conservative, endoscopic and open prostatic packing techniques used for patients who experienced postoperative bleeding.

RESULTS

Of 437 TURPs, 19 required endoscopic intervention for postoperative bleeding. Of 590 PVPs, two patients were successfully managed endoscopically for delayed haemorrhage at 7 and 13 days post-surgery, respectively. In one TURP and one PVP patient, endoscopic management was insufficient to control postoperative haemorrhage and open exploration and packing of the prostatic cavity was performed.

CONCLUSIONS

Significant bleeding after endoscopic prostatic surgery is still a potentially life-threatening complication. Prophylactic measures have been employed to reduce peri-operative bleeding but persistent bleeding post-endoscopic prostatic surgery should be treated promptly to prevent the risk of rapid deterioration. We demonstrated that the technique of open prostate packing may be life-saving.
Managing type II and type IV Lauge-Hansen supination external rotation ankle fractures: current orthopaedic practice
Authors: Kosuge DD , Mahadevan D , Chandrasenan J , Pugh H
Published: July 2015

INTRODUCTION

Differentiating supination external rotation (SER) type II and IV ankle injuries is challenging in the absence of a medial malleolar fracture or talar shift on radiographs. The accurate differentiation between a stable SER-II from an unstable SER-IV injury would allow implementation of the appropriate management plan from diagnosis. The aim of this study was to ascertain the practice of orthopaedic surgeons in dealing with these injuries.

MATERIALS AND METHODS

A postal survey was undertaken on 216 orthopaedic consultants from three regions.

RESULTS

In the presence of medial-sided clinical signs (tenderness, swelling, ecchymosis), 22% of consultants would perform surgical fixation. 53% would choose non-operative treatment and the majority would monitor these fractures through serial radiographs. The remaining 25% of consultants would perform an examination under anaesthesia (EUA; 15%), request stress radiographs (9%) or an MRI scan (1%). Without medial-sided signs, 85% would advocate non-operative treatment and, of these, 74% would perform weekly radiographs. Interestingly, 6% would perform immediate surgical fixation. Stress radiographs (6%) and EUAs (2%) were advocated in the remaining group of consultants. Foot and ankle surgeons utilised stress radiographs more frequently and were more likely to proceed to surgical fixation should talar shift be demonstrated.

CONCLUSIONS

Clinical practice is varied amongst the orthopaedic community. This may lead to unnecessary surgery in SER-II injuries and delay in diagnosis and operative management of SER-IV injuries. We have highlighted the various investigative modalities available that may be used in conjunction with clinical signs to make a more accurate diagnosis.
Gauze packing as damage control for uncontrollable haemorrhage in severe thoracic trauma
Authors: Moriwaki Y , Toyoda H , Harunari N , Iwashita M , Kosuge T , Arata S , Suzuki N
Published: July 2015

Introduction

The usefulness of thoracic damage control (DC) for trauma requiring a thoracotomy is not established. The aim of this study was to clarify the usefulness of thoracic packing as DC surgery.

Methods

This was a retrospective case series study of 12 patients with thoracic trauma suffering uncontrollable intrathoracic haemorrhage and shock who underwent intrathoracic packing. Our thoracic DC technique consisted of ligation and packing over the bleeding point or filling gauze in the bleeding spaces as well as packing for the thoracotomy wound. The success rates of intrathoracic haemostasis, changes in the circulation and the volume of discharge from the thoracic tubes were evaluated.

Results

Packing was undertaken for the thoracic wall in five patients, for the lung in four patients, for the vertebrae in two patients and for the descending thoracic aorta in one patient. Haemostasis was achieved successfully in seven cases. Of these, the volume of discharge from the thoracic tube exceeded 400ml/hr within three hours after packing in three patients, decreased to less than 200ml/hr within seven hours in six patients and decreased to 100ml/hr within eight hours in six patients. Systolic pressure could be maintained over 70mmHg by seven hours after packing.

Conclusions

Intrathoracic packing is useful for some patients, particularly in the space around the vertebrae, at the lung apex, and between the diaphragm and the thoracic wall. After packing, it is advisable to wait for three hours to see whether vital signs can be maintained and then to wait further to see if the discharge from the thoracic tube decreases to less than 200ml/hr within five hours.
Managing supracondylar fractures of the distal humerus in children in a district general hospital
Authors: Pullagura M , Odak S , Pratt R
Published: July 2015

Introduction

Controversy exists regarding the timing of surgery in children with displaced supracondylar fractures of the humerus.

Methods

We reviewed retrospectively the postoperative outcomes and complications in these children managed in a district general hospital.

Results

There were 81 children with displaced supracondylar fractures (64 Gartland type III and 17 type IIA). Of these, 46 children were treated within 6 hours of presentation and 35 were treated later. The rate of open reduction was higher in children treated early (23%) than in late cases (11%). There was no significant difference in the postoperative outcomes and complications between the groups.

Conclusions

In children with a supracondylar fracture, the timing of surgical treatment (before or after six hours from presentation to hospital) had no effect on postoperative complications and outcomes.
Validation of martyn to simulate the keyhole supraorbital subfrontal approach
Authors: Marcus Hani J , Hughes-Hallett Archie , Pratt Philip , Yang Guang-Zhong , Darzi Ara , Nandi Dipankar
Published: July 2015

The Modelled Anatomical Replica for Training Young Neurosurgeons (MARTYN) has been created by the conservation team at The Royal College of Surgeons of England to simulate traumatic pathologies (such as extradural haemorrhage) and has been used with great success at relevant workshops. A modified MARTYN head has recently been developed that incorporates a vascular tree and pathology, allowing for the simulation of the keyhole supraorbital subfrontal approach. 1 Here we present a short validation study assessing its realism (face validity), usefulness (content validity) and ability to differentiate levels of surgical experience (construct validity).
Trainee and trainer opinion on increasing numbers of workplace-based assessments
Authors: Powell HRF , DiMarco AN , Saeed SR
Published: July 2015

The London Postgraduate School of Surgery has increased its minimum requirement for workplace-based assessments (WBAs) from 40 to 80 per annum. Specialty trainees were alerted to this increase by email in March 2012. This has been the requirement for core trainees since October 2011. In response to this increase for specialty trainees, an online survey was carried out to ascertain trainee and trainer opinion.
Government policy and the true cost of post-tonsillectomy bleeding
Authors: Parmar A , Hanks KA , Muir J , Evans K
Published: July 2015

In June 2010 the then Health Minister, Andrew Lansley, announced that hospitals would not be paid for readmissions within 30 days of discharge for all elective patients. This was thought to be in response to reducing bed numbers and climbing readmission rates. Reports have suggested that there had been a 50% increase in readmissions between 1998 and 2008. This government policy signalled a change that makes hospitals responsible for patient care for up to 30 days after discharge.
From Westminster
Authors: Leahy Patrick
Published: July 2015

Believing Cassandra: Will 2015 finally be the year of major service change?
Surgery in space
Authors: Winter George
Published: July 2015

George Winter goes where hardly any surgeons have gone before.
A Gender based Economic Analysis of Yam Production among Resource Poor Farm Households in Kwara State, Nigeria
Authors: Olorunsanya Eniola Oluwatoyin
Published: July 2015

The study carries out a gender based economic analysis of yam production among resource poor farm households in Kwara State with implication for poverty reduction in the state. One hundred and eighty randomly selected representative farm households were used for the study. Descriptive statistics, budgetary analysis and multiple regression model were the analytical tools. The results of the descriptive statistics show that 85% of the heads of the farm households were male with 66% of the male heads having no western education against 59% for the female-headed households. Labour cost was the major cost of production accounting for 64% and 66% of the total cost of production for the male and female-headed households, respectively. Yam production enterprise was profitable in the study area with net farm income of N136,950 and N128,800 for male and female-headed households, respectively. The return on capital employed was 48% and 45% for male and female-headed households, respectively. This shows that for every naira invested in yam production enterprise in the study area, average returns of 48kobo and 45kobo were obtained for the male and female-headed households, respectively. Farm size, family labour and yam seeds were the significant variables explaining the variation in yam output in the study area. Farm size and labour were under-utilised while yam seeds were over-utilised. The study recommends increased farm size and labour use per hectare and reduction in yam seeds per hectare for efficient resource use and increased net farm income for better living standard for the farm households.
Influence of irrigation with NaOCl and chlorhexidine on microleakage
Authors: Mylona Zoumpoulia , Gogos Christos , Economides Nikolaos
Published: July 2015

Background: Irrigation during endodontic therapy is required in order to remove debris, tissue remnants, microbes and smear layer. Sodium hypochlorite (NaOCl) and Chlorhexidine (CHX) are the most commonly used irrigants. Although they are reported to have good antimicrobial effects, both have limitations. Hence, a combination of NaOCl and CHX has been proposed to compensate for these limitations. However, this association forms a dense, orange-brown precipitate that stains walls of the pulp chamber. The aim of this study was to clarify in vitro if this precipitate affects the microleakage of endodontic sealers. Material and Methods: Extracted human teeth were used for this study. The teeth were cut at the height of the cervix and instrumented with NiTi rotary instruments. They were then divided into 2 experimental groups. In the first group (Group A) irrigations were performed with 2ml NaOCl 1%, 1ml EDTA 17% and 1ml CHX 0.2% and in the second (Group B) with 2ml NaOCl and 2ml CHX. Following this, they were obturated with gutta-percha and roth sealer. The microleakage was determined using a fluid filtration method. The measurements were repeated a month later. All analyses were performed using Fisher exact test. Results: Microleakage of Group A was lower than microleakage of Group B but the difference was not statistically significant. Conclusion: The precipitate that is formed by NaOCl and CHX did not affect microleakage of endodontic sealers.
Growing Apart: The Evolution of Income vs. Wealth Inequality
Authors: Cragg Michael , Ghayad Rand
Published: July 2015

The gap between the richest Americans and the rest of the nation has changed dramatically over the past three decades – becoming one of the most challenging political and economic trends for the nation. For decades prior to that, the distribution of wealth and income had been relatively stable, so much that a central problem posed in the economics literature was to explain this stability. But beginning in the early 1980s, inequality began to grow rapidly and has recently been attracting substantial attention from policymakers and researchers reflecting a widespread concern that reflecting a widespread concern that growing labor incomes of senior executives, finance professionals, and successful entrepreneurs is entailing large economic costs to society. The dominant paradigm in the media and Washington is that inequality is purely a matter of divergence in earned (labor) income inequality which can be ameliorated by making earned income taxes more progressive and shifting spending to help the poorer. However, this is not the story: wealth inequality, as it turns out, is much worse. This warrants emphasis for a variety of reasons: (1) a growing body of research that suggests that in the head-on comparison it is wealth inequality, rather than income inequality or poverty that has a negative, statistically significant effect on economic growth.
1

Bagchi and Svejnar (2013).

(2) Historically societies have failed when wealth has become overly concentrated; and (3) the wedge between earned and unearned income tax rates reduces progressivity as capital income rises. We offer a number of solutions which should generate debate amongst economists as they test conventional wisdom.
Intertheoricity: Plasticity, Elasticity and Hybridity of Theories. Part II: Semiotics of Transferogenesis
Authors: Guillaume Astrid
Published: July 2015

Theories are processes modelled by thought. When they evolve in time, they are transformed and become new theories. They may cross from one academic discipline to another, then open up to new areas of human knowledge, mixing together the humanities, art, science and even spirituality. The way they are modelled reveals their plasticity and their elasticity is tested in their potential for transfer from one field to another, while the different contacts they make and mergers they undergo generate a certain hybridity. Plasticity, elasticity and hybridity are the triad which makes the transfer of theories possible.
The Monastic Hermitage in the End of 19th Century French Literature: a New Identity Space
Authors: Cedergren Mickaëlle
Published: July 2015

Through a comparative reading of three novels of the late nineteenth century, namely Le Disciple, A rebours and Un homme libre, the monastic hermitage has emerged as a common place in which the protagonists of the novels, in search for a spiritual space, let themselves be shaped and transformed by the materiality of places. Through the consideration of the specific features of these closed and sacred sanctuaries, as well as the identity and the dream of the end of the 19th century man, a new literature searching for an ideal will appear openly.
Application of Deep Eutectic Solvent (DES) as a Reaction Media for the Esterification of Acrylic Acid with n-Butanol
Authors: Sert Emine
Published: July 2015

Within the framework of green chemistry, catalysts should be met different criteria such as biodegradability, recyclability, flammability, non-toxicity and low price. Acidic deep eutectic solvent (DES) have been synthesized for this purpose, by mixing para-toluene sulfonic acid and choline chloride. The catalytic activity of DES was studied in the esterification of acrylic acid with n-butanol. The usage of DES as catalyst is simple, safe and cheap. The effects of temperature, catalyst loading, n-butanol/acrylic acid molar ratio on the conversion of acrylic acid were performed. The batch reactor experiments were carried out at temperatures of 338, 348, 358 and 368 K, molar ratio of butanol to acrylic acid of 1, 2,3 and catalyst loading of 10, 15, 20 and 90 g/L. 90.2% of acrylic acid conversion was achieved at a temperature of 358 K and catalyst loading of 20 g/L. Reusability of DES was investigated. Reusability and catalytic activity makes DES efficient as catalyst.
Shrink-swell potential, hydraulic conductivity and geotechnical properties of clay materials for landfill liner construction
Authors: Widomski Marcin K. , Stępniewski Witold , Horn Rainer , Bieganowski Andrzej , Gazda Lucjan , Franus Małgorzata , Pawłowska Małgorzata
Published: July 2015

This paper presents studies concerning the applicability of two clay materials for the construction of a sustainable landfill liner. The studies consisted in determination of basic characteristics of the materials, eg particle size distribution, bulk density, particle density, total porosity, pore size, mineralogy, specific surface area, nanoparticle size, and Atterberg limits, as well as measurements of their geotechnical and hydraulic parameters, such as in situ saturated hydraulic conductivity, modules of primary and secondary compression, cohesion, and angle of internal friction. Furthermore, the effects of compaction performed by the Proctor method at various water contents on swelling and shrinkage characteristics and saturated hydraulic conductivity were investigated in order to determine the compliance with the national requirements for selection of material for landfill liner construction. The determined characteristics and geotechnical parameters of the tested clay materials allowed qualifying them as suitable for municipal landfill construction. The shrinkage potential of the tested clays observed was rated as moderate to very high. The cyclic drying and rewetting of the clay materials performed resulted in a significant increase in saturated hydraulic conductivity. Thus, the clay sealing layers, as part of a multilayer liner, should be very carefully operated, preventing the drying out of the clay sealing and assuring the possibility of its constant saturation.
Effects of bisphosphonates to treat osteoporosis in children with cerebral palsy: a meta-analysis
Authors: Kim Min Jeong , Kim Soo-Nyung , Lee In-Sik , Chung Sochung , Lee Joonchul , Yang YouNa , Lee Inho , Koh Seong-Eun
Published: July 2015

In childhood and adolescence, some patients with cerebral palsy (CP) have long-term limited mobility, which can lead to secondary osteoporosis, Prevention and treatment strategies have been evaluated for the management of low bone mineral density (BMD) and fragility fractures. Currently, however, there are no established guidelines for the stratification and individualization of therapeutic interventions. Recently, an increasing number of studies have reported on the use of bisphosphonates to increase BMD in various pediatric conditions, and bisphosphonates have been suggested as a method to treat osteoporosis and prevent fractures.

We performed the current meta-analysis to assess the effects of bisphosphonates on increasing BMD in children who have CP with secondary osteoporosis.

A search of PubMed, Cochrane, and Embase from inception to April 2014 was performed with the following keywords: (bone disease, metabolic OR osteoporosis OR osteopenia) AND (child OR pediatric OR adolescent) AND (cerebral palsy) AND (bisphosphonate). Four studies were ultimately included in the meta-analysis: one randomized, double-blinded, placebo-controlled study and three case-controlled studies.

The Z-score of lumbar spine was significantly improved after bisphosphonates treatment compared with pre-treatment values (standardized mean difference [SMD], 0.799; 95% confidence interval [CI], 0.499–1.100; p<0.001). The Z-score of femur was also improved significantly compared with that of the baseline value (SMD, 0.748; 95% CI, 0.382–1.114; p<0.001).

Bisphosphonates have a significant effect on improving BMD in children with CP. Further standardization of treatment protocols including treatment dosage and duration needs to be established, and long-term follow up studies are needed.
Feasibility of lipid mechanical extraction from viable Monoraphidium minutum
Authors: Dommange Xavier , Tanguy Philippe A. , Jolicoeur Mario
Published: July 2015

Background. Mechanical stress was investigated as a mean to harvest microalgal lipids without affecting algal cells’ viability. Monoraphidium minutum was cultivated in laboratory-scale photobioreactors and suspension cultures were submitted to mechanical stress to compare a cyclone, a centrifuge and a homogenizer. Lipid content within the extracellular medium was analyzed prior to and after treatment, and the amount of released lipids was quantified. Algal cell viability was also evaluated before and after treatment.

Results. After mechanical-stress treatments, 7.0 to 12.7% of the intracellular lipids of Monoraphidium minutum were released and found in the extracellular medium, while recovered algal cells presented low levels of disruption after treatments.

Conclusions. To the best of our knowledge, this is the first proof-of-concept demonstration on the use of mechanical stress for lipid extraction from viable microalgae. Certain level of centrifugation proved to make algae release around 10% of their lipids to the extracellular medium. This mostly exploratory work calls for deeper investigation, paving the way for a biofuel production based on continuous lipid recovery and microalgae reuses.