bluuebunny/crossref_metadata_2025 huggingface dataset:
The French Intervention in Mexico and the Empire of Maximilian and Carlota
Authors: Hernández-Sáenz Luz María
Published: February 2018

In 1861, Spanish, British, and French forces all landed in Veracruz to collect the debts Mexico owed them. After two months, the Spanish and British representatives reached an agreement with the Mexican government, but the French troops remained with the objective of imposing a monarchy. This period of occupation, 1861 to 1867, is known as the French Intervention. France’s interference in Mexico was partly due to the efforts of a group of conservative Mexican politicians who believed that a monarchical rather than a republican system would solve Mexico’s problems. In 1863, with the French army occupying Mexico City, the provisional government offered the crown to the Austrian archduke Maximilian of Habsburg. After long negotiations between Maximilian and the French emperor, Napoleon III (who would lend military support and extend credit to the future emperor), Maximilian signed the Treaty of Miramar and accepted the crown.

The empire faced the opposition of President Benito Juárez and his republicans, who rightfully claimed to be Mexico’s legitimate government. Furthermore, Maximilian, a liberal who believed in a secular society, clashed with both the clergy and his conservative supporters. A dismal financial situation, military opposition, and the emperor’s inability to reconcile the different political factions doomed his reign. The premature withdrawal of the French troops and Maximilian’s inability to form an effective army resulted in the empire’s demise. The last remnants of the imperial army were defeated in Querétaro on May 15, 1867, and Maximilian was executed. The monarchical experiment was a complete political and military failure for those who promoted it and for Napoleon III, who supported it.

Nonetheless, the empire was not a complete failure. The monarchy did set important precedents for the administrative organization of the country: promoting nationalism, solidifying liberal reforms including the separation of church and state, and establishing the foundation for the modernization of Mexico.
auctions
Authors: Andreau Jean
Published: February 2018

An auction is a type of sale consisting of a public competition between several buyers; whoever bids the highest price obtains the object being sold. Such auctions existed in the Greek as well as in the Roman world. Some were organized by the public authorities, while others were organized by individuals selling some of their goods at auction. In Roman Italy, these private auctions served a commercial function. In addition, they facilitated the sale of guarantees for unrepaid loans; likewise, they facilitated the management of private inheritance and estates. Between the 2nd century bce and the 3rd century ce, professional bankers regularly participated in these private auctions by providing credit to the buyers.
lex Cincia on gifts
Authors: Candy Peter
Published: February 2018

The lex Cincia, most likely a plebiscite of 204 bce, was a law that placed restrictions on the giving and receiving of gifts. It contained both an absolute prohibition on gifts made to advocates for the pleading of cases and a general prohibition on gifts exceeding a certain (unknown) value. The general prohibition did not, however, apply to persons who enjoyed a specifically exempted relationship. The law was probably intended to curb the extortionary abuse of gift giving by social and economic elites who, after the devastation of the Second Punic War, were motivated to extract ever-more considerable gifts from their clients. The lex Cincia probably served an expressive function more than anything else, since it made no provision for voiding gifts and only provided for sanctions in limited circumstances.
Korean Syntax
Authors: Yoon James Hye Suk
Published: February 2018

The syntax of Korean is characterized by several signature properties. One signature property is head-finality. Word order variations and restrictions obey head-finality. Korean also possesses wh in-situ as well as internally headed relative clauses, as is typical of a head-final language. Another major signature property is dependent-marking. Korean has systematic case-marking on nominal dependents and very little, if any, head-marking. Case-marking and related issues, such as multiple case constructions, case alternations, case stacking, case-marker ellipsis, and case-marking on adjuncts, are front and center properties of Korean syntax as viewed from the dependent-marking perspective. Research on these aspects of Korean has contributed to the theoretical understanding of case and grammatical relations in linguistic theory. Korean is also characterized by agglutinative morphosyntax. Many issues in Korean syntax straddle the morphology-syntax boundary. Korean morphosyntax constitutes a fertile testing ground for ongoing debates about the relationship between morphology and syntax in domains such as coordination, deverbal nominalizations (mixed category constructions), copula, and other denominal constructions. Head-finality and agglutinative morphosyntax intersect in domains such as complex/serial verb and auxiliary verb constructions. Negation, which is a type of auxiliary verb construction, and the related phenomena of negative polarity licensing, offer important evidence for crosslinguistic understanding of these phenomena. Finally, there is an aspect of Korean syntax that reflects areal contact. Lexical and grammatical borrowing, topic prominence, pervasive occurrence of null arguments and ellipsis, as well as a complex system of anaphoric expressions, resulted from sustained contact with neighboring Sino-Tibetan languages.
Agricultural Methanogenesis
Authors: Hristov Alexander N.
Published: February 2018

Agriculture is a significant source of methane, contributing about 12% of the global anthropogenic methane emissions. Major sources of methane from agricultural activities are fermentation in the reticulo-rumen of ruminant animals (i.e., enteric methane), fermentation in animal manure, and rice cultivation. Enteric methane is the largest agricultural source of methane and is mainly controlled by feed dry matter intake and composition of the animal diet (i.e., fiber, starch, lipids). Processes that lead to generation of methane from animal manure are similar to those taking place in the reticulo-rumen. Methane emissions from manure, however, are greatly influenced by factors such as manure management system and ambient temperature. Systems that handle manure as a liquid generate much more methane than systems in which manure is handled as a solid. Low ambient temperatures drastically decrease methane emissions from manure. Once applied to soil, animal manure does not generate significant amounts of methane. Globally, methane emissions from rice cultivation represent about 10% of the total agricultural greenhouse gas emissions. In the rice plant, methane dissolves in the soil water surrounding the roots, diffuses into the cell-wall water of the root cells, and is eventually released through the micropores in the leaves. Various strategies have been explored to mitigate agricultural methane emissions. Animal nutrition, including balancing dietary nutrients and replacement of fiber with starch or lipids; alternative sinks for hydrogen; manipulation of ruminal fermentation; and direct inhibition of methanogenesis have been shown to effectively decrease enteric methane emissions. Manure management solutions include solid-liquid separation, manure covers, flaring of generated methane, acidification and cooling of manure, and decreasing manure storage time before soil application. There are also effective mitigation strategies for rice that can be categorized broadly into selection of rice cultivars, water regime, and fertilization. Alternate wetting and drying and mid-season drainage of rice paddies have been shown to be very effective practices for mitigating methane emissions from rice production.
Efficient Estimation of Risk Preferences
Authors: Wu Feng , Guan Zhengfei
Published: February 2018

Risk and the risk attitude of agents are two fundamental elements of decision making under risk and uncertainty. Recent developments in risk and risk preference analyses have raised questions on conventional approaches to estimating risk preferences. This study proposes an estimation procedure that employs a seminonparametric estimator to estimate the density function of risk without imposing distributional assumptions, as well as a numerical integration method to construct closed‐form expressions of conditional moment conditions for efficient estimation. The method achieves a substantial efficiency improvement relative to the conventional GMM approach in Monte Carlo simulations. The proposed approach is general and applies to the estimation of behavioral choice models under risk, or models that require expectation operations and closed‐form equations for estimation.
External Ventricular Drain Placement Accuracy and Safety When Done by Midlevel Practitioners
Authors: Ellens Nathaniel R , Fischer D Luke , Meldau Jason E , Schroeder Brett A , Patra Sanjay E
Published: February 2018

BACKGROUND

External ventricular drains (EVDs) measure intracranial pressure, divert cerebrospinal fluid, and allow for orthotropic administration of pharmacologic agents. Currently, neurosurgeons and neurosurgery residents are the primary practitioners placing EVDs. Due to the urgency of neurosurgical pathologies and the lack of qualified residents at most hospitals, midlevel practitioner (MLP) placement of EVDs would be advantageous.

OBJECTIVE

To assess the accuracy and complication rates of MLP and neurosurgeon EVD placement.

METHODS

This was a retrospective cohort of all patients with an EVD placed between January 2012 and September 2016 at a level 1 trauma center. We compared safety and accuracy of EVD placement between neurosurgeons and MLPs.

RESULTS

MLP first attempted EVD placement in 238 patients and senior neurosurgeon first attempted EVD placement in 70 subjects. There was no significant difference between accuracy of placement within the ventricle (87.4% vs 90.0%, P = .5557), hemorrhage rate (5.9% vs 4.3%, P = .77), or infection rate (0.8% vs 1.4%, P = .5399) for placement attempted by an MLP compared with a neurosurgeon, respectively.

CONCLUSION

MLPs perform EVD placement safely with no significant difference in accuracy of placement or complication rates compared with placement by senior neurosurgeons. This may allow for earlier management of elevated intracranial pressure and access to care where previously unavailable; leading to improved patient outcomes.
Silent Witnesses: Faculty Reluctance to Report Medical Students’ Professionalism Lapses
Authors: Ziring Deborah , Frankel Richard M. , Danoff Deborah , Isaacson J. Harry , Lochnan Heather
Published: February 2018

Purpose

Assessing students’ professionalism is a critical component of medical education. Nonetheless, faculty reluctance to report professionalism lapses remains a significant barrier to the effective identification, management, and remediation of such lapses. The authors gathered information from faculty who supervise medical students to better understand their perceived barriers to reporting.

Method

In 2015–2016, data were collected using a group concept mapping methodology, which is an innovative, asynchronous, structured mixed-methods approach using qualitative and quantitative measures to identify themes characterizing faculty reluctance to report professionalism lapses. Participants from four U.S. and Canadian medical schools brainstormed, sorted, and rated statements about perceived barriers to reporting. Multidimensional scaling and hierarchical cluster analyses were used to analyze these data.

Results

Of 431 physicians invited, 184 con-tributed to the brainstorming task (42.7%), 48 completed the sorting task (11.1%), and 83 completed the rating task (19.3%). Participants identified six barriers or themes to reporting lapses. The themes “uncertainty about the process,” “ambiguity about the ‘facts,’” “effects on the learner,” and “time constraints” were rated highest as perceived barriers. Demographic subgroup analysis by gender, years of experience supervising medical students, years since graduation, and practice discipline revealed no significant differences (P > .05).

Conclusions

The decision to report medical students’ professionalism lapses is more complex and nuanced than a binary choice to report or not. Faculty face challenges at the systems level and individual level. The themes identified in this study can be used for faculty development and to improve processes for reporting students’ professionalism lapses.
Advancing Health Professions Education Research by Creating a Network of Networks
Authors: Carney Patricia A. , Brandt Barbara , Dekhtyar Michael , Holmboe Eric S.
Published: February 2018

Producing the best evidence to show educational outcomes, such as competency achievement and credentialing effectiveness, across the health professions education continuum will require large multisite research projects and longitudinal studies. Current limitations that must be overcome to reach this goal include the prevalence of single-institution study designs, assessments of a single curricular component, and cross-sectional study designs that provide only a snapshot in time of a program or initiative rather than a longitudinal perspective.

One solution to overcoming these limitations is to develop a network of networks that collaborates, using longitudinal approaches, across health professions and regions of the United States. Currently, individual networks are advancing educational innovation toward understanding the effectiveness of educational and credentialing programs. Examples of such networks include (1) the American Medical Association’s Accelerating Change in Medical Education initiative, (2) the National Center for Interprofessional Practice and Education, and (3) the Accreditation Council for Graduate Medical Education’s Accreditation System. In this Invited Commentary, the authors briefly profile these existing networks, identify their progress and the challenges they have encountered, and propose a vigorous way forward toward creating a national network of networks designed to determine the effectiveness of health professions education and credentialing.
Neuroimaging of Pain
Authors: Martucci Katherine T. , Mackey Sean C.
Published: February 2018

Neuroimaging research has demonstrated definitive involvement of the central nervous system in the development, maintenance, and experience of chronic pain. Structural and functional neuroimaging has helped elucidate central nervous system contributors to chronic pain in humans. Neuroimaging of pain has provided a tool for increasing our understanding of how pharmacologic and psychologic therapies improve chronic pain. To date, findings from neuroimaging pain research have benefitted clinical practice by providing clinicians with an educational framework to discuss the biopsychosocial nature of pain with patients. Future advances in neuroimaging-based therapeutics (e.g., transcranial magnetic stimulation, real-time functional magnetic resonance imaging neurofeedback) may provide additional benefits for clinical practice. In the future, with standardization and validation, brain imaging could provide objective biomarkers of chronic pain, and guide treatment for personalized pain management. Similarly, brain-based biomarkers may provide an additional predictor of perioperative prognoses.
Validation of a Novel Molecular Host Response Assay to Diagnose Infection in Hospitalized Patients Admitted to the ICU With Acute Respiratory Failure
Authors: Koster-Brouwer Maria E. , Verboom Diana M. , Scicluna Brendon P. , van de Groep Kirsten , Frencken Jos F. , Janssen Davy , Schuurman Rob , Schultz Marcus J. , van der Poll Tom , Bonten Marc J.M. , Cremer Olaf L. ,   on behalf of the MARS Consortium
Published: February 2018

Objectives:

Discrimination between infectious and noninfectious causes of acute respiratory failure is difficult in patients admitted to the ICU after a period of hospitalization. Using a novel biomarker test (SeptiCyte LAB), we aimed to distinguish between infection and inflammation in this population.

Design:

Nested cohort study.

Setting:

Two tertiary mixed ICUs in the Netherlands.

Patients:

Hospitalized patients with acute respiratory failure requiring mechanical ventilation upon ICU admission from 2011 to 2013. Patients having an established infection diagnosis or an evidently noninfectious reason for intubation were excluded.

Interventions:

None.

Measurement and Main Results:

Blood samples were collected upon ICU admission. Test results were categorized into four probability bands (higher bands indicating higher infection probability) and compared with the infection plausibility as rated by post hoc assessment using strict definitions. Of 467 included patients, 373 (80%) were treated for a suspected infection at admission. Infection plausibility was classified as ruled out, undetermined, or confirmed in 135 (29%), 135 (29%), and 197 (42%) patients, respectively. Test results correlated with infection plausibility (Spearman’s rho 0.332; p < 0.001). After exclusion of undetermined cases, positive predictive values were 29%, 54%, and 76% for probability bands 2, 3, and 4, respectively, whereas the negative predictive value for band 1 was 76%. Diagnostic discrimination of SeptiCyte LAB and C-reactive protein was similar (p = 0.919).

Conclusions:

Among hospitalized patients admitted to the ICU with clinical uncertainty regarding the etiology of acute respiratory failure, the diagnostic value of SeptiCyte LAB was limited.
Presepsin and Inflammatory Markers Correlate With Occurrence and Severity of Nonocclusive Mesenteric Ischemia After Cardiovascular Surgery
Authors: Stroeder Jonas , Bomberg Hagen , Wagenpfeil Stefan , Buecker Arno , Schaefers Hans-Joachim , Katoh Marcus , Groesdonk Heinrich Volker , Minko Peter
Published: February 2018

Objectives:

To prospectively evaluate the relationship of established inflammatory markers and presepsin on nonocclusive mesenteric ischemia and to correlate presepsin levels to the occurrence and severity of nonocclusive mesenteric ischemia.

Design:

Patients were prospectively enrolled and blood samples taken, followed by a retrospective evaluation of laboratory values and angiographic findings. The study was ethics committee approved.

Settings:

Patients with clinical suspicion of nonocclusive mesenteric ischemia underwent catheter angiography of the superior mesenteric artery. Images were assessed by two experienced radiologists on consensus basis using a previously published standardized reporting system (Homburg-Nonocclusive Mesenteric Ischemia-Score). Two groups were formed according to the severity of nonocclusive mesenteric ischemia, mild and severe, patients without clinical signs of nonocclusive mesenteric ischemia formed the reference group. These data were correlated to inflammatory blood markers assessed pre- and postoperatively: C-reactive protein, leucocytes, procalcitonin, and presepsin as well as outcome data.

Patients:

Between January 2010 and March 2011, a total of 839 patients undergoing cardiovascular surgery participated in this study.

Measurements and Main Results:

Mild nonocclusive mesenteric ischemia was diagnosed in 4.5%, and severe nonocclusive mesenteric ischemia in 3.2%. Median postoperative presepsin concentrations were significantly greater in mild and severe nonocclusive mesenteric ischemia than in non-nonocclusive mesenteric ischemia. Statistics showed that postoperative presepsin better discriminated mild and severe nonocclusive mesenteric ischemia than any other tested biomarker.

Conclusions:

Elevated postoperative plasma presepsin concentrations are an independent predictor of mild and severe nonocclusive mesenteric ischemia. The established inflammatory blood markers significantly correlate with the development and severity of nonocclusive mesenteric ischemia.
Exploring the Knowledge Structure of Nursing Care for Older Patients With Delirium
Authors: Choi Jung Eun , Kim Mi So
Published: February 2018

Prevention of delirium is considered a critical part of the agenda for patient safety and an indicator of healthcare quality for older patients. As the incidence rate of delirium for older patients has increased in recent years, there has been a significant expansion in knowledge relevant to nursing care. The purposes of this study were to analyze the knowledge structure and trends in nursing care for older adults with delirium based on a keyword network analysis, and to provide a foundation for future research. Data analysis showed that knowledge structure in this area consists of three themes of research: postoperative acute care for older patients with delirium, prevention of delirium for older patients in intensive care units, and safety management for the improvement of outcomes for patients with delirium. Through research trend analysis, we found that research on care for patients with delirium has achieved both quantitative and qualitative improvements over the last decades. Concerning future research, we propose the expansion of patient- and family-centered care, community care, specific nursing interventions, and the integration of new technology into care for patients with delirium. These results provide a reference framework for understanding and developing nursing care for older adults with delirium.
Uncertainty and Quality of Life in Women With Breast Cancer
Authors: Ahadzadeh Ashraf Sadat , Sharif Saeed Pahlevan
Published: February 2018

Background

The negative relationship between uncertainty and quality of life is well reported in the literature. Also, there is abundant research linking coping strategies to cancer patients' quality of life. However, there exists a paucity of information on the moderating effect of coping styles on the relationship between uncertainty and quality of life in cancer patients.

Objective

The aim of this study was to examine whether uncertainty in illness is negatively correlated with quality of life and whether this relationship is moderated by coping strategies, namely, problem-focused, avoidant, and active emotional coping.

Methods

A convenience sample of 135 Malaysian women with breast cancer participated in the study. Participants completed measures of uncertainty in illness, quality of life, and coping styles.

Results

Uncertainty in breast cancer was negatively related to quality of life (β = −0.379,P< .001), and active emotional coping was found to moderate this negative relationship (β = 0.155,P< .05). The model explained 22.20% of the variance of quality of life.

Conclusion

Lack of information about breast cancer, treatment, hospitalization, and disease recurrence is related to poorer quality of life. However, this negative relationship becomes weaker when active emotional coping strategies are used.

Implications for Practice

Nurses and health providers should help patients reduce their uncertainty in illness by providing them information on breast cancer or referring them to relevant sources. Moreover, they could reduce the deleterious effect of uncertainty on quality of life by encouraging patients to use more active emotional coping strategies.
When Advocacy Extends Life
Authors: Matey Laurl
Published: February 2018

Despite education and professional preparation, age and diagnosis discrimination persists in health care. A case scenario describes discrimination that could have resulted in untimely death without advocacy and intervention by 1 informed professional. Nurses must identify their own attitudes and behaviors associated with age, diagnosis, and their role within the interprofessional team to identify when discrimination may be occurring and claim their responsibility as advocate to ethically intervene on behalf of patients and families when appropriate.
Simulation as an Assessment Strategy to Assist With Unit Placement for New Graduate Nurses
Authors: Arias Alicia , Sander Rebecca , Siek Terry
Published: February 2018

Orienting new graduates through simulation, which incorporated critical thinking performance at the bedside, improved their readiness to respond to critical situations and eased transition to the appropriately assigned unit. Graduate nurses’ critical thinking processes at the bedside were observed and scored according to how quickly correct diagnoses were made and interventions identified. A scorecard was developed based on defined criteria.
Can You Escape? Creating an Escape Room to Facilitate Active Learning
Authors: Adams Vickie , Burger Stephanie , Crawford Kaile , Setter Robyn
Published: February 2018

Nursing professional development practitioners have the responsibility to find creative and innovative ways to teach and provide learners with the education needed to practice safely in the hospital setting. This article describes an interactive game-based learning experience as a way to engage and empower both nurse residents and experienced nurses.
Clinical Transition Framework
Authors: Boyer Susan A. , Mann-Salinas Elizabeth A. , Valdez-Delgado Krystal K.
Published: February 2018

The clinical transition framework (CTF) is a competency-based practice development system used by nursing professional development practitioners to support nurses’ initial orientation or transition to a new specialty. The CTF is applicable for both new graduate and proficient nurses. The current framework and tools evolved from 18 years of performance improvement and research projects engaged in both acute and community care environments in urban and rural settings. This article shares core CTF concepts, a description of coaching plans, and a professional accountability statement as experienced within the framework.
Continuous Intravenous Valproate as Abortive Therapy for Pediatric Status Migrainosus
Authors: Zafar Muhammad S. , Stewart Alejandra M. , Toupin David N. , Cook Aaron M. , Baumann Robert J.
Published: February 2018

Objective:

This study describes the use of continuous intravenous valproate as an abortive therapy for pediatric status migrainosus.

Background:

Intravenous valproate as a bolus dose has been shown to be an effective abortive therapy for status migrainosus in children; however, Valproate’s pharmacokinetic profile suggests that it would be safer and more therapeutic as a continuous infusion. This dosing strategy results in less serum concentration fluctuations, more consistent therapeutic effects, and less adverse effects.

Methods:

A retrospective chart review between August 2009 and August 2012 identified 83 patients who had presented with status migrainosus and had received continuous intravenous valproate after failing to respond to initial abortive treatment. These patients had received a 20 mg/kg loading dose, followed by continuous infusion at 1 mg/kg/h. Serum valproate levels had been drawn 4 hours and 24 hours after the loading dose. Infusion rate had been adjusted to maintain serum levels of 80 to 100 mcg/mL. Age-appropriate pain assessments had been recorded at regular intervals. Excellent response was defined as a 100% reduction in pain scores, moderate response as 50% to 99% reduction, and poor response as <50% reduction.

Results:

Of the 83 patients, 55 (66.2%) had reported an excellent response, 4 (4.8%) a moderate response, and 24 (28.9%) a poor response. Of those reporting an excellent response, 76% had responded within 24 hours. Nausea (8.4%) and vomiting (2.4%) had been the only reported side effects. Twenty-four hour serum levels had been within the goal range 91.9% of the time.

Conclusions:

Continuous intravenous valproate is safe, easy to monitor, and therapeutic in the abortive treatment of status migrainosus in pediatric patients.
Stiff Neck and Drooling in a Young Girl
Authors: Prince William B. , Cantor Richard M.
Published: February 2018

A 3-year-old girl was brought to the emergency department 4 days after she was playing with a button battery and subsequently had a choking episode. The patient was seen immediately at a different emergency department and was discharged home after a normal chest x-ray finding and able to tolerate an oral challenge with liquids. She was later evaluated by her primary care physician and started on amoxicillin for possible pharyngitis. On examination in our emergency department, the patient had pooling of secretions and was unwilling to range her neck due to pain. Soft tissue neck x-ray confirmed a 20-mm button battery in the esophagus with air lucencies in the prevertebral soft tissues.
Examining the Reproducibility of 6 Published Studies in Public Health Services and Systems Research
Authors: Harris Jenine K. , Wondmeneh Sarah B. , Zhao Yiqiang , Leider Jonathon P.
Published: February 2018

Objective:

Research replication, or repeating a study de novo, is the scientific standard for building evidence and identifying spurious results. While replication is ideal, it is often expensive and time consuming. Reproducibility, or reanalysis of data to verify published findings, is one proposed minimum alternative standard. While a lack of research reproducibility has been identified as a serious and prevalent problem in biomedical research and a few other fields, little work has been done to examine the reproducibility of public health research. We examined reproducibility in 6 studies from the public health services and systems research subfield of public health research.

Design:

Following the methods described in each of the 6 papers, we computed the descriptive and inferential statistics for each study. We compared our results with the original study results and examined the percentage differences in descriptive statistics and differences in effect size, significance, and precision of inferential statistics. All project work was completed in 2017.

Results:

We found consistency between original and reproduced results for each paper in at least 1 of the 4 areas examined. However, we also found some inconsistency. We identified incorrect transcription of results and omitting detail about data management and analyses as the primary contributors to the inconsistencies.

Recommendations:

Increasing reproducibility, or reanalysis of data to verify published results, can improve the quality of science. Researchers, journals, employers, and funders can all play a role in improving the reproducibility of science through several strategies including publishing data and statistical code, using guidelines to write clear and complete methods sections, conducting reproducibility reviews, and incentivizing reproducible science.
Beyond Research Ethics: Novel Approaches of 3 Major Public Health Institutions to Provide Ethics Input on Public Health Practice Activities
Authors: Klingler Corinna , Barrett Drue H. , Ondrusek Nancy , Johnson Brooke R. , Saxena Abha , Reis Andreas A.
Published: February 2018

Public health institutions increasingly realize the importance of creating a culture in their organizations that values ethics. When developing strategies to strengthen ethics, institutions will have to take into account that while public health research projects typically undergo thorough ethics review, activities considered public health practice may not be subjected to similar oversight. This approach, based on a research-practice dichotomy, is increasingly being criticized as it does not adequately identify and manage ethically relevant risks to those affected by nonresearch activities. As a reaction, 3 major public health institutions (the World Health Organization, US Centers for Disease Control and Prevention, and Public Health Ontario) have implemented mechanisms for ethics review of public health practice activities. In this article, we describe and critically discuss the different modalities of the 3 approaches. We argue that although further evaluation is necessary to determine the effectiveness of the different approaches, public health institutions should strive to implement procedures to ensure that public health practice adheres to the highest ethical standards.
Dual-Energy Computed Tomography–Based Display of Bone Marrow Edema in Incidental Vertebral Compression Fractures
Authors: Frellesen Claudia , Azadegan Mehrnoush , Martin Simon S. , Otani Katharina , D'Angelo Tommaso , Booz Christian , Eichler Katrin , Panahi Bita , Kaup Moritz , Bauer Ralf W. , Vogl Thomas J. , Wichmann Julian L.
Published: February 2018

Purpose

The aim of this study was to evaluate the diagnostic performance of virtual noncalcium (VNCa) dual-energy computed tomography (DECT) reconstructions enabling visualization of bone marrow edema for characterization of incidental thoracolumbar compression fractures in routine thoracoabdominal staging computed tomography (CT).

Materials and Methods

We retrospectively analyzed 51 oncological patients without suspected fracture or indicative complaints presenting at least 1 thoracolumbar compression fracture on routine thoracoabdominal staging DECT who had been examined between October 2015 and June 2017 using third-generation dual-source CT, had a previous CT within 3 months before, and also had undergone additional magnetic resonance imaging within 14 days, which served as the standard of reference. Three independent and blinded radiologists initially evaluated all vertebrae on conventional grayscale DECT series; after at least 8 weeks, observers reevaluated all cases using grayscale and color-coded VNCa DECT images. The age of each fracture was determined as either acute, chronic, or inconclusive. Specificity, sensitivity, and intraobserver and interobserver agreements were calculated taking into account clustering.

Results

A total of 98 vertebral compression fractures were detected in 51 patients (20 women, 31 men; median of 1 fracture per patient). The reference standard defined 45 as acute and 53 as chronic. For identification of only acute fractures (cutoff 1), the combination of grayscale and VNCa image series showed a higher sensitivity (91% vs 47%;P< 0.001) but equal specificity (both 100%) compared with analysis of grayscale images alone. When defining a positive finding as a fracture considered either acute or inconclusive (cutoff 2), combined analysis of grayscale and VNCa images showed similar sensitivity (96% vs 93%;P= 0.28) but significantly higher specificity (96% vs 75%;P< 0.001) compared with evaluation of grayscale images alone. Area under the curve analysis for detection of vertebral compression fractures showed superior results for reading of grayscale and VNCa image series (0.98) compared with analysis of grayscale images alone (0.89;P< 0.001).

Conclusion

Dual-energy CT–derived color-coded VNCa reconstructions substantially improve the characterization of incidental thoracolumbar compression fractures seen on routine thoracoabdominal staging DECT by allowing for visualization of bone marrow edema.
Contour Restoration of Over-Resected Mandibular Angle and Lower Border by Reduction Mandibuloplasty Using Three-Dimensional Planning and Computer-Aided Design and Manufacturing Custom-Made Titanium Implants
Authors: Woo Jae Man , Baek Seung-Hak , Kim Jong-Cheol , Choi Jin-Young
Published: February 2018

Objective:

The purpose of this clinical report was to introduce a new methodology for contour restoration of the over-resected mandible by reduction mandibuloplasty using 3-dimensional (3D) planning and computer-assisted design and manufacturing (CAD-CAM) custom-made titanium implants.

Patient and method:

A 20-year-old male patient had undergone reduction of the zygoma and mandibular angle and lower border for esthetic reason 1 year ago at a private clinic. However, he was not satisfied with surgical outcome and wanted to restore his original facial volume and contour. To assess the volume and dimension of resected bone, 3D-computed tomography (3D-CT) data at the original stage was superimposed with postsurgical CT. For restoration of the malar prominence, porous polyethylene malar implants with extensions into the lateral malar region (Medpor) were placed and fixed with microscrews. Custom-made titanium implants were fabricated for contour restoration of the mandibular angle and lower border using CAD-CAM technology (iDDA, Daegu, South Korea). Two-piece design per each titanium implant was adopted for easy placement and avoidance of tissue damage during placement. Thin buccal extension was incorporated for placement of screw holes. Location, direction, and length of bicortical screws were planned to avoid damage of the inferior alveolar nerve.

Result:

With the help of 3D planning and CAD-CAM technology, rigid fixation of the custom-made titanium implants into the mandibular angle and lower border successfully restored the contour of over-resected mandible to the original state.

Conclusion:

When over-resection by reduction mandibuloplasty becomes an issue, this method may be an effective treatment option for contour restoration of over-resected mandibular angle and lower border.
Simplified Access for Reduction and Fixation of a Frontal Bone Fracture
Authors: Pires Willian Ricardo , Oliveira Puttini Igor de , Oliva André Hergesel de , Jacob Ricardo Garcia Mureb , Figueira Júnior Heldo Cesar , Sonoda Celso Koogi , Fabris André Luis da Silva , Faverani Leonardo Perez , Souza Francisley Ávila , Júnior Idelmo Rangel Garcia
Published: February 2018

The frontal bone fractures occur very often in service units in oral and maxillofacial surgery. Bicoronal access is the most common for the surgical treatment of frontal bone fractures. However, patients are surprised when they receive notice that such invasive access will be made. This approach allows adequate visualization of the fracture site, but may be associated with complications, which can be avoided by the use of less invasive techniques. We describe an alternative approach that aims to minimize the complications of a coronal incision.
Virtual Surgical Planning for Correction of Delayed Presentation Scaphocephaly Using a Modified Melbourne Technique
Authors: Macmillan Alexandra , Lopez Joseph , Mundinger Gerhard S. , Major Melanie , Medina Miguel A. , Dorafshar Amir H.
Published: February 2018

Background:

Late treatment of scaphocephaly presents challenges including need for more complex surgery to achieve desired head shape. Virtual surgical planning for total vault reconstruction may mitigate some of these challenges, but has not been studied in this unique and complex clinical setting.

Methods:

A retrospective chart review was conducted for patients with scaphocephaly who presented to our institution between 2000 and 2014. Patients presenting aged 12 months or older who underwent virtual surgical planning-assisted cranial vault reconstruction were included. Patient demographic, intraoperative data, and postoperative outcomes were recorded. Pre- and postoperative anthropometric measurements were obtained to document the fronto-occipital (FO) and biparietal (BP) distance and calculate cephalic index (CI). Virtual surgical planning predicted, and actual postoperative anthropometric measurements were compared.

Results:

Five patients were identified who fulfilled inclusion criteria. The mean age was 50.6 months. One patient demonstrated signs of elevated intracranial pressure preoperatively. Postoperatively, all but one needed no revisional surgery (Whitaker score of 1). No patient demonstrated postoperative evidence of bony defects, bossing, or suture restenosis. The mean preoperative, simulated, and actual postoperative FO length was 190.3, 182, and 184.3 mm, respectively. The mean preoperative, simulated, and actual postoperative BP length was 129, 130.7, and 131 mm, respectively. The mean preoperative, simulated, and actual postoperative CI was 66, 72, and 71.3, respectively.

Conclusions:

Based on our early experience, virtual surgical planning using a modified Melbourne technique for total vault remodeling achieves good results in the management of late presenting scaphocephaly.
Short-Blunt Injury in Child Resulting From Pet Bite
Authors: de Lima Valthierre Nunes , Momesso Gustavo Antonio Correa , Colombo Luara Teixeira , Mulinari-Santos Gabriel , de Sousa Cecília Alves , Polo Tárik Ocon Braga , Garcia-Júnior Idelmo Rangel , Faverani Leonardo Perez
Published: February 2018

The frequency of accidents due to dog bite in children is high, and in the most cases, the child already knows the aggressor dog. Patient, 3 years, female, melanoderm, victim of pet dog attack on the right side of the face region. After the physical examination, conscious sedation was performed with the supplementation of oxygen by pediatrics and the suture by oral and maxillofacial surgeon, under local anesthesia with adrenergic vasoconstrictor, with internal points in the muscles using vicryl 4-0 and in the skin with 5-0 nylon; the lesser number of stitches were performed in the lower region of the wound, allowing spontaneous drainage spaces. The immediate wounds closure of dog bites on the face is safe, even in cases after several hours of the injury.
Autologous Free Fat Grafting for Management of the Facial Contour Asymmetry
Authors: Denadai Rafael , Raposo-Amaral Cesar Augusto , Buzzo Celso Luiz , Raposo-Amaral Cassio Eduardo
Published: February 2018

Background:

The purposes of this study were to report autologous free fat grafting as the workhorse procedure to augment the facial soft-tissue envelope and restore facial contour symmetry of patients with asymmetric facial malformations; to detail the SOBRAPAR Hospital algorithm for soft-tissue reconstruction of patients with facial contour asymmetry; and to assess facial symmetry after fat grafting.

Methods:

A retrospective analysis of consecutive patients (n = 178) who underwent fat grafting to restore the facial contour symmetry according to the SOBRAPAR Hospital algorithm between 2009 and 2016 was conducted. Computerized photogrammetric quantitative and qualitative facial symmetry analyses were performed.

Results:

There were significant (all P < 0.05) postoperative quantitative facial symmetry enhancement and an overall qualitative facial symmetry enhancement, with a mean fat graft procedures per patient of 1.6 ± 0.7, ranging of 1 to 3.

Conclusion:

A significant improvement of facial contour symmetry was obtained in a subset of patients using fat grafting according to the SOBRAPAR Hospital algorithm.
Autologous Bone Marrow Concentrates and Concentrated Growth Factors Accelerate Bone Regeneration After Enucleation of Mandibular Pathologic Lesions
Authors: Talaat Wael M. , Ghoneim Mohamed M. , Salah Omar , Adly Osama A.
Published: February 2018

Stem cell therapy is a revolutionary new way to stimulate mesenchymal tissue regeneration. The platelets concentrate products started with platelet-rich plasma (PRP), followed by platelet-rich fibrin (PRF), whereas concentrated growth factors (CGF) are the latest generation of the platelets concentrate products which were found in 2011. The aim of the present study was to evaluate the potential of combining autologous bone marrow concentrates and CGF for treatment of bone defects resulting from enucleation of mandibular pathologic lesions. Twenty patients (13 males and 7 females) with mandibular benign unilateral lesions were included, and divided into 2 groups. Group I consisted of 10 patients who underwent enucleation of the lesions followed by grafting of the bony defects with autologous bone marrow concentrates and CGF. Group II consisted of 10 patients who underwent enucleation of the lesions without grafting (control). Radiographic examinations were done immediately postoperative, then at 1, 3, 6, and 12 months, to evaluate the reduction in size and changes in bone density at the bony defects. Results indicated a significant increase in bone density with respect to the baseline levels in both groups (P < 0.05). The increase in bone density was significantly higher in group I compared with group II at the 6- and 12-month follow-up examinations (P < 0.05). The percent of reduction in the defects’ size was significantly higher in group I compared with group II after 12 months (P = 0.00001). In conclusion, the clinical application of autologous bone marrow concentrates with CGF is a cost effective and safe biotechnology, which accelerates bone regeneration and improves the density of regenerated bone.
Active Intracystic Negative Pressure Could Induce Osteogenesis
Authors: Castro-Núñez Jaime
Published: February 2018

Based on previous findings, the author introduces the term “sugosteogenesis,” a biological phenomenon that occurs by using the Evocyst, a device that exerts active intracystic negative pressure. The term “sugosteogenesis” comes from the Latin word “sugo-,” meaning “suck,” and Greek words “osteo-,” meaning “bone,” and genesis, “origin.”
Clinical Efficacy Evaluation for Treating Trigeminal Neuralgia Using a Personalized Digital Guide Plate-Assisted Temperature-Controlled Radiofrequency
Authors: Zhao Suli , Deng Mohong , Cai Hengxing , Meng Qinggong , Fang Wei , Ke Jin , Long Xing
Published: February 2018

The aim of this study was to explore the application and efficacy of personalized digital guiding plate-aided radiofrequency in treating trigeminal neuralgia (TN). A total of 117 cases (93 patients) of TN from January 2015 to December 2016 were divided into the study group (n = 53) and the traditional group (n = 64). Patients in the study group were treated by the radiofrequency through a personalized digital guiding plate, whereas those in the traditional group were treated by the traditional method. We found that no significant difference between these 2 groups in age, sex, and divisions affected (V2, V3). However, the values for operation time, recurrence rate, and patient's satisfaction in the plate assisted group were significantly improved compared with those in the traditional group. Therefore, the personalized digital guiding plate-assisted radiofrequency has higher application value than traditional method.
Suitability of Wrist External Fixator for Treatment of Mandibular Fracture
Authors: Alencar Marília Gabriela Mendes de , Bortoli Manoela Moura De , Silva Thiago Coelho Gomes da , Silva Emanuel Dias de Oliveira e , Laureano Filho José Rodrigues
Published: February 2018

The mandibular fracture is one of the most commonly fractures of the facial bones. In high-energy traumas, a comminuted mandible fracture may occur. The closed reduction with external fixator is an interesting alternative for these types of fractures. The aim of this article is to report the case of a patient with comminuted fracture in the right mandibular body, whose surgical treatment was the noninvasive reduction of fracture and stabilization using a Colles’ wrist external fixator. After 1 year of follow-up, the patient is without complaints, with satisfactory dental occlusion, adequate contour, and mandibular alignment. External fixation with wrist orthopedic fixators adapted to the mandible provides many advantages owing to its versatility and simplicity of use. Therefore, this method should be remembered as a valid and affordable option for the treatment of complex lesions when indicated correctly.
Bidirectional Management of a Transnasal Intracranial Chopstick Transecting Optic Nerve
Authors: Tsai Tsung-You , Lee Li-Ang , Chao Wei-Chieh , Lee Yi-Chan
Published: February 2018

Herein, the authors report a rare patient with a transnasal intracranial penetration injury caused by a chopstick that resulted in optic nerve transection as well as the removal of the chopstick using a bidirectional approach. A 25-year-old male presented to our emergency department with right blindness and bilateral epistaxis. Preoperative computed tomographic angiography demonstrated a transnasal stick-like foreign body causing a skull base fracture and suspected vascular injury. Due to the shape of the chopstick and the high risk of massive bleeding, an exclusively endoscopic or open craniotomy approach is not suitable for removal. A bidirectional method, including both an open craniotomy and transnasal endoscopy, was used to remove the chopstick. After the operation, there were no further neurologic deficits or complications during the treatment course and follow-up. The bidirectional approach may provide an alternative method to address a foreign body when the patient is not a candidate for an exclusively endoscopic or open craniotomy approach management.