bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjuvant radiotherapy for Stage I seminoma
Authors: Kanyilmaz Gul , Saricanbaz Irem , Bora Huseyin , Karahacioglu Eray , Erkal Eda Yirmibesoglu 
Published: October 2018

Objectives:
There is no consensus regarding the management of Stage 1 seminomas following inguinal orchiectomy. In this study, we evaluated the treatment results and treatment-related toxicity for patients with Stage 1 seminomas treated with adjuvant radiotherapy (RT) at a single institution.

Methods:
Sixty-five patients who underwent adjuvant RT following orchiectomy for Stage 1 seminomas between January 1996 and December 2007 were retrospectively reviewed. The age, tumor location, histopathological type, stage, tumor size, RT field, and radiation dose were recorded for all patients.

Results:
The patients' ages ranged from 17 to 61 years (median, 37 years). Sixty-three patients (97%) were diagnosed with classical seminoma and the remaining two patients (3%) had spermatocytic seminoma. After orchiectomy, 37 patients (57%) received para-aortic RT and 28 patients (43%) received dog-leg field RT. RT was applied with 1.8–2 Gy/day fractionation and the median RT dose was 26 Gy (range, 20–38). Follow-up ranged from 0.3 to 18 years (median, 9.5 years). Local control had been achieved in all patients and all of them were alive with no evidence of disease. Fifty-one patients (77%) had at least 5 years of follow-up and 27 patients (41%) had at least 10 years of follow-up. Overall survival at 10 years was 100%.

Conclusion:
Although retrospective in nature, this single-institutional study provides useful information about the outcomes and toxicities associated with adjuvant RT in patients with Stage 1 seminomas reporting excellent disease control and survival rates at the expense of acceptable toxicity.
Adjuvant radiotherapy after surgical resection for adrenocortical carcinoma
Authors: Viani Gustavo Arruda , Viana Bruno Silveira 
Published: October 2018

Purpose:
Historically, the role of adjuvant radiotherapy (RT) for patients with adrenocortical carcinoma (ACC) has been controversial. The objective of this research is to review systematically the literature evaluating the role of adjuvant RT in patients with ACC undergone a surgical resection.

Materials and Methods:
The electronic databases were searched for articles published until July 2017 without language restriction: Lilacs, Medline, Embase, and the Cochrane. Two reviewers independently appraised the eligibility criteria and extracted data. When possible, a fixed-effect meta-analysis was done. The systematic review (SR) followed all the criteria of the MOOSE guideline.

Results:
Overall, 382 citations were identified. After the screening of titles and abstracts, 12 articles (eight case series [48 patients] and 4 cohort studies [136 patients]) were included in the final analysis. For the local recurrence, the pooled relative risk (RR) was RR = 0.46 (95% confidence interval: 0.28–0.75), in favor of adjuvant RT when compared with surgery alone. Concerning overall mortality and disease recurrence, no significant difference between adjuvant RT and surgery was detected, RR = 0.77 (CI 95% 0.49–1.22, P = 0.27), and RR = 0.95 (IC 95% 0.74–1.24, P = 0.67). In all cohort studies, the acute toxicities were graduated as mild and self-limited with nausea and fatigue being the most common symptoms. Only one case (1/50) of impairment of kidney function was detected as late toxicity in these studies.

Conclusions:
This SR and meta-analysis indicate that adjuvant RT dramatically reduces the local recurrence of ACC after surgery. Moreover, the treatment has a low acute and late toxicity, resulting in a high therapeutic index. Further, prospective studies are needed to confirm or refute the role of RT on survival and disease recurrence.
Caregiver’s Psychosocial Concerns and Psychological Distress in Emergency and Trauma Care Setting
Authors: Kanmani T. R. , Raju Birudu 
Published: October 2018

ABSTRACTBackground: Traumatic brain injury (TBI) will be the third largest killer by the year 2020 in the world. It creates the great amount of morbidity, disability, mortality, and reduces the psychosocial well-being of the patients and their caregivers. Hence, the current paper aimed to explore the psychosocial distress and caregivers' concerns in emergency and trauma care (ETC) setting. Methodology: This study adopted qualitative research design. All caregivers of TBI survivors were considered as a universe of the study. A total of 50 caregivers were recruited, and the predesigned questionnaire was administered. Depression, anxiety, stress scale was used to identify the caregivers' depression, stress, and anxiety. The simple thematic analysis was used to derive the themes from the verbatim data. Data were analyzed using SPSS version 21.0 (SPSS South Asia Pvt.Ltd, Bengaluru, Karnataka, India). Results: In the quantitative analysis, caregivers' mean age was found to be 45 (mean = 45.00 ± 13.83) years. Caregivers had experienced mild depression (13.36 ± 3.07), moderate anxiety (13.70 ± 3.03), and minimum stress (13.66 ± 2.98) levels. Qualitative results identified the following themes: difficulty in accessing timely care, uncertainty about the prognosis and future, family concerns and financial constraints, personal feelings and personal needs, and supportive care. Chi-square test revealed that there was no significant association between gender and depression (χ2 = 2.381 P < 0.12), anxiety (χ2 = 0.01 P < 0.92), and stress (χ2 = 0.235 P < 0.61) levels of caregivers. Conclusion: To accomplish, providing psychosocial care in ETC setting, the role of psychiatric social workers is pivotal.
Nonadherence to Antiepileptic Medications: Still a Major Issue to be Addressed in the Management of Epilepsy
Authors: Zafar Azra , Shahid Rizwana , Nazish Saima , Aljaafari Danah , Alkhamis Fahd Ali , Alsalman Sadiq , Msmar Amir H. , Abbasi Badaruddin , Alsulaiman Abdulla A. , Alabdali Majed 
Published: October 2018

ABSTRACT
Context: Medication nonadherence is a significant barrier in achieving seizure freedom in patients with epilepsy. There is a deficiency of data about the reasons for nonadherence in Saudi population. Aims: The aim of this study is to prove the existence of nonadherence to antiepileptic drugs (AEDs) in patients with epilepsy and identify the responsible factors. Setting and Design: This is a prospective, cross-sectional study carried in the Department of Neurology at King Fahd Hospital of the University affiliated with Imam Abdulrahman Bin Faisal University. Subjects and Methods: Patients of all ages diagnosed to have epilepsy as mentioned in their medical record and taking antiepileptic medications were interviewed using a questionnaire. Statistical Analysis Used: Statistical analysis was performed using IBM Statistical Package for the Social Sciences version 21 (IBM Corp., Armonk, NY, USA). Statistical significance was defined as two-tailed with a P ≤ 0.05. Results: Among 152 participants, 52.6% were male and 47.4% were female. Mean age of the patients was 28 ± 14.3 (mean ± standard deviation) years. Of 152 patients, 48.7% were found to be nonadherent to their AED therapy. The most commonly identified factor was forgetfulness. Nonadherence was significantly associated with poor seizure control (P = 0.002). Conclusion: Nonadherence to the AED is common among patients with epilepsy and affects seizure control adversely.
Design, Ecology, Politics
Authors: Boehnert Joanna 
Published: October 2018

Design, Ecology, Politics links social and ecological theory to design theory and practice, critiquing the ways in which the design industry perpetuates unsustainable development.
Boehnert argues that when design does engage with issues of sustainability, this engagement remains shallow, due to the narrow basis of analysis in design education and theory. The situation is made more severe by design cultures which claim to be apolitical. Where design education fails to recognise the historical roots of unsustainable practice, it reproduces old errors. New ecologically informed design methods and tools hold promise only when incorporated into a larger project of political change. Design, Ecology, Politics describes how ecological literacy challenges many central assumptions in design theory and practice.
By bringing design, ecology and socio-political theory together, Boehnert describes how power is constructed, reproduced and obfuscated by design in ways which often cause environmental harms. She uses case studies to illustrate how communication design functions to either conceal or reveal the ecological and social impacts of current modes of production. The transformative potential of design is dependent on deep-reaching analysis of the problems design attempts to address. Ecologically literate and critically engaged design is a practice primed to facilitate the creation of viable, sustainable and just futures. With this approach, designers can make sustainability not only possible, but attractive.
In response to the converging crises of the Anthropocene, where economic ‘growth’ has broken planetary boundaries, the author proposes an age where people and design practices identify ecological frames of reference. An emergent Ecocene depends on creative transformations in all domains and on all levels, from human subjectivities to political economies. Joanna Boehnert’s cogent and illuminating study integrates ecological and critical positions into design theory, to put forward a theoretical foundation for critical and ecologically informed design.
Upper tropospheric ice sensitivity to sulfate geoengineering
Authors: Visioni Daniele , Pitari Giovanni , di Genova Glauco , Tilmes Simone , Cionni Irene 
Published: October 2018

Abstract. Aside from the direct surface cooling that sulfate geoengineering (SG) would
produce, investigations of the possible side effects of this method are still
ongoing, such as the exploration of the effect that SG may have on upper
tropospheric cirrus cloudiness. The goal of the present study is to better
understand the SG thermodynamical effects on the freezing mechanisms leading
to ice particle formation. This is undertaken by comparing SG model
simulations against a Representative Concentration Pathway 4.5 (RCP4.5)
reference case. In the first case, the aerosol-driven surface cooling is
included and coupled to the stratospheric warming resulting from the aerosol
absorption of terrestrial and solar near-infrared radiation. In a second SG
perturbed case, the surface temperatures are kept unchanged with respect to
the reference RCP4.5 case. When combined, surface cooling and lower
stratospheric warming tend to stabilize the atmosphere, which decreases the
turbulence and updraft velocities (−10 % in our modeling study). The
net effect is an induced cirrus thinning, which may then produce a
significant indirect negative radiative forcing (RF). This RF would go in the
same direction as the direct effect of solar radiation scattering by
aerosols, and would consequently influence the amount of sulfur needed to
counteract the positive RF due to greenhouse gases. In our study, given an
8 Tg-SO2 yr−1 equatorial injection into the lower
stratosphere, an all-sky net tropopause RF of −1.46 W m−2 is
calculated, of which −0.3 W m−2 (20 %) is from the indirect
effect on cirrus thinning (6 % reduction in ice optical depth). When
surface cooling is ignored, the ice optical depth reduction is lowered to
3 %, with an all-sky net tropopause RF of −1.4 W m−2, of which
−0.14 W m−2 (10 %) is from cirrus thinning. Relative to the
clear-sky net tropopause RF due to SG aerosols (−2.1 W m−2), the
cumulative effect of the background clouds and cirrus thinning accounts for
+0.6 W m−2, due to the partial compensation of large positive
shortwave (+1.6 W m−2) and negative longwave adjustments
(−1.0 W m−2). When surface cooling is ignored, the net cloud
adjustment becomes +0.8 W m−2, with the shortwave contribution
(+1.5 W m−2) almost twice as much as that of the longwave
(−0.7 W m−2). This highlights the importance of including all of the
dynamical feedbacks of SG aerosols.
BGC-val: a model- and grid-independent Python toolkit to evaluate marine biogeochemical models
Authors: de Mora Lee , Yool Andrew , Palmieri Julien , Sellar Alistair , Kuhlbrodt Till , Popova Ekaterina , Jones Colin , Allen J. Icarus 
Published: October 2018

Abstract. The biogeochemical evaluation toolkit, BGC-val, is a model- and
grid-independent Python toolkit that has been built to evaluate marine
biogeochemical models using a simple interface. Here, we present the ideas
that motivated the development of the BGC-val software framework, introduce
the code structure, and show some applications of the toolkit using model
results from the Fifth Climate Model Intercomparison Project (CMIP5). A brief
outline of how to access and install the repository is presented in
Appendix A, but the specific details on how to use the
toolkit are kept in the code repository. The key ideas that directed the toolkit design were model and grid
independence, front-loading analysis functions and regional masking,
interruptibility, and ease of use. We present each of these goals, why they
were important, and what we did to address them. We also present an outline of
the code structure of the toolkit illustrated with example plots produced by
the toolkit. After describing BGC-val, we use the toolkit to investigate the performance
of the marine physical and biogeochemical quantities of the CMIP5 models and
highlight some predictions about the future state of the marine ecosystem
under a business-as-usual CO2 concentration scenario (RCP8.5).
The Healing Rate of Type II Odontoid Fractures Treated With Posterior Atlantoaxial Screw-rod Fixation: A Retrospective Review of 77 Patients
Authors: Huang Da-Geng , Zhang Xin-Liang , Hao Ding-Jun , He Bao-Rong , Wang Xiao-Dong , Liu Tuan-Jiang 
Published: October 2018

Background:
In theory, temporary posterior atlantoaxial screw-rod fixation for type II odontoid fractures is a way to preserve rotatory motion. However, the healing rate of type II odontoid fractures treated in this way is unknown; that is, the risk associated with conducting a temporary screw-rod fixation for type II odontoid fractures is unknown. This study investigates the healing rate of type II odontoid fractures treated with posterior atlantoaxial screw-rod fixation by CT imaging and evaluates the feasibility of conducting a temporary screw-rod fixation for type II odontoid fractures.

Methods:
Patients with type II odontoid fracture who underwent posterior atlantoaxial screw-rod fixation in our spine center from January 2011 to December 2014 were identified. Patients older than 65 years or younger than 18 years were excluded. Those who were confirmed to have healing odontoid fractures on CT imaging were included. Those in whom fracture healing was not confirmed were asked to undergo a CT examination. Fracture healing was confirmed on the basis of the presence of bridging bone across the odontoid fracture site on CT imaging.

Results:
Seventy-seven patients (56 men and 21 women) were included in the study. The average age of the patients was 40.7 ± 11.6 years (range, 18 to 64 years). The mean duration of follow-up was 26.4 ± 4.6 months (range, 24 to 40 months). Fracture healing was observed in 73 patients (94.8%).

Discussion:
The healing rate of type II odontoid fractures (with an age range of 18 to 64 years) treated with modern posterior atlantoaxial fixation is relatively high. For patients at that age range, posterior atlantoaxial temporary screw-rod fixation for type II odontoid fractures can be conducted with a low risk of nonunion.

Level of Evidence:
Level IV, therapeutic
Inadvertent Radial Head Inversion During Closed Reduction of a Pediatric Radial Neck Fracture
Authors: Sirois Zachary J. , Kreul Sarah M. , Shank Craig F. 
Published: October 2018

Management of displaced pediatric radial neck fractures can be fraught with challenges. This unique case presents an 11-year-old female with a Salter-Harris type II radial neck fracture and how her radial head overturned 180° with the articular surface facing the radial shaft rather than the capitellum during closed manipulation under anesthesia. The malreduction subsequently required open reduction and highlights the importance of a careful stepwise approach to managing markedly displaced radial neck fractures. After closed reduction, meticulous assessment of intraoperative imaging when determining proper alignment is of the utmost importance as a result of the transverse nature of Salter-Harris type I and II fractures.

Level of Evidence:
Level IV
Stijlenspagaat van hedendaags bestuur
Authors: Zouridis Stavros , Tops Pieter 
Published: October 2018

Styles of Governance and 21st Century Politics in the Netherlands
Whereas constitutions establish the institutions of government, human beings actually govern countries, municipalities, and regions. The institutional position of these people may be constitutionally constrained but the people who occupy these positions always have some discretion with regard to the way they fulfil their duties. Either consciously or unconsciously these officials develop their styles of governance. A style of governance reflects a combination of personal traits, institutional constraints, and a genuine set of beliefs with regard to what these duties exactly entail. While some people in a government position believe that a debate in Parliament constitutes the core of their work others may prefer developing policies or meeting citizens. Twenty years ago, observational research conducted in Dutch municipalities led to a set of five coherent beliefs or styles of governance. Over the past two decades, politics in the Netherlands has changed dramatically. The stable pillars that characterized and stabilized the Dutch political system have been replaced by political online and offline swarms, the volatility of the electorate has increased more than in other European countries, and incident driven politics has replaced the ideological and managerial political styles of the 1970s, 1980s, and 1990s. In this article we explore the implications of these dramatic changes for the styles of governance in the Netherlands. As recent empirical research is not available yet, we analyse the changes in the Dutch political context to derive a number of implications for the styles of governance.
Bekwaam, betrouwbaar en betrokken: over de eigenschappen die volksvertegenwoordigers en bestuurders waarderen in medebestuurders
Authors: van Zuydam Sabine , Karsten Niels , Oostendorp Hans , Hoogstad Maarten , van Kooten Frank 
Published: October 2018

Competent, trustworthy, and caring: The qualities peers value in executive politicians in decentralized government
Credibility is an essential quality for executive politicians but cannot be taken for granted. The literature on political leadership suggests that credible politicians are competent, trustworthy, and caring. Existing studies, however, often do not take into account differences between various offices and tend to ignore the distinction between disparate layers of government. In this article, we analyze as yet unutilized data from local and provincial councilors’ and executives’ evaluations on the qualities they ascribe to their fellow executive politicians. The data were collected for the 2015 Best Dutch Executive election and covers almost all executives who were in office at the time. In contrast to what the existing literature often presumes, our secondary quantitative analysis of this data on 1,776 executives shows that there are significant differences in the qualities that are used to evaluate the most appreciated local and provincial chairpersons on the one hand, and the most appreciated executives on the other hand. Whereas municipal mayors and provincial King’s Commissioners are championed for being particularly caring and showing decisiveness, municipal aldermen and provincial executives are valued in particular for their expertise. This finding indicates that a politician’s credibility for his peers depends on his office as each position requires a particular set of qualities.
De ongekende effecten van deregulering: een experiment in Hollands Kroon
Authors: Kruyen Peter , Brandsen Taco , Tholen Berry 
Published: October 2018

The unknown effects of deregulation: An experiment in Hollands Kroon
What happens in the case of massive deregulation in the local public domain? Despite the widespread call for ‘less regulation’, the effects of large-scale deregulation have received surprisingly little academic attention. In this article, we present the results of a longitudinal study on the effects of deregulation in the Dutch municipality of Hollands Kroon. The municipality abolished a vast number of regulations on public order offences in a radical two-year policy experiment, encouraging citizens to exercise more social control. In contrast, criticasters expected that the experiment would lead to more public offenses and conflict. Based on our data collected over three survey rounds; focus groups with citizens, politicians and civil servants; and several secondary data sources, we conclude that there was little effect: neither an increase in public order offences, nor an increase in social control. Our research shows that, in the short term, deregulation did not significantly affect the behavior of citizens.
PENINGKATAN KUALITAS HIDUP LANJUT USIA (LANSIA) DI KOTA DEPOK DENGAN LATIHAN KESEIMBANGAN
Authors: Kiik Stefanus Mendes , Sahar Junaiti , Permatasari Henny 
Published: October 2018

Kualitas hidup lansia dipengaruhi berbagai faktor seperti kesehatan fisik, kesehatan psikologis, hubungan sosial dan lingkungan. Penelitian ini bertujuan mengetahui pengaruh latihan keseimbangan terhadap kualitas hidup lansia di Kota Depok. Penelitian quasi experiment ini dilakukan pada dua kelompok; 30 lansia sebagai kelompok kontrol dan 30 lansia sebagai kelompok perlakuan. Teknik pengambilan sampel yang digunakan adalah multistage random sampling. Hasil penelitian menunjukkan bahwa latihan keseimbangan berpengaruh signifikan, meningkatkan kualitas hidup lansia (p<0,001). Hal ini disebabkan karena latihan keseimbangan dapat meningkatkan kesehatan fisik, kesehatan psikologis, hubungan sosial dan lingkungan. Latihan keseimbangan lansia dapat digunakan sebagai salah satu upaya untuk meningkatkan kualitas hidup pada lansia di komunitas. Penelitian selanjutnya dapat melakukan penelitian pada kelompok usia yang berbeda untuk mengetahui keefektifan latihan keseimbangan lansia. Kata Kunci: lansia, latihan keseimbangan, kualitas hidup Abstract Quality Improvement of Elderly Life in Depok City with Balance Exercise. The quality of life (QOL) of the older adult is affected by various factors such as physical health, psychological health, social relationships and environment. This study aimed to investigate the effect of balance exercise on quality of life among older adults. This quasi-experimental design included two groups; 30 subjects as intervention groups and 30 subjects as control groups. The sample was taken by multistage random sampling. There were significant improvements in quality of life among older adults (p<0,001). Balance exercise can improve physical health, psychological health, social relationships, and environment. Balance exercise can be utilized as one of the preventive efforts to increase the quality of life among older adults in the community. Further research may consider a variety of age to know the effectiveness of balance exercise. Keywords: balance exercise, older adult, quality of life