bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to participation in global surgery academic collaborations, and possible solutions: a qualitative study
Authors: Fallah Parisa Nicole , Bernstein Mark 
Published: April 2018

OBJECTIVEThere is a global lack of access to surgical care, and this issue disproportionately affects those in low- and middle-income countries. Global surgery academic collaborations (GSACs) between surgeons in high-income countries and those in low- and middle-income countries are one possible sustainable way to address the global surgical need. The objective of this study was to examine the barriers to participation in GSACs and to suggest ways to increase involvement.METHODSA convenience sample of 86 surgeons, anesthesiologists, other physicians, residents, fellows, and nurses from the US, Canada, and Norway was used. Participants were all health care providers from multiple specialties and multiple academic centers with varied involvement in GSACs. More than half of the participants were neurosurgeons. Participants were interviewed in person or over Skype in Toronto over the course of 2 months by using a predetermined set of open-ended questions. Thematic content analysis was used to evaluate the participants’ responses.RESULTSBased on the data, 3 main themes arose that pointed to individual, community, and system barriers for involvement in GSACs. Individual barriers included loss of income, family commitments, young career, responsibility to local patients, skepticism of global surgery efforts, ethical concerns, and safety concerns. Community barriers included insufficient mentorship and lack of support from colleagues. System barriers included lack of time, minimal academic recognition, insufficient awareness, insufficient administrative support and organization, and low political and funding support.CONCLUSIONSSteps can be taken to address some of these barriers and to increase the involvement of surgeons from high-income countries in GSACs. This could lead to a necessary scale-up of global surgery efforts that may help increase worldwide access to surgical care.
The relationship of older age and perioperative outcomes following thoracolumbar three-column osteotomy for adult spinal deformity: an analysis of 300 consecutive cases
Authors: Lau Darryl , Osorio Joseph A. , Deviren Vedat , Ames Christopher P. 
Published: April 2018

OBJECTIVEThree-column osteotomies are increasingly being used in the elderly population to correct rigid spinal deformities. There is hesitation, however, in performing the technique in older patients because of the high risk for blood loss, longer operative times, and complications. This study assesses whether age alone is an independent risk factor for complications and length of stay.METHODSAll patients with thoracolumbar adult spinal deformity (ASD) who underwent 3-column osteotomy (vertebral column resection or pedicle subtraction osteotomy) performed by the senior author from 2006 to 2016 were identified. Demographics, clinical baseline, and surgical details were collected. Outcomes of interest included perioperative complication, ICU stay, and hospital stay. Bivariate and multivariate analyses were used to assess the association of age with outcomes of interest.RESULTSA total of 300 patients were included, and 38.3% were male. The mean age was 63.7 years: 10.3% of patients were younger than 50 years, 36.0% were 50–64 years, 45.7% were 65–79 years, and 8.0% were 80 years or older. The overall mean EBL was 1999 ml. The overall perioperative complication rate was 24.7%: 18.0% had a medical complication and 7.0% had a surgical complication. There were no perioperative or 30-day deaths. Age was associated with overall complications (p = 0.002) and medical-specific complications (p < 0.001); there were higher rates of overall and medical complications with increased age: 9.7% and 6.5%, respectively, for patients younger than 50 years; 16.7% and 10.2%, respectively, for patients 50–64 years; 31.4% and 22.6%, respectively, for patients 65–79 years; and 41.7% and 41.7%, respectively, for patients 80 years or older. However, after adjusting for relevant covariates on multivariate analysis, age was not an independent factor for perioperative complications. Surgical complication rates were similar among the 4 age groups. Longer ICU and total hospital stays were observed in older age groups, and age was an independent factor associated with longer ICU stay (p = 0.028) and total hospital stay (p = 0.003). ICU stays among the 4 age groups were 1.6, 2.3, 2.0, and 3.2 days for patients younger than 50 years, 50–64 years, 65–79 years, and 80 years or older, respectively. The total hospital stays stratified by age were 7.3, 7.7, 8.2, and 11.0 days for patients younger than 50 years, 50–64 years, 65–79 years, and 80 years or older, respectively.CONCLUSIONSOlder age was associated with higher perioperative complication rates, but age alone was not an independent risk factor for complications following the 3-column osteotomy for ASD. Comorbidities and other unknown variables that come with age are likely what put these patients at higher risk for complications. Older age, however, is independently associated with longer ICU and hospital stays.
Histopathological features predictive of local control of atypical meningioma after surgery and adjuvant radiotherapy
Authors: Chen William C. , Magill Stephen T. , Wu Ashley , Vasudevan Harish N. , Morin Olivier , Aghi Manish K. , Theodosopoulos Philip V. , Perry Arie , McDermott Michael W. , Sneed Penny K. , Braunstein Steve E. , Raleigh David R. 
Published: April 2018

OBJECTIVEThe goal of this study was to investigate the impact of adjuvant radiotherapy (RT) on local recurrence and overall survival in patients undergoing primary resection of atypical meningioma, and to identify predictive factors to inform patient selection for adjuvant RT.METHODSOne hundred eighty-two patients who underwent primary resection of atypical meningioma at a single institution between 1993 and 2014 were retrospectively identified. Patient, meningioma, and treatment data were extracted from the medical record and compared using the Kaplan-Meier method, log-rank tests, multivariate analysis (MVA) Cox proportional hazards models with relative risk (RR), and recursive partitioning analysis.RESULTSThe median patient age and imaging follow-up were 57 years (interquartile range [IQR] 45–67 years) and 4.4 years (IQR 1.8–7.5 years), respectively. Gross-total resection (GTR) was achieved in 114 cases (63%), and 42 patients (23%) received adjuvant RT. On MVA, prognostic factors for death from any cause included GTR (RR 0.4, 95% CI 0.1–0.9, p = 0.02) and MIB1 labeling index (LI) ≤ 7% (RR 0.4, 95% CI 0.1–0.9, p = 0.04). Prognostic factors on MVA for local progression included GTR (RR 0.2, 95% CI 0.1–0.5, p = 0.002), adjuvant RT (RR 0.2, 95% CI 0.1–0.4, p < 0.001), MIB1 LI ≤ 7% (RR 0.2, 95% CI 0.1–0.5, p < 0.001), and a remote history of prior cranial RT (RR 5.7, 95% CI 1.3–18.8, p = 0.03). After GTR, adjuvant RT (0 of 10 meningiomas recurred, p = 0.01) and MIB1 LI ≤ 7% (RR 0.1, 95% CI 0.003–0.3, p < 0.001) were predictive for local progression on MVA. After GTR, 2.2% of meningiomas with MIB1 LI ≤ 7% recurred (1 of 45), compared with 38% with MIB1 LI > 7% (13 of 34; p < 0.001). Recursive partitioning analysis confirmed the existence of a cohort of patients at high risk of local progression after GTR without adjuvant RT, with MIB1 LI > 7%, and evidence of brain or bone invasion. After subtotal resection, adjuvant RT (RR 0.2, 95% CI 0.04–0.7, p = 0.009) and ≤ 5 mitoses per 10 hpf (RR 0.1, 95% CI 0.03–0.4, p = 0.002) were predictive on MVA for local progression.CONCLUSIONSAdjuvant RT improves local control of atypical meningioma irrespective of extent of resection. Although independent validation is required, the authors’ results suggest that MIB1 LI, the number of mitoses per 10 hpf, and brain or bone invasion may be useful guides to the selection of patients who are most likely to benefit from adjuvant RT after resection of atypical meningioma.
Pilot study of intracranial venous physiology in craniosynostosis
Authors: Cornelissen Martijn J. , de Goederen Robbin , Doerga Priya , Cuperus Iris , van Veelen Marie-Lise , Lequin Maarten , Govaert Paul , Mathijssen Irene M. J. , Dudink Jeroen , Tasker Robert C. 
Published: April 2018

OBJECTIVEIn addition to craniocerebral disproportion, other factors, such as Chiari malformation type I, obstructive sleep apnea, and venous outflow obstruction, are considered to have a role in the occurrence of intracranial hypertension in craniosynostosis. This pilot study examined cerebral venous flow velocity to better characterize the complex intracranial venous physiology of craniosynostosis.METHODSThe authors performed a prospective cohort study of craniosynostosis patients (n = 34) referred to a single national (tertiary) craniofacial unit. Controls (n = 28) consisted of children who were referred to the unit’s outpatient clinic and did not have craniosynostosis. Transfontanelle ultrasound scans with venous Doppler flow velocity assessment were performed at the first outpatient clinic visit and after each surgery, if applicable. Mean venous blood flow velocities of the internal cerebral vein (ICVv) and the superior sagittal sinus (SSSv) were recorded and blood flow waveform was scored.RESULTSPreoperatively, SSSv was decreased in craniosynostosis patients compared with controls (7.57 vs 11.31 cm/sec, p = 0.009). ICVv did not differ significantly between patients and controls. Postoperatively, SSSv increased significantly (7.99 vs 10.66 cm/sec, p = 0.023). Blood flow waveform analyses did not differ significantly between patients and controls.CONCLUSIONSPremature closure of cranial sutures was associated with decreased SSSv but not ICVv; indicating an effect on the superficial rather than deep venous drainage. Further Doppler ultrasound studies are needed to test the hypothesis that at an early stage of craniosynostosis pathology SSSv, but not pulsatility, is abnormal, and that abnormality in both SSSv and the superficial venous waveform reflect a more advanced stage of evolution in suture closure.
Reconstruction of the Dark Energy Equation of State from the Latest Observations
Authors: Dai Ji-Ping , Yang Yang , Xia Jun-Qing 
Published: April 2018

Abstract
Since the discovery of the accelerating expansion of our universe in 1998, studying the features of dark energy has remained a hot topic in modern cosmology. In the literature, dark energy is usually described by w ≡ P/ρ, where P and ρ denote its pressure and energy density. Therefore, exploring the evolution of w is the key approach to understanding dark energy. In this work, we adopt three different methods, polynomial expansion, principal component analysis, and the correlated prior method, to reconstruct w with a collection of the latest observations, including the type-Ia supernova, cosmic microwave background, large-scale structure, Hubble measurements, and baryon acoustic oscillations (BAOs), and find that the concordance cosmological constant model (w = −1) is still safely consistent with these observational data at the 68% confidence level. However, when we add the high-redshift BAO measurement from the Lyα forest (Lyα FB) of BOSS DR11 quasars into the calculation, there is a significant impact on the reconstruction result. In the standard ΛCDM model, since the Lyα FB data slightly prefer a negative dark energy density, in order to avoid this problem, a dark energy model with a w significantly smaller than −1 is needed to explain this Lyα FB data. In this work, we find the consistent conclusion that there is a strong preference for the time-evolving behavior of dark energy w at high redshifts, when including the Lyα FB data. Therefore, we think that this Lyα FB data needs to be watched carefully attention when studying the evolution of the dark energy equation of state.
A Three-dimensional Simulation of a Magnetized Accretion Disk: Fast Funnel Accretion onto a Weakly Magnetized Star
Authors: Takasao Shinsuke , Tomida Kengo , Iwasaki Kazunari , Suzuki Takeru K. 
Published: April 2018

Abstract
We present the results of a global, three-dimensional magnetohydrodynamics simulation of an accretion disk with a rotating, weakly magnetized central star. The disk is threaded by a weak, large-scale poloidal magnetic field, and the central star has no strong stellar magnetosphere initially. Our simulation investigates the structure of the accretion flows from a turbulent accretion disk onto the star. The simulation reveals that fast accretion onto the star at high latitudes occurs even without a stellar magnetosphere. We find that the failed disk wind becomes the fast, high-latitude accretion as a result of angular momentum exchange mediated by magnetic fields well above the disk, where the Lorentz force that decelerates the rotational motion of gas can be comparable to the centrifugal force. Unlike the classical magnetospheric accretion scenario, fast accretion streams are not guided by magnetic fields of the stellar magnetosphere. Nevertheless, the accretion velocity reaches the free-fall velocity at the stellar surface due to the efficient angular momentum loss at a distant place from the star. This study provides a possible explanation why Herbig Ae/Be stars whose magnetic fields are generally not strong enough to form magnetospheres also show indications of fast accretion. A magnetically driven jet is not formed from the disk in our model. The differential rotation cannot generate sufficiently strong magnetic fields for the jet acceleration because the Parker instability interrupts the field amplification.
Chronique des décisions de la Cour Interaméricaine des Droits de l’Homme (Avril 2017 – Mars 2018)
Authors: Ronderos  Alejandro , Cruz Sánchez   Emma-Luna , Lamas Oriane , Rodrigues Débora , Gorski Sandro , Cruz Sánchez Emma-Luna , Gauchy Marine 
Published: April 2018

Très active dans son rôle de gardienne des droits fondamentaux, la Cour interaméricaine des Droits de l’Homme cherche à garantir l’effectivité de ces droits dans les États latino-américains depuis 1979. Sa ligne jurisprudentielle reflète cet engagement non seulement en raison du nombre d’arrêts rendus chaque année (plus d’une centaine), mais également de la complexité des affaires analysées. La protection du droit à la vie, l’interdiction de l’esclavage et de la torture, les disparitions forcées ou le contrôle des multiples violations au principe de l’Habeas corpus ne sont que quelques exemples de l’action remarquable de la Cour IADH. Après analyse des affaires portées devant elle, il est possible de relever l’importance des atteintes aux droits dits « de première génération », majoritairement imputables aux instabilités politiques et aux transitions démocratiques difficiles. Si les décisions de la Cour ne sont pas contraignantes, il ne faut néanmoins pas négliger leur portée, soutenue par l’opinion publique et la pression des acteurs internationaux. À l’heure actuelle, la pérennité d’une institution comme la Cour IADH semble vitale aux citoyens des pays latino-américains en ce qu’elle constitue le dernier rempart garantissant la justiciabilité et l’effectivité de leurs droits.
National Athletic Trainers' Association Position Statement: Evaluation, Management, and Outcomes of and Return-to- Play Criteria for Overhead Athletes With Superior Labral Anterior-Posterior Injuries
Authors: Michener Lori A. , Abrams Jeffrey S. , Bliven Kellie C. Huxel , Falsone Sue , Laudner Kevin G. , McFarland Edward G. , Tibone James E. , Thigpen Charles A. , Uhl Timothy L. 
Published: April 2018

Objective:
To present recommendations for the diagnosis, management, outcomes, and return to play of athletes with superior labral anterior-posterior (SLAP) injuries.

Background:
In overhead athletes, SLAP tears are common as either acute or chronic injuries. The clinical guidelines presented here were developed based on a systematic review of the current evidence and the consensus of the writing panel. Clinicians can use these guidelines to inform decision making regarding the diagnosis, acute and long-term conservative and surgical treatment, and expected outcomes of and return-to-play guidelines for athletes with SLAP injuries.

Recommendations:
Physical examination tests may aid diagnosis; 6 tests are recommended for confirming and 1 test is recommended for ruling out a SLAP lesion. Combinations of tests may be helpful to diagnose SLAP lesions. Clinical trials directly comparing outcomes between surgical and nonoperative management are absent; however, in cohort trials, the reports of function and return-to-sport outcomes are similar for each management approach. Nonoperative management that includes rehabilitation, nonsteroidal anti-inflammatory drugs, and corticosteroid injections is recommended as the first line of treatment. Rehabilitation should address deficits in shoulder internal rotation, total arc of motion, and horizontal-adduction motion, as well as periscapular and glenohumeral muscle strength, endurance, and neuromuscular control. Most researchers have examined the outcomes of surgical management and found high levels of satisfaction and return of shoulder function, but the ability to return to sport varied widely, with 20% to 94% of patients returning to their sport after surgical or nonoperative management. On average, 55% of athletes returned to full participation in prior sports, but overhead athletes had a lower average return of 45%. Additional work is needed to define the criteria for diagnosing and guiding clinical decision making to optimize outcomes and return to play.
Audiencia televisiva y memoria: estudio de caso de la ficción Los archivos del cardenal en Chile
Authors: Chamorro Maldonado Miguel Alejandro 
Published: April 2018

La serie de ficción televisiva del canal público TVN en Chile, Los archivos del cardenal, causó impacto de impresión, recuerdo y dramatismo en los espectadores al revivir con sus dos temporadas en el 2011 y 2014, acontecimientos ocurridos en Chile durante la dictadura militar. Objetivos. Se pretende ofrecer una visión de la percepción de los espectadores seguidores de la serie de ficción televisiva para conocer sus apreciaciones respecto al recuerdo y la memoria reciente de un Chile golpeado por la dictadura. Método. Se ha aplicado la técnica del grupo de discusión formado por 28 personas seguidoras de la serie televisiva, donde se ha analizado el contenido del discurso desde una visión cognitiva y psicológica en el marco de la memoria perceptiva entre la historia real y la ficción. Conclusiones. La investigación demostró que en el trabajo de campo los seguidores tuvieron la oportunidad de hablar de los contenidos de la serie de ficción y valorar los episodios como material educativo para valorar la verosimilitud de la ficción con la realidad reciente del país.
Análise comparativa entre dois tipos de agregados utilizados em obras de pequeno e médio porte no município de Tucuruí - PA [Comparative analysis between two types of aggregates used in small and middle size works in the municipality of Tucuruí - PA]
Authors: Lucena de Sousa Diego , Gonçalves de Oliveira Mateus , Sérgio Lima Souza Paulo 
Published: April 2018

O objetivo deste estudo consiste no fato de se realizar uma comparação concisa entre o seixo lavado e o seixo misto utilizados com frequência na composição de traços de concreto em obras de pequeno e médio porte no município de Tucuruí/PA-Brasil. Desse modo, a partir dos ensaios de resistência à compressão, a determinação da absorção de água, índice de vazios e massa específica e a partir do uso de uma dosagem pré-estabelecida para o seixo lavado, pode-se realizar uma comparação entre os dois tipos de agregados. Assim, em posse dos resultados, notou-se que o seixo misto obteve certa superioridade em relação ao seixo lavado e que apesar disso, tal material não pode ser considerado ideal para a produção de concreto estrutural, visto que o mesmo não possibilita a utilização de um teor de argamassa ideal para viabilizar seu uso. A pesquisa corroborou o quanto é importante a realização de estudos na área em foco para o desenvolvimento local, assim, tal estudo evidencia a possibilidade do emprego do seixo misto em obras de pequeno e médio porte, visto que o mesmo apresentou resultados considerados satisfatórios para esta finalidade.
Abstract
The objective of this study is to perform a concise comparison between the washed pebble and the mixed pebble used frequently in the composition of concrete traces in small and medium size works in the municipality of Tucuruí / PA-Brazil. Like this, from the tests of compressive strength, determination of water absorption, voids index and specific mass and from the use of a pre-established dosage for the washed pebble, a comparison can be made between the two types of aggregates. Thereby, in the possession of the results, it was noticed that the mixed pebble obtained some superiority in relation to the washed pebble and that nevertheless, such material cannot be considered ideal to produce structural concrete, since it does not allow the use of an ideal mortar content to enable its use. The research corroborated how important it is to carry out studies in the area in focus for local development, so, this study evidences the possibility of the use of the mixed pebble in small and medium sized works, since it presented results considered satisfactory for this finality.
Cadre pédagogique pour l’enseignement-apprentissage de l’improvisation musicale classique fondé sur la pratique des experts du domaine
Authors: Després Jean-Philippe , Burnard Pamela , Dubé Francis , Stévance Sophie 
Published: April 2018

Cette recherche porte sur l’enseignement-apprentissage de l’improvisation musicale classique. Afin d’offrir une perspective en profondeur de cet objet d’étude, des entrevues semi-dirigées ont été menées auprès de N = 15 participants, au sujet de leur processus d’apprentissage, de production et d’enseignement de l’improvisation. Différentes composantes de l’enseignement-apprentissage de l’improvisation musicale classique ont été identifiées : 18 compétences à développer chez l’apprenant et 23 approches d’enseignement-apprentissage. Ces connaissances offrent à celui qui s’intéresse à l’improvisation — qu’il soit enseignant ou apprenant, de niveau novice, débutant ou intermédiaire — des balises pour guider son apprentissage instrumental ou sa pratique pédagogique.
Sensory evaluation of complementary food based on cooking banana (musa spp.)and African yam bean (sphenostylis stenrcarpa)
Authors: Chisom Adeoye-Agomoh Queen , Ezenwa Happiness Chidinma 
Published: April 2018

This study evaluated the sensory qualities of infant complementary food based on cooking banana (CB) (Musa sapientum) and African yam bean (AYB) (Sphenostylis stenocarpa). These raw materials were purchased from Nkwoegwu local market in Umuahia North Local Government Area, Abia State. The legumes were picked and washed, boiled for 25 minutes and dehulled while cooking banana was washed, peeled, washed with warm water and sliced to 2mm thickness. The samples were separated, dried, milled and sifted into fine flour with muslin cloth. The flour was blended to composites in various proportions (80:20 (CAA), 60:40 (CAB)and 40:60 (CAC). Porridges were produced based on the composites. The organoleptic attributes of this food was assessed using 20 mothers, from a mother and child health clinic of Umuahia North Local Government, Abia State. The sensory assessment showed that the formulated porridges had moderate acceptability. This could be because the judges were not familiar with these porridges. The result was compared with “Nutrend” (a complementary food in the market produced by Nestlé Foods Nigeria) and pap (maize traditional complementary food).