bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical Facial Clefts From Northcentral Nigeria, Review of 36 Cases
Authors: Bello Seidu A. , Ibikari Allwell Brown , Oketade Ifeoluwa , Balogun Saliu A. 
Published: July 2018

Objective: This study aims to present the pattern and management of atypical facial clefts from a Nigerian population. Design: This is a retrospective study of patients seen during series of surgical outreach programs in North Central Nigeria, between 2011 and 2017. All cases of atypical facial clefts encountered were evaluated for the pattern of presentation using Tessier classification system. All of them were surgically repaired and outcome was determined using a Likert scale. Data were presented using descriptive statistics. Setting: Outreach programs in North Central Nigeria by Cleft & Facial Deformity Foundation. Results: Thirty-six patients, 19 (52.8%) males and 17 (47.2%) females, were studied. The age range was 1 week to 34 years, with mean (standard deviation) of 11.2 (11.8) years. Fifty-eight cleft cases were recorded, with Tessier 1 being the commonest (n = 14; 24.1%) cleft type. There were 35 (60.3%) cases of middle cleft, 14 (24.2%) cases of oblique cleft, and 9 (15.5%) cases of lateral cleft. Typical cleft lip and palate coexisted with atypical facial cleft in 2 (5.6%) patients. Cleft was found to be median in 12 (33.3%) patients and right sided in 9 (25%) patients. Majority (n = 24, 66.7%) of the cases were repaired by simple excision plus direct closure with successful outcome. Conclusions: Numerical classification by Paul Tessier has reduced the inconsistencies of nomenclature among practitioners. Majority of atypical facial clefts could be treated by simple techniques with satisfactory outcomes. However, the more complex cases will require multistaged surgical approach.
Radiofrequency Ablation Combined With Transarterial Chemoembolization for Specially Located Small Hepatocellular Carcinoma
Authors: Yuan Wei , Yang Min-Jie , Xu Jiang , Yan Zhi-Ping , Liu Rong , Qu Xu-Dong , Wang Jian-Hua , Qian Sheng 
Published: July 2018

Objective: To investigate the safety and efficacy of radiofrequency ablation combined with transarterial chemoembolization in patients with specially located small hepatocellular carcinoma. Materials and Methods: Between March 2014 and March 2017, a total of 26 patients with 26 lesions (10 perivascular, 6 subdiaphragmatic, 5 subcapsular, 5 perivascular, and subdiaphragmatic location; mean diameter 2.12 (0.62) cm), who received radiofrequency ablation–transarterial chemoembolization treatment, were retrospectively analyzed. Local tumor response was assessed by computed tomography/magnetic resonance imaging 1 month after the procedure. Tumor-free survival was also assessed according to the modified Response Evaluation Criteria in Solid Tumors. Complications were evaluated according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events (version 4.0). Results: Complete response was achieved in all patients 1 month after the procedure. During a median follow-up duration of 16.76 months (95% confidence interval: 7.78-25.73 months), local tumor recurrence occurred in 2 patients and new intrahepatic lesions developed in 7 patients. The 1-, 2-, and 3-year cumulative local tumor progression rates were 3.84%, 7.69%, and 7.69%, respectively. The median tumor-free survival duration was 21.96 months (95% confidence interval: 17.58-26.34 months). The 1-, 2-, and 3-year tumor-free survival rates were 67.4%, 46.1%, and 39.3%, respectively. Conclusion: The radiofrequency ablation–transarterial chemoembolization combination therapy appears to be safe and effective and might be a treatment option for specially located small hepatocellular carcinoma lesions that have a risk of incomplete ablation or major complications.
Implementation of a point-of-care ultrasound skills practicum for hospitalists
Authors: Cochard Emily , Fulkerson Zachary , Carlos W Graham 
Published: July 2018

Introduction Point-of-care ultrasound is recognized as a safe and valuable diagnostic tool for patient evaluation. Hospitalists are prime candidates for advancing the point-of-care ultrasound field given their crucial role in inpatient medicine. Despite this, there is a notable lack of evidence-based ultrasound training for hospitalists. Most research focuses on diagnostic accuracy rather than the training required to achieve it. This study aims to improve hospitalists' point-of-care ultrasound knowledge and skills through a hands-on skills practicum. Methods Four skill practicums were conducted with pre-course, post-course, and six-month evaluations and knowledge assessments. Results The mean pre- vs. post-course knowledge assessment scores significantly improved, 41.7% vs. 75.9% (SD 16.1% and 12.7%, respectively, p < 0.0001). The mean ultrasound skills confidence ratings on a 10-point Likert scale significantly increased post-course (2.60 ± 1.66 vs. 6.33 ± 1.63, p < 0.0001), but decreased at six months (6.33 ± 1.63 vs. 4.10 ± 2.22, p < 0.0001). The greatest limitations to usage pre-course and at six months were knowledge/skills and lack of machine access. While knowledge/skills decreased from pre-course (82.0%) as compared to six-months (64.3%), lack of machine access increased from pre-course (15.8%) to six-months (28.6%) ( p = 0.28). Conclusion Hospitalists agree that point-of-care ultrasound has utility in the diagnostic and therapeutic management of patients, though the lack of training is a significant limitation. Our study demonstrated that a brief skills practicum significantly improves hospitalists’ confidence and knowledge regarding ultrasound image acquisition and interpretation in the short term. Long-term confidence and usage wanes, which appears to be due to the lack of machine access.
Trickle-Down Ethnic Politics: Drunk and Absent in the Kenya Police Force (1957–1970)
Authors: Vanden Eynde Oliver , Kuhn Patrick M. , Moradi Alexander 
Published: July 2018

How does ethnic politics affect the state’s ability to provide policing services? Using a panel of administrative personnel data on the full careers of 6,784 police officers, we show how the rise of ethnic politics around Kenya’s independence influenced policemen’s behavior. We find a significant deterioration in discipline after Kenya’s first multiparty election for those police officers of ethnic groups associated with the ruling party. These effects are driven by a behavioral change among these policemen. We find no evidence of favoritism within the police. Instead, our results are consistent with co-ethnic officers experiencing an emboldenment effect. Our findings highlight that the state’s security apparatus, at its most granular level, is not insulated from ethnic politics. (JEL D72, J15, K42, O15, O17)
Does 3DMR provide equivalent information as 3DCT for the pre-operative evaluation of adult Hip pain conditions of femoroacetabular impingement and Hip dysplasia?
Authors: Yan Kevin , Xi Yin , Sasiponganan Chayanit , Zerr Joseph , Wells Joel E , Chhabra Avneesh 
Published: July 2018

Objective:
Femoroacetabular impingement (FAI) and hip dysplasia (HD) are frequently evaluated by isotropic CT (3DCT) for preoperative planning at the expense of radiation. The aim was to determine if isotropic MRI (3DMR) imaging can provide similar quantitative and qualitative morphological information as 3DCT.

Methods:
25 consecutive patients with a final diagnosis of FAI or HD were retrospectively selected from December 2016-December 2017. Two readers (R1, R2) performed quantitative angular measurements on 3DCT and 3DMR, blinded to the diagnosis and each other's measurements. 3DMR and 3DCT of the hips were qualitatively and independently evaluated by a radiologist (R3), surgeon (R4), and fellow (R5). Interobserver and intermodality comparisons were performed.

Results:
The ICC was good to excellent for all measurements between R1 and R2 (ICC:0.60-0.98) and the majority of intermodality measurements for R1 and R2. Average inter-reader and inter-modality PABAK showed good to excellent agreement for qualitative reads. On CT, all alpha angles (AA) were significantly lower in dysplasia patients than in cam patients (p &lt; 0.05). All lateral center-edge angle (LCEA) were significantly lower in dysplasia than in cam patients (p &lt; 0.05). On MR, AA at 12, 1, and 2 o'clock, and LCEA at center were significantly lower in dysplasia patients than in cam patients (p &lt; 0.05).

Conclusion:
3DMR offers similar qualitative and quantitative analysis as 3DCT in adult painful hip conditions.

Advances in knowledge:
3DMR has good potential to replace 3DCT and serve as a one-stop modality for bone and soft tissue characterizations in the pre-operative evaluation of FAI and HD.
Predictors of quality of life of older persons in rural Uganda: A cross sectional study
Authors: Maniragaba Fred , Kwagala Betty , Bizimungu Emmanuel , Ojiambo Wandera Stephen , Ntozi James 
Published: July 2018

Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda. Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied. Results: Older persons in northern (OR=0.39; p=0.002) and western (OR=0.33; p<0.001) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; p=0.031) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; p=<0.001). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06; p=0.040) relative to those whose assets were controlled by their children. Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.
Probing Plasmodium falciparum sexual commitment at the single-cell level
Authors: Brancucci Nicolas M.B. , De Niz Mariana , Straub Timothy J. , Ravel Deepali , Sollelis Lauriane , Birren Bruce W. , Voss Till S. , Neafsey Daniel E. , Marti Matthias 
Published: July 2018

Background: Malaria parasites go through major transitions during their complex life cycle, yet the underlying differentiation pathways remain obscure. Here we apply single cell transcriptomics to unravel the program inducing sexual differentiation in Plasmodium falciparum. Parasites have to make this essential life-cycle decision in preparation for human-to-mosquito transmission. Methods: By combining transcriptional profiling with quantitative imaging and genetics, we defined a transcriptional signature in sexually committed cells. Results: We found this transcriptional signature to be distinct from general changes in parasite metabolism that can be observed in response to commitment-inducing conditions. Conclusions: This proof-of-concept study provides a template to capture transcriptional diversity in parasite populations containing complex mixtures of different life-cycle stages and developmental programs, with important implications for our understanding of parasite biology and the ongoing malaria elimination campaign.
Beyond Heavy-Traffic Regimes: Universal Bounds and Controls for the Single-Server Queue
Authors: Huang Junfei , Gurvich Itai 
Published: July 2018

Central-limit (Brownian) approximations are widely used for the performance analysis and optimization of queueing networks because of their tractability relative to the original queueing models. The stationary distributions of the approximations are used as proxies for those of the queues. The convergence of suitably scaled and centered processes provides mathematical support for the use of these Brownian models. As with the central limit theorem, to establish convergence, one must impose assumptions directly on the primitives or indirectly on the parameters of a related optimization problem. These assumptions reflect an interpretation of the underlying parameters—a classification into so-called heavy-traffic regimes that specify a scaling relationship between the utilization and the arrival rate. Here, it matters whether a utilization of 90% in a queue with an arrival rate of λ = 100 is read as [Formula: see text] or as ρ(λ) ≡ 0.9, because different interpretations lead to different limits and, in turn, to different approximations. However, from a heuristic point of view, there is an immediate Brownian (i.e., normal) analogue of the queueing model that is derived directly from the primitives and requires no scaling interpretation of the parameters. In this model, the drift is that of the original queue, and the noise term is replaced by a Brownian motion with the same variance. This is intuitive and appealing as a tool, but it lacks mathematical justification. In this paper, we prove that for the fundamental M/GI/1 + GI queue, this direct intuitive approach works: the Brownian model is accurate uniformly over a family of patience distributions and universally in the heavy-traffic regime. The validity of this approach extends to dynamic control in that the solution of the directly derived diffusion control problem is universally accurate. To build mathematical support for the accuracy of this model, we introduce a framework built around “queue families” that allows us to treat various patience distributions simultaneously, and it uncovers the role of a concentration property of the queue. The e-companion is available at https://doi.org/10.1287/opre.2017.1715 .
A process evaluation of the first year of Leading Change, Adding Value
Authors: Zubairu Kate , Lievesley Kate , Silverio Sergio A. , McCann Stacey , Fillingham Jill , Kaehne Axel , Sandars John , Carey Lynda , Aitkenhead Susan , Brown Jeremy 
Published: July 2018

Background: Leading Change, Adding Value (LCAV) is a national framework to support transformational change across health and social care. Design: a qualitative approach of semi-structured interviews was used to capture information on how LCAV has been disseminated in its early stages from the perspective of key stakeholders and partners. This also included looking at how it might be embedded into everyday practice. Methods: data collection took place over a 3-month period between January and March 2017. Twenty semi-structured telephone interviews were conducted with key LCAV partners and stakeholders from across health and social care. Perceptions were sought as to how LCAV has been, and may be, used by frontline staff following initial dissemination and any potential barriers and enablers to taking the framework forward. Results: a thematic framework analysis of data identified a three-theme paradigm to evaluate LCAV: past—where has this come from? Present—where is it now? Future—where is this going?. Conclusion: a programme of dissemination events and examples of good practice in the form of case studies have been valuable tools to engage nursing, midwifery and care staff across health and social care. Continuing to establish networks of frontline staff engaging with LCAV and supporting each other will help facilitate best practice sharing, and multi-professional and cross-boundary working.
Cathodic modification of stainless steels with ruthenium: a review of recent advances in making the cheaper option cheaper
Authors: Moyo Fortunate , van der Merwe Josias W. , Wamwangi Daniel , Mgwebi Yonela A. 
Published: July 2018

AbstractCorrosion resistance of stainless steels is significantly compromised in oxygen-deficient environments, leading to limited service life as well as unsatisfactory performance of the structures made of these alloys. Cathodic modification with ruthenium has been demonstrated to remarkably improve the corrosion resistance of stainless steels in reducing acidic media, even in the presence of an abrasive suspension. Although ruthenium is several times cheaper than other platinum group metals (PGMs), alloying with ruthenium remains prohibitively more expensive than alloying with conventional, although less effective, metals. A number of strategies have been explored to reduce the amount of ruthenium required to cathodically modify stainless steels in a bid to make this cheaper option much cheaper and thus increase the cost-benefits of using these alloys. Some of the strategies include partially substituting ruthenium with cheaper metals, as well as introducing the PGM as a surface alloy.
Cortical and meningeal pathology in progressive multiple sclerosis: a new therapeutic target?
Authors: Silva Berenice Anabel , Ferrari Carina Cintia 
Published: July 2018

Abstract
Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease that involves an intricate interaction between the central nervous system and the immune system. Nevertheless, its etiology is still unknown. MS exhibits different clinical courses: recurrent episodes with remission periods (‘relapsing-remitting’) that can evolve to a ‘secondary progressive’ form or persistent progression from the onset of the disease (‘primary progressive’). The discovery of an effective treatment and cure has been hampered due to the pathological and clinical heterogeneity of the disease. Historically, MS has been considered as a disease exclusively of white matter. However, patients with progressive forms of MS present with cortical lesions associated with meningeal inflammation along with physical and cognitive disabilities. The pathogenesis of the cortical lesions has not yet been fully described. Animal models that represent both the cortical and meningeal pathologies will be critical in addressing MS pathogenesis as well as the design of specific treatments. In this review, we will address the state-of-the-art diagnostic and therapeutic alternatives and the development of strategies to discover new therapeutic approaches, especially for the progressive forms.
Lotman, Leibniz, and the semiospheric monad: Lost pages from the archives
Authors: Restaneo Pietro 
Published: July 2018

AbstractThroughout his life, Jurij Lotman lived at the crossroad between different worlds, ages, and cultures. The many authors, cultures, and ideas that shaped his thought and influenced his theories are scattered at either side of countless geographical, political, and cultural borders, beginning with the one that separates “Russian culture” from “European culture,” porous and ambiguous as any boundary.The task of reconstructing how Lotman’s ideas came to being, how they shifted their meaning as their context shifted, is more and more a crucial task not only for the historian. Many Lotmanian concepts, first and foremost that of semiosphere, are acquiring major relevance not only for semiotics itself and its branches, such as the rising political semiotics, but also for many neighboring disciplines, such as cultural studies and political sciences. Therefore, gaining a better understanding of the meaning of Lotman’s ideas could be of value also for the applied semiotician or the political analyst.The present paper is the result of research started in the Lotman Archives in Tallin, Estonia. Through an analysis of archival material, it aims at reconstructing the origins and meaning of the most political tropes of Lotman’s theories, especially what I will call his theory of the political subject. In the first part, I will argue that, in order to understand this political aspect of Lotman, it is necessary to take into consideration the intellectual debates inside which the author started his intellectual journey in 1930s–1940s Soviet Russia, and how he sought answers to those debates in the works of G. W. Leibniz.In the final part of the paper, I will try to show how this reconstruction of Lotman’s history could contribute to the contemporary debate in semiotics and other connected disciplines.
Epidural Anesthesia for Caesarean Section in a Patient with Risk of Malignant Hyperthermia
Authors: Vukotic Aleksandra , Vukotic Milovan 
Published: July 2018

Abstract
Malignant hyperthermia is a hypermetabolic disorder of skeletal muscle that occurs in genetically susceptible individuals after exposure to anesthetic. Basic disorder is an increase of calcium ions inside the skeletal muscle, increasing metabolism and reducing cell energy supplies leading to development of acidosis, cell membrane destruction and cell death. Due to the increased metabolism occurs hypercarbia and strong stimulation of the sympathetic nervous system (tachycardia, hypertension, ventricular arrhythmia, tachypnea dropped for the neuromuscular blockade). Sweating, cyanosis, muscle rigidity and hyperthermia are also present.
This work presents the case of a female patient aged 32 who was heterozygous for the mutation RYR1 gene and therefore has an increased risk of malignant hyperthermia. Per anamnesis we got data that patient’s brother suffers from central core disease (myopathy). Patient has no muscle disease, 41st week of pregnancy and was admitted to the hospital for childbirth. Vaginal delivery in epidural analgesia was planned. Epidural catheter is placed in the space L3 - L4, through which she received 0.25% levobupivacaine 10 ml. Due to adverse obstetric findings cesarean section underwent after two hours. Given the increased risk of malignant hyperthermia, the safest type of anesthesia for cesarean is epidural anesthesia. Over the epidural catheter has received 0.5% levobupivacaine 18 ml. Anesthesia machine was verified, hoses were replaced with new ones, CO2 absorber system was replaced, and whole system is flushed with pure oxygen, before surgery started. During the operation the patient had stable vital parameters that are monitored. She got a male child Apgar score of 9/10 and saw her child at birth. After the operation was transferred to the intensive care unit where we monitored the vital parameters, laboratory analysis, the amount and color of urine. Since all parameters were satisfactory, following day she was transferred to the ward, and she was discharged with a child on the fourth day after the surgery.
The Surgical Management of Gardner Syndrome Manifestation in the Maxillofacial Region: A Case Report
Authors: Loncarevic Slobodan , Brajkovic Denis , Popovic Milica , Gardasevic Milka , Sekulic Miona , Matejic Suzana 
Published: July 2018

ApstraktGardner syndrome is a rare autosomal-dominant genetic disorder, considered a variant of familial adenomatous polyposis. It is characterized by intestinal polyposis and various bone and soft-tissue tumors, including osteomas, epidermal and dermal cysts, lipomas and fibromas. Intestinal polyps have high potential to become malignant, and the screening of intestinal lesions is mandatory. Maxillofacial manifestations, such as jaw osteomas, odontomas, dental abnormalities and soft tissue tumors frequently precede the intestinal manifestations. Thus, maxillofacial surgeons and dental practitioners may have important role in early detection of Gardner syndrome. In this case report we present a 22 year old male patient who was reffered to maxillofacial surgeon due to osteoma of the mandible. After obtaining clinical and radiological examinations, as well as data from family history, Gardner syndrome was suspected, which was later confirmed after gastroenterological examination.