bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors that facilitate and constrain the utilization of a Kaupapa Māori therapeutic approach with Mahi-a-Atua
Authors: Kopua Diana M 
Published: November 2018

Objectives: To further progress Kaupapa Māori ( Māori focused) approaches within mental health services this study explored the experiences of Māori clinicians from a dedicated Māori mental health service in New Zealand, with a focus on a specific Kaupapa Māori therapeutic approach, Mahi-a-Atua. Methods: A qualitative approach was used to ascertain factors that facilitate and obstruct the utilization of Mahi-a-Atua. In a focus group hui ( Māori meeting process), eight Māori clinicians discussed their experiences. Results: Facilitation of Mahi-a-Atua by Māori clinicians occurred through interconnectedness of a number of factors including cultural identity, relationships, wairuatanga (spirituality), kaitiakitanga (guardianship), validation of the model and the ability to co-work and engage in meaningful wānanga (learning) around the intervention. The extent to which clinicians used the model depended on their own perceived knowledge and confidence and how best able to integrate both cultural and clinical knowledge. Other constraining factors pertained to inadequate prior training, limited workforce development training and lack of adequate resourcing for specialized services. Conclusions: This research highlights the need for Māori focused specialized training that utilizes co-working within sessions and ongoing wānanga.
Recurrent PAX 6 mutation in a Chinese family with congenital aniridia, progressive cataracts and mental retardation
Authors: Chen Dou-Dou , Yang Tao , Zhu Si-Quan 
Published: November 2018

Background: One prominent pathological feature of congenital aniridia is hypoplasia of the iris, often accompanied by other eye abnormalities. The objective of this study is to identify gene mutations responsible for autosomal dominance in a Chinese family with congenital aniridia, progressive cataracts and mental retardation. Methods: A total of 11 family members, including 6 affected and 5 unaffected individuals were recruited. Whole exome sequencing was performed on the proband and Sanger sequencing was applied to identify the causal mutation in the other family members and control samples. Results: A heterozygous mutation, c. 112delC (p. Arg38fs) in PAX 6, was identified in the family that was associated with congenital aniridia, progressive cataracts and mental retardation. The mutation was exclusively observed in all affected individuals but not in unaffected family members or unrelated healthy controls without aniridia recruited from Beijing Tongren Hospital. Bioinformatics analysis indicated that the mutation c. 112delC (p. Arg38fs) in PAX 6 affected sugar phosphate backbone construction, leading to half reduction of the full-length protein. Other symptoms such as lens opacity, keratitis, lens dislocation, ciliary body hypoplasia, foveal hypoplasia and mental development retardation were also observed in this family. Conclusion: These results provided a new insight into the effects of PAX 6 as a mutational hotspot, with a symptom complex that includes congenital aniridia, progressive cataracts and mental retardation. These findings suggested the cognitive treatment of PAX 6-mutated individuals could be considered earlier clinically, combined with medication or surgery of congenital aniridia and progressive cataracts.
Operative duration-based learning period analysis for reverse and total shoulder arthroplasty: A multicenter study
Authors: Testa Edward J , Lowe Jeremiah T , Namdari Surena , Gillespie Robert J , Sears Benjamin W , Johnston Peter S ,   Rothman Institute Shoulder Consortium Group,   The Association of Shoulder Surgeons, Jawa Andrew 
Published: November 2018

Background A surgical learning period may be quantified after which operative duration is significantly reduced. We sought to retrospectively quantify and compare surgeon’s learning experience for total shoulder arthroplasty and reverse shoulder arthroplasty. Methods We reviewed 2055 shoulder arthroplasty cases from 2011 to 2015 for four early-career and four later-career fellowship-trained shoulder surgeons from four institutions. We plotted consecutive case number versus operative time for each surgeon separately for total shoulder arthroplasty or reverse shoulder arthroplasty. Two-step regression approach was used to determine a plateau point or end of the learning period. Additionally, the mean annual volume of reverse shoulder arthroplasty and total shoulder arthroplasty for each surgeon was plotted against mean surgery duration. Early- and later-career surgeons were compared with regression analysis. Results Early-career surgeons demonstrated a significant decrease in operative time with increasing annual case volume for reverse shoulder arthroplasty ( p = 0.01; m = −1.1) and total shoulder arthroplasty ( p = 0.02; m = −0.8). Three of four early-career surgeons reached a plateau point for either reverse shoulder arthroplasty or total shoulder arthroplasty between 12 and 86 cases. Conclusion For only early-career surgeons, higher case volume yields decreased operative duration, with improvement more pronounced for reverse shoulder arthroplasty compared to total shoulder arthroplasty. Though the learning period varies, it may be fewer than 90 cases.
Assessment of histopathology of wounds based on protein distribution detected by wound blotting
Authors: Kitamura Aya , Minematsu Takeo , Nakagami Gojiro , Sanada Hiromi 
Published: November 2018

Background: Shortening the duration of healing based on an accurate assessment is important in pressure ulcer management. This study focused on the peroxidase and alkaline phosphatase activity detected by wound blotting, a non-invasive method of collecting wound exudate, to establish a non-invasive and point-of-care assessment method for analyzing the histopathology of wounds using an animal model. Methods: Wounds were created on the dorsal skin of rats. Peroxidase and alkaline phosphatase activities in the wound exudate were detected by wound blotting on post-wounding days 1, 4, 7, and 10. Wound tissue was collected on the same sampling days. Peroxidase and alkaline phosphatase activity within the tissue and myeloperoxidase were visualized. Two types of peroxidase activities were detected by wound blotting: ring and non-ring signals. The histopathological features were compared between wounds with ring and non-ring signals. Results: The wounds with ring signals showed a high level of peroxidase activity, and histological analysis demonstrated that the secreted or deviated peroxidase activity originated from myeloperoxidase, indicating a strong inflammation reaction within the tissue. The histopathology of wounds related to the alkaline phosphatase signals was not identified. Conclusion: The results suggested that ring signals indicated a strong inflammatory reaction and that they could be used to assess non-visible inflammation.
Medial Elbow Pain During the Return-to-Throwing Period After Ulnar Collateral Ligament Reconstruction in Pitchers
Authors: Keller Robert A. , Marshall Nathan E. , Limpisvasti Orr , DeGiacomo Anthony F. , Banffy Michael , ElAttrache Neal S. 
Published: November 2018

Background: Ulnar collateral ligament reconstruction (UCLR) is common in the sport of baseball, particularly among pitchers. Postoperative return-to-sport protocols have many players beginning to throw at 4 to 5 months and returning to full competition between 12 and 16 months after surgery. Medial elbow pain during the return-to-throwing period often occurs and can be difficult to manage. Purpose: To evaluate the incidence of medial elbow pain and associations with outcomes and revision surgery during the return-to-throwing period after UCLR. Study Design: Case-control study; Level of evidence, 3. Methods: Between the years of 2002 and 2014, all pitchers who underwent UCLR at a single institution were identified. Charts were reviewed for incidence of medial elbow pain during return to throwing, return to sport, and subsequent operative interventions, including revision ulnar collateral ligament surgery. Results: Of a total of 616 pitchers who underwent UCLR during the study period, 317 were included in this study. Medial elbow pain was experienced by 45.1% (143 of 317), with a mean time of complaint of 9.75 months after surgery. The groups with and without pain did not differ statistically with regard to age (pain, 20.6 years; no pain, 20.9 years) or level of competition. Of those who experienced medial elbow pain, 10.5% did not return to sport; 5.6% underwent revision UCLR; and 19.6% underwent other operative procedures at the elbow. Among those who did not experience medial elbow pain when returning to throw, 8.7% did not return to sport, with only 1.7% undergoing revision UCLR and 6.9% undergoing other operative elbow procedures. Conclusion: Of the pitchers evaluated in the study, approximately half reported pain during the return-to-throwing phase after UCLR. Those who experienced medial elbow pain had a higher rate of subsequent surgical intervention.
Αμφίγραπτη εικόνα στο βυζαντινό μουσείο Καστοριάς
Authors: ΤΣΙΓΑΡΙΔΑΣ(Euthymios N. TSIGARIDAS) Ευθύμιος Ν. 
Published: November 2018

Στην αμφίγραπτη εικόνα της Καστοριάς εικονίζεται στην κυρία όψη ο άγιος Γεώργιος ολόσωμος με σκηνές του βίου του και στη δευτερεύουσα οι άγιοι Θεόδωροι αντωποί. Οι δύο όψεις της εικόνας είναι σύγχρονες και αποτελούν έργο ενός ζωγράφου της Καστοριάς του τέλους του 14ου αιώνα. Ο ζωγράφος αυτός παρουσιάζει στενή εικονογραφική, τυπολογική, προσωπογραφική και τεχνοτροπική συνάφεια με τοιχογραφίες ναών της πόλεως του δεύτερου μισού του 14ου αιώνα, όπως είναι του Αγίου Γεωργίου του Βουνού (1368-1385) και κυρίως του Αγίου Αθανασίου του Μουζάκη (1383/84) και του Χριστού Ζωοδότη στο Borje της Κορυτσάς (1389/90).
Do differences exist in the planning models across public and private hospitals?
Authors: Ochonma Ogbonnia , Nwatu Steve , Eze Bartholomew Soludo , Nwankwor Chikezie A , Henry-Arize Ifeyinwa , Igwe Sylvester , Nwodoh Chijioke 
Published: November 2018

Introduction: The hospital system in Nigeria has a dominant public sector coupled with an emerging private sector. There is an ongoing perception that public hospitals are inefficient compared to their private counterparts. These differences are being fuelled by perceived inequalities in managerial competencies. This study was conducted to explore these differing perceptions. Methods: A cross-sectional survey was distributed among healthcare managers in 25 hospitals. The data were analysed using the Statistical Package for Social Sciences. Results: The results established dominance of skills and competency for public hospital managers over private hospital managers in strategic planning (P=0.015), programme planning (P=0.007), and vision creation (P=0.003). Conclusion: The self-reported higher skills knowledge of public hospital managers was reinforced by the developed workforce, as well as the enhanced budgetary allocations that public hospitals received compared to their private counterparts.
The effects of residual hip deformity on coronal alignment of the lower extremity in patients with unilateral slipped capital femoral epiphysis
Authors: Ucpunar H. , Tas S. K. , Camurcu Y. , Sofu H. , Mert M. , Bayhan A. I. 
Published: November 2018

Purpose The aim of our explorative study was to compare the differences in the coronal alignments of the hip, knee and ankle on the slip side and non-slip sides in patients with slipped capital femoral epiphysis (SCFE). Methods The study group consisted of 28 patients. On the full-length standing radiographs, measurements of articulo-trochanteric distance (ATD), neck-shaft angle (NSA), femoral offset, hip-knee-ankle axis, femur-tibial angle, mechanical axis deviation ratio (MAD-r), anatomical medial proximal femoral angle (aMPFA), mechanical lateral proximal femoral angle (mLPFA), anatomical lateral distal femoral angle (aLDFA), mechanical lateral distal femoral angle (mLDFA), knee joint line congruency angle, mechanical medial proximal tibial angle (mMPTA), mechanical lateral distal tibial angle (mLDTA), ankle joint line orientation angle (AJOA), and leg length discrepancy (LLD) were performed. The data from the slip side were compared with those from the non-slip side. Results At skeletal maturity, there were significant differences between the slip side and non-slip side in ATD (p <0.001), NSA (p <0.001), MAD-r (p <0.001), aMPFA (p <0.001), aLDFA (p = 0.03), mLDFA (p = 0.04), mLDTA (p = 0.02), AJOA (p <0.001) and LLD (p<0.001). Conclusion Residual deformity in the proximal femur after epiphyseal slip and premature epiphysiodesis could cause changes in the coronal alignment of the lower extremity. We can add lower extremity alignment examination to follow-up protocol to rule out secondary problems in patients with SCFE. Level of Evidence Level III, retrospective comparative study
Overproduction and Purification of Soluble Recombinant Human Granulocyte Colony Stimulating Factor in <i>Escherichia coli</i> Using Thioredoxin as Fusion
Authors: Agustiyanti Dian Fitria , Retnoningrum Debbie Sofie , Rachmawati Heni , Fuad Asrul Muhamad 
Published: November 2018

Recombinant human Granulocyte Colony Stimulating Factor (G-CSF) has been produced in a soluble form in Escherichia coli BL21 (DE3) as a fusion protein. The open reading frame of G-CSF was synthetically constructed in previous work and was codon optimized for best expression in E. coli. In this research, the gene was fused to thioredoxin (Trx) at the N-terminal in pET32 vector. The purpose of this research was to optimize the overproduction and purification processes to obtain high yield recombinant protein in soluble form, and to characterize the Trx-G-CSF fusion protein. Overproduction was performed using IPTG induction method for 3 and 6 hours. The protein was purified by Ni-NTA affinity chromatography and separated using gradient concentration of imidazole. The purified protein was then characterized by SDS-PAGE and Western Blot analysis. Further, enterokinase was used to separate G-CSF from the fusion protein. The purified form of G-CSF was subsequently characterized using Western Blot and mass spectrometry using MALDI-TOF. The results showed that the fusion protein was successfully produced in soluble part as much as 48.25% were obtained after 3 hours of induction. The yield of fusion protein was 67.37% from total protein (229.65 mg protein/L culture). The Western Blot analysis showed the G-CSF band at around 18.6 kDa. Mass spectrometry with MALDI-TOF/ TOF revealed that 25.86% of amino acid residue was recognized as part of human G-CSF sequence.
Bestandsmonitoring in kulturellen Einrichtungen
Authors: Großmann Marcel , Illig Steffen , Lappe Jannik , Matějka Cornelius 
Published: November 2018

Zusammenfassung
Bislang werden in vielen kulturellen Einrichtungen die Umweltbedingungen für vorhandene Bestände lediglich in regelmäßigen Intervallen händisch kontrolliert. Dieses pragmatische Vorgehen ist dem Umstand geschuldet, dass für ein Monitoring in Bestandsobjekten bislang nur kommerzielle Systeme zur Verfügung stehen, die auch aufgrund des Kostenfaktors meist nur in spezialisierten Anwendungsfällen zum Einsatz kommen. Basierend auf dieser Ausgangslage wurde ein Open-Source-Framework entwickelt, das mit günstiger Hardware betrieben werden kann. An der Universitätsbibliothek Bamberg wird dieses System seit September 2017 an unterschiedlichen Standorten erfolgreich eingesetzt.
Effect of an activated charcoal product (DOAC Stop™) intended for extracting DOACs on various other APTT-prolonging anticoagulants
Authors: Exner Thomas , Ahuja Monica , Ellwood Lisa 
Published: November 2018

Abstract

Background
The aim of the study was to investigate the specificity of an activated charcoal-based product (DOAC Stop™) initially intended for the specific extraction of direct oral anticoagulants (DOACs) from test plasmas on a range of other anticoagulants.

Methods
Test plasmas were prepared by adding various anticoagulants to pooled normal plasma at concentrations prolonging an activated partial thromboplastin time (APTT) test by a factor of 1.5–3. These plasmas were treated with DOAC Stop™ for 5 and 20 min. Then APTTs were repeated and residual anticoagulant concentrations estimated from dose-response curves.

Results
The activated charcoal (AC)-based product was found to extract DOACs efficiently. It also bound the intravenous anticoagulants argatroban and lepirudin, but it had no effect on heparin, enoxaparin or danaparoid in plasma. Among other APTT-inhibiting agents that might be present in test plasmas from patients, it extracted protamine, aprotinin and polymyxin. It had no effect on annexin V, thrombomodulin, a typical lupus anticoagulant, a factor VIII antibody, activated protein C or its activator, but it did bind some cationic inhibitors of the APTT with molecular weight below approximately 30 kDa.

Conclusions
The AC-based product extracted DOACs efficiently with no effect on heparin-type anticoagulants. It did bind argatroban and hirudin-type anticoagulants, which might occur in plasmas from some inpatients, and APTT results obtained after its use should be interpreted after due consideration of patient medications.
Learning from tragedy: the Julia Berg story
Authors: Graber Mark L. , Berg Dan , Jerde Welcome , Kibort Phillip , Olson Andrew P.J. , Parkash Vinita 
Published: November 2018

AbstractThis is a case report involving diagnostic errors that resulted in the death of a 15-year-old girl, and commentaries on the case from her parents and involved providers. Julia Berg presented with fatigue, fevers, sore throat and right sided flank pain. Based on a computed tomography (CT) scan that identified an abnormal-appearing gall bladder, and markedly elevated bilirubin and “liver function tests”, she was hospitalized and ultimately underwent surgery for suspected cholecystitis and/or cholangitis. Julia died of unexplained post-operative complications. Her autopsy, and additional testing, suggested that the correct diagnosis was Epstein-Barr virus infection with acalculous cholecystitis. The correct diagnosis might have been considered had more attention been paid to her presenting symptoms, and a striking degree of lymphocytosis that was repeatedly demonstrated. The case illustrates how cognitive “biases” can contribute to harm from diagnostic error. The case has profoundly impacted the involved healthcare organization, and Julia’s parents have become leaders in helping advance awareness and education about diagnostic error and its prevention.
L

p(·)–L

q(·) boundedness of some integral operators obtained by extrapolation techniques
Authors: Urciuolo Marta , Vallejos Lucas 
Published: November 2018

Abstract
Given a matrix A such that

A
M

=
I

{A^{M}=I}

and

0
≤
α
<
n

{0\leq\alpha<n}

, for an exponent p satisfying

p
⁢

(

A
⁢
x

)

=

p
⁢

(
x
)

{p(Ax)=p(x)}

for a.e.

x
∈

ℝ
n

{x\in\mathbb{R}^{n}}

, using extrapolation techniques, we obtain

L

p
⁢

(
⋅
)

→

L

q
⁢

(
⋅
)

{L^{p(\,\cdot\,)}\rightarrow L^{q(\,\cdot\,)}}

boundedness,

1

q
⁢

(
⋅
)

=

1

p
⁢

(
⋅
)

-

α
n

{\frac{1}{q(\,\cdot\,)}=\frac{1}{p(\,\cdot\,)}-\frac{\alpha}{n}}

, and weak type estimates for integral operators of the form

T
α

⁢
f
⁢

(
x
)

=

∫

f
⁢

(
y
)

|

x
-

A
1

⁢
y

|

α
1

⁢
⋯
⁢

|

x
-

A
m

⁢
y

|

α
m

⁢

𝑑
y

,

T_{\alpha}f(x)=\int\frac{f(y)}{|x-A_{1}y|^{\alpha_{1}}\cdots|x-A_{m}y|^{\alpha%
_{m}}}\,dy,

where

A
1

,
…
,

A
m

{A_{1},\dots,A_{m}}

are different powers of A such that

A
i

-

A
j

{A_{i}-A_{j}}

is invertible for

i
≠
j

{i\neq j}

,

α
1

+
⋯
+

α
m

=

n
-
α

{\alpha_{1}+\cdots+\alpha_{m}=n-\alpha}

.
We give some generalizations of these results.
An Efficient Lossless ROI Image Compression Using Wavelet-Based Modified Region Growing Algorithm
Authors: Sreenivasulu P. , Varadarajan S. 
Published: November 2018

Abstract
Nowadays, medical imaging and telemedicine are increasingly being utilized on a huge scale. The expanding interest in storing and sending medical images brings a lack of adequate memory spaces and transmission bandwidth. To resolve these issues, compression was introduced. The main aim of lossless image compression is to improve accuracy, reduce the bit rate, and improve the compression efficiency for the storage and transmission of medical images while maintaining an acceptable image quality for diagnosis purposes. In this paper, we propose lossless medical image compression using wavelet transform and encoding method. Basically, the proposed image compression system comprises three modules: (i) segmentation, (ii) image compression, and (iii) image decompression. First, the input medical image is segmented into region of interest (ROI) and non-ROI using a modified region growing algorithm. Subsequently, the ROI is compressed by discrete cosine transform and set partitioning in hierarchical tree encoding method, and the non-ROI is compressed by discrete wavelet transform and merging-based Huffman encoding method. Finally, the compressed image combination of the compressed ROI and non-ROI is obtained. Then, in the decompression stage, the original medical image is extracted using the reverse procedure. The experimentation was carried out using different medical images, and the proposed method obtained better results compared to different other methods.
Effect of aggregate gradation on rutting of asphalt concrete by using a wheel tracking device in Vietnam
Authors: Nguyen Hoang Long , Le Thanh Hai 
Published: November 2018

Abstract
This paper presents the relationship between rutting and aggregate gradation of asphalt concrete using a wheel tracking device at 60°C, with 30,000 cycles in air. The experiment was carried out on hot mix asphalt samples using three aggregate gradations which included maximum aggregate sizes of 9.5 mm, 12.5 mm and 19 mm. The result of the experiment showed that the maximum aggregate size has a great influence on the rutting of asphalt concrete.
2D:4D Ratio differs in ischemic stroke: A single center experience
Authors: Yang Ke , Ding XianHui , Zhou ZhiMing , Shi XiaoLei 
Published: November 2018

Abstract

Background
The index to ring finger length (2D:4D) ratio is a proxy biomarker for prenatal exposure of sex hormones. Sex hormones are associated with the pathogenesis of ischemic stroke. The purpose of the study was to demonstrate the association between 2D:4D and ischemic stroke.

Methodology
This study retrospectively reviewed the data of 100 patients with first ever ischemic stroke between September, 2016 and June, 2017. The lengths of index finger and ring finger of both hands were measured using electronic calipers and calculated for 2D:4D ratios. Receive operating characteristic (ROC) mode was used to detect predicting performance of 2D:4D ratios for ischemic stroke.

Results
2D:4D ratios in ischemic stroke patients were higher than controls in both hands (P < 0.05), except right 2D:4D ratio in females. The ROC analyses showed that the area under the curve (AUC) were 0.635 (95%CI: 0.527-0.743) for left 2D:4D ratio, and 0.647 for right (95%CI: 0.539-0.755) (P < 0.05). The AUC of left and right 2D:4D ratio in male were 0.667 (95%CI: 0.514-0.820) and 0.670 (95%CI: 0.519-0.822) (P < 0.05). In female, no significance were found in ROC analysis. And there were no correlation between 2D:4D value and stroke severity (P > 0.05).

Conclusions
The current study indicated that the diagnostic value of 2D:4D ratio was limited in ischemic stroke. Further research is required to explore the role of it in screening ischemic stroke.