bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Black Sombrero: A Helpful Landmark in Axial Imaging Evaluation of the Larynx and Hypopharynx
Authors: Fernando Adrian F. , Lapeña Jose Florencio F. , Maglalang Gil M. 
Published: April 2019

Computed Tomograpy (CT) scan and Magnetic Resonance Imaging (MRI) evaluation of the larynx and hypopharynx can be tricky for the untrained eye. We discuss a peculiar pattern of the supraglottic airway at the level of the base of the epiglottis seen on axial CT and MR images, resembling a “black hat” or a “black sombrero.” The level of the base of the epiglottis also corresponds to that of the hyoid bone, where two valuable hypopharyngeal sub-sites are visible- the pyriform sinuses and the posterior hypophayngeal wall.

A hat has basically two parts, an apical convex crown and a basal horizontal brim. (Figure 1.A) Correlating the hat’s appearance on axial CT and MR imaging, the hat appears black due to the presence of air at the supraglottic level wherein the crown is positioned anteriorly and the brim positioned posteriorly. (Figure 1.B)

The top-most convex part of the crown corresponds to the base of the epiglottis. Anterior to it is the pre-epiglottic fat plane and the body of the hyoid bone. The crown is also flanked by the paraglottic fat plane on both sides that appears hypodense (dark) on CT and hyperintense (bright) on T1 MRI. On the other hand, the posterior-most portion of the hat’s brim abuts the posterior hypopharyngeal wall - laterally outlining the pyriform sinuses on each side. The area where the crown joins the brim corresponds to the aryepiglotic folds that are delineated laterally by the medial walls of the pyriform sinuses while its medial aspects correspond to portions of the supraglottis. (Figure 2)
The size and configuration of the hat varies and can range from one with a big crown and a small brim (resembling a “bowler” or “derby hat”) to one with a tall crown and a floppy brim (resembling a “Mexican sombrero”). (Figures 2, 3) Infiltrating tumors and inflammatory processes can distort the hat’s usual symmetric configuration, and can be useful in determining possible sites of inflammation or infection, tumor origin, and spread to hypopharyngeal and supraglottic structures, as the hat’s center represents a potential space at the supraglottic area devoid of any soft tissue structures. (Figure 4)
In radiology, “the bowler hat sign” and “Mexican hat sign” have been used to describe gastrointestinal polyps.1,2,3 The former “is produced by the acute angle of attachment of the polyp to the mucosa” while the latter “consists of two concentric rings and is produced by visualizing a pedunculated polyp head-on.”1 The “Mexican hat sign” has also been used to describe osmotic demyelination on MRI.4

To our knowledge, these terms have not been applied to the interpretation of supraglottic and hypopharyngeal CT and MRI axial images. Recognition of the “Black Sombrero” pattern can be helpful in understanding the anatomic relationship of the supraglottic and hypopharynx structures on axial CT and MR imaging, particularly in the evaluation of supraglottic and hypopharyngeal tumor spread.
Tube Extrusion and Cheese Wiring Five Years Post Dacryocystorhinostomy
Authors: Anuar Khairullah Bin , Gendeh Balwant Singh 
Published: April 2019

Objective: Dacrocystorhinostomy (DCR) with silicone tube stenting is a common procedure for congenital nasolacrimal duct obstruction (NLDO). The incidence of congenital NLDO is about 6% in the newborn. The duration the tube is left in place varies depending on surgeon preference. Cheese wiring is one of the tube-related complications when the tube is left behind for a long duration. The term cheese wiring refers to the silicone stent or tubing cutting through soft tissue close to the punctum or canaliculi like wire cuts through cheese. We present a case of tube extrusion with cheese wiring 5 years post DCR.
Methods:
Study Design: Case report
Setting: Tertiary Referral Centre
Patient: One
Results: A 16 year old Indian male with congenital bilateral NLDO underwent right and left DCR at ages 9 and 11 respectively. The patient presented with smelly nasal discharge 5 years later to the ENT clinic. On initial examination the right tube was in place but the left tube was not visualized. Nasal endoscopy however revealed that both tubes were still there and were subsequently removed.
Conclusion: DCR with silicone intubation is a common practice. Early follow up is essential to prevent complications. If tube extrusion is suspected, early endoscopic examination is essential to confirm it

Keywords: nasolacrimal duct obstruction, dacrocystorhinostomy, tube extrusion, cheese wiring
Association of Excessive Daytime Sleepiness and Obesity with Apnea-Hypopnea Index in Adult Patients Suspected of Obstructive Sleep Apnea Syndrome
Authors: King-Chao Nikki Lorraine Y. , Sarte Michael A. 
Published: April 2019

Objective: To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI.
Methods:
Study Design: Non-Concurrent Cohort Study
Setting: Tertiary Private Hospital
Population: The charts of 389 patients suspected to have sleep disorders and referred for polysomnography (PSG) at the Center for Snoring and Sleep Disorders in year 2009 were reviewed. Inclusion criteria were patients aged 19 and above with complete data. A total of 238 patient charts were included in the study.
Results:The study included a total of 238 patient charts. Results showed no significant association between ESS and AHI (p-value >0.05), even when correlated with the different severities of OSAS (p-value>0.05). Sensitivity and specificity of ESS was found to be 54% and 57%, respectively, indicating that ESS is not a sensitive and specific tool to predict the presence of OSAS. These findings suggest that ESS may not be able to significantly identify patients with OSAS. However, BMI showed a significant association with ESS (p-value<0.05), representing more patients with EDS belonging to the obese category. Conversely, obese patients were twice more likely to have EDS, represented by ESS scores of ³10. BMI wasalso significantly associated with AHI using one-way Anova test.
Conclusion: This report concludes that the ESS alone is insufficient to identify patients with OSAS. Nevertheless, questionnaires like the ESS supplement relevant history to help diagnose patients with sleep disorders, particularly OSAS. On the other hand, the ESS showed a significant association with BMI, representing more obese patients had excessive daytime sleepiness. The likelihood ratio of having excessive daytime sleepiness is 2 times more for obese patients. BMI was also significantly associated with AHI, which confirms the well established relationship of obesity with OSAS, and shows that obese patients are at higher risk for severe OSAS.
Keywords:obstructive sleep apnea syndrome, daytime sleepiness, Epworth sleepiness scale, polysomnography, apnea-hypopnea index, body-mass index.
L’individu d’abord ?
Authors: Iori Ruggero 
Published: April 2019

Cet article se focalise sur le travail de formation des assistantes sociales, en regardant de près les contenus de son curriculum. Dans une optique comparée France/Italie, nous montrons les usages que les différents instituts de formation font des enseignements professionnels, en s’éloignant d’une logique scolaire et dans l’objectif de la fabrication de professionnelles assistantes sociales. À partir de l’étude de différents dispositifs mis en place à l’entrée et en cours de formation, il s’agit d’appréhender comment l’accent mis sur la « personnalité » des étudiantes produit un double regard, une homogénéisation biographique de l’étudiante et une vision singulière de l’usager de l’action sociale, dans le cadre d’une matrice disciplinaire commune aux deux pays.
Hypergamie et célibat selon le statut social en France depuis 1969
Authors: Bouchet-Valat Milan 
Published: April 2019

À la suite de l’augmentation du niveau d’éducation des femmes, les couples dans lesquels la femme est plus diplômée que son conjoint sont désormais majoritaires en France : l’hypergamie féminine s’est inversée. Cet article actualise ce résultat à partir des enquêtes Emploi de l’Insee, et met en évidence une tendance similaire quoique de moindre ampleur sur le plan professionnel : la proportion de femmes appartenant à une classe sociale (classification EGP) plus élevée que leur conjoint est passée de 13 % en 1969 à 23 % en 2016. Ces tendances sont allées au-delà de ce que l’évolution de la structure de la population impliquait (hypergamie relative). En revanche, on ne relève aucune hypergamie en termes d’origine sociale. La théorie classique liant l’hypergamie à une distribution asymétrique du célibat selon le sexe est pleinement confirmée. Ainsi, si le célibat augmentait à mesure que le diplôme, la classe sociale et l’origine sociale s’élevaient chez les femmes en début de période, cette échelle s’est inversée pour les deux premières dimensions et a disparu pour la dernière. La distribution du célibat des femmes s’est globalement rapprochée de celle des hommes.
Sécurité réglée et/ou sécurité gérée : quand l’ingénierie de la résilience réinterroge l’ergonomie de l’activité
Authors: Cuvelier Lucie , D. Woods David 
Published: April 2019

En 10 ans, l’émulation scientifique autour de « l’ingénierie de la résilience » a suscité de nombreux débats et mobilisé une diversité de concepts : décisions de sacrifices, compromis, marge de manœuvre, adaptabilité / variabilité, culture de sécurité… Ces différentes notions ont toutes en commun leur lien fort avec les concepts développés depuis les années 1950 dans le cadre de l’ergonomie dite « de l’activité » (Leplat & Cuny, 1977 ; Ombredane & Faverge, 1955 ; Wisner, 1972) . Bien que la distinction entre le travail prescrit et le travail réel (désormais discutée en anglais sous l’angle de l’écart entre le travail réalisé (WAD, pour « work-as-done ») et le travail imaginé (WAI, pour « work-as-imagined »)) soit un pilier de l’ergonomie francophone, les débats qu’elle engendre sont loin d’être clos, et il semble que toutes les conclusions n’ont pas été tirées de ce postulat (Duraffourg, 2003 ; Maline & Guérin, 2009). Les formulations telles que « sécurité réglée versus sécurité gérée » développées dans le domaine de la sécurité par les auteurs francophones dans la continuité du courant de l’ingénierie de la résilience, et les diverses tentatives de combiner ces deux formes de sécurité, nous invitent à discuter des positions possibles des ergonomes de l’activité (Maline & Guérin, 2009). À partir des trois orientations que Béguin (2007b, 2012) distingue dans le domaine de la conception, cet article dessine trois perspectives possibles selon les objectifs généraux que poursuivent les ergonomes face à l’écart entre le travail prescrit et le travail réel.
Lire Ovide au xiie siècle : Arnoul d’Orléans, commentateur des Métamorphoses
Authors: Fritz Jean-Marie , Noacco Cristina 
Published: April 2019

Le commentaire d’Arnoul aux Métamorphoses d’Ovide que forment son accessus et, surtout, les Allegorie super Ovidii Metamorphosin, ouvre la voie à une vaste palette d’interprétations à caractère didactique, suivant un code tantôt courtois, tantôt religieux, mais où le point de vue essentiel est la lecture morale de la fable mythologique. La tradition manuscrite de ces textes, recopiés seuls comme une sorte de Compendium ou dans les marges du texte ovidien, couplés le plus souvent avec un autre commentaire, celui de Jean de Garlande, est complexe et révèle l’importance du travail des copistes. Dans ce type de commentaires scolaires, le copiste est plus qu’un simple scribe : il prend des initiatives, il décide de démembrer un texte antérieur et propose d’autres associations. À côté d’Ovide, l’auctor, et à côté d’Arnoul, le grammaticus ou commentator (ou glossator), il faut donc envisager la présence d’un troisième homme, la figure anonyme, et pourtant essentielle, du copiste.
Knowledge management in knowledge-intensive organisations: Understanding its benefits, processes, infrastructure and barriers
Authors: Mazorodze Alfred H. , Buckley Sheryl 
Published: April 2019

Background: Knowledge management aims to improve organisational performance and it marks the beginning of organisational transformation. Most knowledge-intensive organisations engage and practise knowledge management without a full understanding of its benefits. A knowledge-intensive organisation is an organisation whose services and operations are heavily reliant on professional knowledge. The study, therefore, provides a solid understanding of knowledge management benefits, processes, infrastructure and barriers in knowledge-intensive organisations.Objectives: To understand knowledge management, its benefits, processes, infrastructure and barriers in knowledge-intensive organisations. The research objectives extend our understanding of knowledge management in organisations, identify and describe knowledge management benefits. Identification of the most important knowledge management process and associated infrastructure are among other objectives.Method: A survey was used to solve the problem. A structured questionnaire was used to collect quantitative data from 112 participants from knowledge-intensive firms in Namibia. The quantitative data were analysed using Microsoft Excel 2013 spreadsheet package.Results: The study has revealed that the prime benefit of knowledge management in knowledge-intensive organisations is to allow improved knowledge flow, thereby enhancing the capability of the organisation to manage change with more than 50% representation of the participants. In addition to that, the study also found that knowledge sharing is the most important knowledge management process, among other processes such as knowledge creation, knowledge capture and knowledge reuse. All the participants (100%) concurred that a flat organisational structure supports knowledge sharing. The research findings have further discovered that the biggest barrier to effective knowledge management is the lack of budget to support knowledge management efforts. This was represented by 67.9% of the participants. Lack of executive support and lack of time were also among the great barriers with 57.1% and 52.7%, respectively.Conclusion: Knowledge management allows improved knowledge flow in knowledge-intensive organisations. We can, therefore, conclude that the participants believed that knowledge sharing is more important than creation, capturing, transferring and reuse. It is, therefore, important to underscore that knowledge sharing should be taken as a priority if organisations are to remain competitive. Research results have also revealed that a flat organisational structure is the best for knowledge sharing. For improved organisational performance, knowledge management barriers must be removed with the assistance of management.
Inpatient Cross-Cover Consensus Recommendations for Medical and Surgical Residents: A Delphi Analysis
Authors: Heidemann Lauren A. , Fitzgerald James T. , Hughes David T. , Hartley Sarah 
Published: April 2019

ABSTRACT

Background
Residents regularly care for hospitalized patients for whom they are not the primary provider (cross-cover), often without guidance.

Objective
We identified and defined components of safe cross-cover care.

Methods
Sixty medical and surgical faculty physicians and chief residents from the Midwest were invited to participate in a Delphi study analyzing the appropriateness of cross-covering residents evaluating patients at bedside, deferring issues to the primary team, documenting a note, contacting the attending, and communicating with nurses. The first survey was free text, and responses were categorized. In the second survey, physicians rated categorized responses based on appropriateness using a 5-point Likert scale. High consensus was defined as ≥ 80% agreement, approaching consensus as 51% to 79% agreement, and nonconsensus as ≤ 50% agreement. Results were analyzed by specialty and cross-cover experience in the past year using Pearson χ2 test or Fisher exact test.

Results
Forty respondents (67%) completed the first survey and 30 (50%) completed the second. Responses led to 46 categories. Twenty-eight items (60%) achieved high consensus, 8 (17%) approached consensus, and 10 (22%) did not achieve consensus, with no difference based on specialty or experience. Responses with 100% consensus included: residents should evaluate a patient at bedside whenever asked by the nurse; documentation should occur for change in level of care, death, code, or rapid response team activation; and physician-nurse communication should be respectful and closed loop.

Conclusions
This regional physician panel reached consensus on 28 elements important in cross-cover care, which can be used for training and future studies.
Deriving stratospheric age of air spectra using an idealized set of chemically active trace gases
Authors: Hauck Marius , Fritsch Frauke , Garny Hella , Engel Andreas 
Published: April 2019

Abstract. Analysis of stratospheric transport from an observational
point of view is frequently realized by evaluation of the mean age of air values
from long-lived trace gases. However, this provides more insight into
general transport strength and less into its mechanism. Deriving complete
transit time distributions (age spectra) is desirable, but their deduction
from direct measurements is difficult. It is so far primarily based on model
work. This paper introduces a modified version of an inverse method to infer
age spectra from mixing ratios of short-lived trace gases and investigates
its basic principle in an idealized model simulation. For a full description
of transport seasonality the method includes an imposed seasonal cycle to
gain multimodal spectra. An ECHAM/MESSy Atmospheric
Chemistry (EMAC) model simulation is utilized for a general
proof of concept of the method and features an idealized dataset of 40
radioactive trace gases with different chemical lifetimes as well as 40
chemically inert pulsed trace gases to calculate pulse age spectra. It is
assessed whether the modified inverse method in combination with the
seasonal cycle can provide matching age spectra when chemistry is
well-known. Annual and seasonal mean inverse spectra are compared to pulse
spectra including first and second moments as well as the ratio between them
to assess the performance on these timescales. Results indicate that the
modified inverse age spectra match the annual and seasonal pulse age spectra
well on global scale beyond 1.5 years of mean age of air. The imposed seasonal
cycle emerges as a reliable tool to include transport seasonality in the age
spectra. Below 1.5 years of mean age of air, tropospheric influence intensifies
and breaks the assumption of single entry through the tropical tropopause,
leading to inaccurate spectra, in particular in the Northern Hemisphere. The
imposed seasonal cycle wrongly prescribes seasonal entry in this lower
region and does not lead to a better agreement between inverse and pulse age
spectra without further improvement. Tests with a focus on future application
to observational data imply that subsets of trace gases with 5 to 10 species
are sufficient for deriving well-matching age spectra. These subsets can also
compensate for an average uncertainty of up to ±20 % in the knowledge
of chemical lifetime if a deviation of circa ±10 % in modal age
and amplitude of the resulting spectra is tolerated.
De processuele positie van de aansprakelijk gestelde bestuurder
Authors: Vetter H.J. 
Published: April 2019

De processuele positie van de aansprakelijk gestelde bestuurder
Recente rechtspraak roept de vraag op welke verweermogelijkheden een op grond van art. 2:11 BW aansprakelijk gestelde bestuurder heeft als de rechtspersoon-bestuurder onherroepelijk is veroordeeld. En hoe is de positie van een op grond van onrechtmatige daad aansprakelijk gestelde bestuurder die zich wil verweren tegen de omvang van de schade van een crediteur van de rechtspersoon, als de rechtspersoon zelf is veroordeeld bij in kracht van gewijsde gegaan vonnis? In deze bijdrage wordt met een beroep op het leerstuk van het gezag van gewijsde bepleit dat de bestuurder meer ruimte voor verweer heeft dan wel wordt aangenomen.
Bevoegde rechter en toepasselijk recht bij de actio pauliana
Authors: van Asperen P. 
Published: April 2019

Bevoegde rechter en toepasselijk recht bij de actio pauliana
In oktober 2018 heeft het Hof van Justitie van de Europese Unie (hierna: HvJ) duidelijk gemaakt in welke lidstaat partijen een vraagstuk over de actio pauliana aan een rechter kunnen voorleggen. In eerdere arresten gaf het HvJ vooral aan wat niet mogelijk was. Volgens het HvJ volgt de bevoegdheid van een rechter mede uit de contractuele relatie tussen schuldeiser en schuldenaar. Dit betekent dat de schuldeiser veelal in de eigen lidstaat naar de rechter kan stappen. De schuldeiser heeft de mogelijkheid van forum shopping. Het HvJ zegt niets over het toepasselijke recht. Aannemelijk is dat het recht dat de actio pauliana beheerst, wordt bepaald door het recht dat op de benadelende rechtshandeling van toepassing is.
Microlasers Enabled by Soft‐Matter Technology
Authors: Ta Van Duong , Wang Yue , Sun Handong 
Published: April 2019

AbstractSoft‐matter microlasers are an interesting part of soft‐matter photonics, which are based on liquids, liquid crystals, polymers, biological materials, and fabricated mainly by solution‐processing approaches. Soft‐matter microlasers comprehend a multitude of attractive features, including low‐cost, mechanical flexibility, wide range wavelength tunability and, in some cases, biocompatibility, and biodegradability. As such, they are recognized as versatile candidates for efficient light sources with enhanced performances and applications as ultrasensitive physical, chemical, and biological sensors. Here, the recent developments of soft‐matter microlasers are reviewed in time and the prospect in this field is provided. First, the characteristics of the representative soft‐matter microlasers are discussed with focus on their laser structures, lasing mechanisms, fabrication approaches, and gain material origins, followed by an introduction about the current cutting‐edge soft‐technologies that are applied in soft‐matter microlasers. Afterward, their potential applications as wavelength tunable sources, sensors, and displays are highlighted. Finally, the work is summarized and the prospect of soft‐matter microlasers for expanding this emerging research field is presented.
The use of M@p(4‐VP) and M@p (VI) (M:Co, Ni, Cu) cryogel catalysts as reactor in a glass column in the reduction of p‐nitrophenol to p‐aminophenol under gravity
Authors: Sahiner Nurettin , Demirci Sahin 
Published: April 2019

AbstractIn this study, metal@p(4‐Vinyl pyridine) (M@p(4‐VP)) and metal@p (vinyl imidazole) (M@p (VI)) (M: Co, Ni, and Cu) cryogel catalysts as continuous reactor were used in reduction of p‐nitrophenol (p‐NP) to p‐amino phenol (p‐AP). The aqueous solution of p‐NP passed through these super porous cryogel catalysts under gravity, and reaction kinetic for p‐AP generation was investigated. The effect of metal species, amount of p‐NP solution, amount of metal nanoparticle (increased by loading/reducing cycles), and temperature on the reduction reaction for p‐NP to p‐AP catalyzed by M@p(4‐VP) and M@p (VI) cryogel catalysts were investigated. It was found that Co@p(4‐VP) and Co@p (VI) cryogel catalysts provided the best catalytic performances than the other used metal species with 2.19 and 1.37 mol p‐NP/(mol catalyst.min)−1 turn‐over frequency (TOF) values. Furthermore, in addition better TOF values, low Ea values of the prepared Co@p(4‐VP) and Co@p (VI) cryogel catalysts with the values of 18.9 ± 1.3, and 25.4 ± 1.8 kJ/mol were found to be better than most of the similar works reported in the literature.