bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, perceptions and practices of menstrual hygiene among degree college students in Guntur city of Andhra Pradesh, India
Authors: Balla Christina Patricia , Nallapu Samson Sanjeeva Rao 
Published: September 2018

Background: The unmet menstrual hygiene needs of young girls in India restrict their mobility and daily activities. Taboos and socio-cultural restrictions contribute to poor knowledge and practices leading to adverse health outcomes. This study is set to look at the knowledge, perceptions and practices concerning menstruation among college going girls.Methods: This study was conducted with 254-degree college students from a women’s degree college in Guntur city. After assuring adequate confidentiality, a self-administered questionnaire was administered to each participant. The information obtained was entered and analysed in MS excel. Important findings were subjected to statistical tests like Chi square and Z test for significance testing at 5% LOS.Results: Mother’s education was significantly related to the girls’ knowledge about menses (2 16.6, p 0.00002). A positive perception of menses was associated with good knowledge about it. (p < 0.00001). Complaints related to menses were also associated with good knowledge scores (2 9.8, p 0.002). Absenteeism during periods was 81.5%, the causes being pain 60.4%, heavy bleeding 31.4%, both pain and heavy bleeding 4.8% and nausea 3.4%.Conclusions: The associated symptoms of menstruation need to be addressed in schools and colleges and in their respective homes. Ensuring availability of sanitary products, water, privacy and appropriate waste disposal in all public services and institutions can address the challenges.
Efficacy and safety of mifepristone-misoprostol combination with extraamniotic ethacridine lactate-misoprostol for termination of second trimester pregnancy
Authors: G. Hemavathi , C. Jagruthi 
Published: September 2018

Background: Mid trimester termination of pregnancy is one of the most controversial areas of gynecological practice. It has moral, emotional, social and technical issues. This study was designed for comparison of efficacy and safety of Mifepristone-Misoprostol combination with exrtaamniotic Ethacridine Lactate-misoprostol for termination of second trimester pregnancy.Methods: The present was undertaken among the patients admitted to hospitals attached to J.J.M. Medical College; Bapuji hospital, Women and Children hospital and Chigateri general hospital Davangere during the study period from November 2016 - October 2017. Patients coming for second trimester abortion to above mentioned hospitals were assigned serial number from 1 to 80 and all patients with even number will be allocated to group 1 and all patients with odd number will be allocated in group 2, each group comprising 40 women each.Results: Majority of the cases in both the groups were between 21-25 yrs. Majority of the cases in both the groups were multigravidas. 11 cases from group 1 and 12 cases from group 2 were of gestational age between 14-16 wks. 29 cases from group 1 and 28 cases from group 2 were of gestational age between 18-20 wks. In the present study the mean induction abortion interval for group 1 was 19.56±1.82 hours and group 2 was 14.13±2.72 hours. This was statistically significant. Of the 40 cases in each group, 37 had complete abortion i.e. 92.5% 3 cases (7.5%) from both the groups had incomplete abortion. The side effects were relatively more in more in group 1 when compared to group 2.Conclusions: It was concluded that with this combination success rate was high (92.5 %), with Short induction abortion interval, less rate of incomplete abortion without any major complications.
Primary ovarian leiomyoma in young woman with premature ovarian failure
Authors: Chaudhary Vidhi , Aggarwal Kiran , Nangia Anita 
Published: September 2018

Authors present a rare case of primary ovarian leiomyoma in a young female with premature ovarian failure. A 39-year-old female with premature ovarian failure presented with large unilateral adnexal mass, with mildly elevated CA-125 levels, underwent staging laparotomy where the left ovarian mass along with tubes was removed. Contralateral ovary and uterus were preserved. Final diagnosis was Primary ovarian leiomyoma on histopathology and immunohistochemical analysis. Preoperative diagnosis is difficult with solid ovarian tumors. In presence of mildly elevated CA-125 and negative tumor markers, ovarian leiomyoma must be considered as a differential diagnosis and conservative surgery be planned as these patients are desirous of future fertility options. Definitive diagnosis is confirmed by histopathology and immunohistochemical analysis.
Clinical study of 100 cases of hoarseness of voice: a hospital based study
Authors: Gupta Anchal , Jamwal Padam Singh 
Published: September 2018

<p class="abstract"><strong>Background:</strong> Hoarseness is defined as roughness of voice resulting from variations of periodicity or intensity of consecutive sound waves. Hoarseness is a symptom not a disease.</p><p class="abstract"><strong>Methods:</strong> The present study was carried out in the Department of ENT and Head and Neck Surgery, SMGS Hospital, Jammu over a period of 2 years from March 2016 to February 2018. During this period the patients who presented with hoarseness of voice were evaluated. </p><p class="abstract"><strong>Results:</strong> Total 100 cases were studied. Average age group was found to be between 15-85 years. The number of female patients were 36 (36%) and male 64 (64%). In the present series the most common lesion was vocal nodule (30%) followed by vocal polyp (23%), squamous cell carcinoma (16%), papilloma (10%), Reinkes oedema (9%), keratosis (7%), vocal cord paralysis (4%) and laryngeal tuberculosis (1%).</p><p class="abstract"><strong>Conclusions:</strong> Hoarseness is a common symptom of laryngeal dysfunction. The micro laryngeal surgery is a minimally invasive procedure used to correct voice disorder or other problems affecting the larynx.</p>
PERSONAGENS JORNALISTAS NA LITERATURA DA DÉCADA DE 1970: UMA ANÁLISE DO ROMANCE A FESTA
Authors: Quintino Felipe 
Published: September 2018

<p>Este artigo aborda aspectos das relações possíveis entre jornalismo e literatura no período da ditadura militar no Brasil, como a participação de profissionais da imprensa na escrita de ficção e a presença do jornalista como personagem de narrativas literárias. Essas questões serão discutidas e analisadas a partir do romance <em>A</em><em> Festa</em>, escrito por Ivan Ângelo e publicado em 1976. As características dos três jornalistas retratados no livro, a capacidade de o romance apresentar os meandros da imprensa e os indícios do momento político foram abordados neste artigo. Constatou-se a pluralidade de visões da figura do jornalista, abrindo caminhos para uma gama de sentidos sobre o lugar social da imprensa e de seus profissionais, bem como diversas formas de mobilização da memória sobre o jornalismo e o momento histórico. </p>
Karin Cheng Discusses Using Educational “Gamification” to Increase Motivation and Participation in Secondary-Level English Language Learners
Authors: Cheng Karin , 2016 Class of 
Published: September 2018

Video Segments:
Can you describe your research? 0:04-0:40
What inspired your research? 0:40-1:40
What was your favorite part? 1:40-2:37
What was the most challenging part? 2:37-5:00
What was the research process like? 5:00-6:00
What is your advice for students? 6:00-6:53
Revolutionizing Maghrebi Art to Move Toward a Cultural Identity
Authors: Haider Ali , 2018 Class of 
Published: September 2018

The Maghreb, or North Africa west of Egypt, has encountered countless revolutions since the early 1950’s, such as the Algerian War of Independence from 1954 to 1962, the Moroccan protests against King Mohammed VI in 2012, the Tunisian Revolution which forced the exit of President Zine el-Abidine Ben Ali , and the Libyan Civil War in which the dictator Muammar Gadhafi was executed by rebels. The steady rise in these political revolts was not simply a rise to sovereignty, however; these revolutions and wars devastated families who could no longer continue their businesses and lives in their homelands, pushing the large-scale diaspora of Maghrebi people into Europe. After years of attempting to assimilate into European communities, Maghrebi immigrants and refugees have been left on their own to discover where they come from and who they identify as. Pushed out of their homes into more unwelcoming territory, they have founded a culture of their own through artistic expression. In a worldwide exhibition tour called Memory, Place, Desire: Contemporary Art of the Maghreb and Maghrebi Diaspora, artists conceive a culture of expression out of the conflicted emotions arising from their immigration. This essay examines how this exhibition and the combination of various elements of different Maghrebi artists’, scholars’ and writers’ work—such as Tahar Ben Jelloun’s The Happy Marriage and Bouchra Khalili’s Mapping Journey Project—embodies collective feelings of displacement, nostalgia, guilt, and loss of identity.
Empathy is the Remedy
Authors: Brown David , 2018 Class of 
Published: September 2018

This article will show how empathy can be used to alleviate the stress and anxiety many people feel when going to the doctor, as well as argue why empathy should be taught in medical and nursing school to counteract the diminished levels of empathy many students face and, by extension, improve the quality of care these students will be able to provide as they transition into the medical field. It is not only the job of the patient to accurately describe their symptoms, but it is also the doctor’s responsibility to alleviate any stress or discomfort his or her patient may be feeling, as well as making an appropriate diagnosis. Empathy is an integral part of healthcare. If nurses and doctors are better able to understand the feelings of their patients, they will better be able to care for their patients on a physiological level as well as an emotional level. Because many Americans suffer from fear about going to the doctor, as physicians learn to employ empathy in their practice they can more easily lessen any stress or anxiety that their patients are feeling.
Fatores que influenciam a escolha pelo curso de ciências contábeis: uma pesquisa com alunos ingressantes em uma IES privada do interior paulista
Authors: Públio Damaris De Souza 
Published: September 2018

Este artigo tem como objetivo identificar quais os fatores que influenciam/atraem os alunos a ingressarem no curso de Ciências Contábeis em uma Instituição de Ensino Superior (IES) privada do interior do estado de São Paulo. Para alcançar esse objetivo, foi realizada a coleta de dados através de um questionário fechado. A amostra foi representada por 121 alunos ingressantes nos anos de 2015, 2016 e 2017, os quais responderam ao questionário na terceira semana do período letivo, respectivamente. A análise dos dados foi possível com a planilha eletrônica Excel, onde foram tabulados os dados coletados durante os três anos e, posteriormente, apresentados os resultados em gráficos e tabelas. Como principais resultados, foi constatado que a maioria dos acadêmicos ingressantes pertence ao sexo masculino, estão inseridos na faixa etária entre 16 e 20 anos e buscaram informações suficientes para a escolha do curso superior sem que houvesse pressão externa. Grande parcela dos alunos (86%) afirmou que a profissão traz segurança financeira, quase 90% veem na profissão contábil o status e prestígio sonhados, e 81% acreditam que a contabilidade irá proporcionar ascensão acelerada no trabalho. Foi possível concluir que os principais fatores que motivam a decisão dos acadêmicos pelo curso de Ciências Contábeis são a empregabilidade, perspectivas de carreira e percepção de vocação.
Bazı Yonca (Medicago sativa L.) Genotipleri Arasındaki Varyasyonun Kümeleme ve Temel Bileşen Analizi Metodu ile Belirlenmesi
Authors: ÖTEN Mehmet , ALBAYRAK Sebahattin 
Published: September 2018

Bu
çalışmanın amacı; yonca ileri ıslah programlarında kullanılmak üzere, 26 adet
yonca populasyonunu, 21 özellik açısından değerlendirip, morfolojik olarak
akrabalık dereceleri NTSYS 2.1 paket programı kullanılarak korelasyon matriksi
ile kümeleme/tartısız aritmetik grup ortalamaları (UPGMA) metotlarına göre
belirlenmesidir. Araştırmada tarla denemesi 2013 ve 2014 yıllarında Batı
Akdeniz Tarımsal Araştırma Enstitüsü Müdürlüğü deneme alanında yürütülmüştür. Yapılan
kümeleme analizi sonucunda; hatlar % 50 ile % 98 arasında benzerlik
göstermiştir. Genotiplerin ortalama benzerlik katsayısı r= 0.50 olup, buna
göre genotipler 2 ana grup altında 5 alt gruba ayrılmıştır. Temel bileşen
analizi sonucu ise genotiplere ait toplam varyasyonun % 84.33’ünü
tanımlayan 6 adet temel bileşen ekseni elde edilmiştir.
Spine-Pelvis-Hip Relationship in the Functioning of a Total Hip Replacement
Authors: Ike Hiroyuki , Dorr Lawrence D. , Trasolini Nicholas , Stefl Michael , McKnight Braden , Heckmann Nathanael 
Published: September 2018

* Spine-pelvis-hip motion is normally coordinated to allow balance of the mass of the trunk and hip motion with standing and sitting.* Normal motion from standing to sitting involves hip flexion of 55° to 70° and pelvic posterior tilt of 20°. Because the acetabulum is part of the pelvis, as the pelvis tilts posteriorly during sitting, the inclination and anteversion increase (the acetabulum opens) to allow clearance of the femoral head and neck during hip flexion. This can be considered the biological opening of the acetabulum.* Decreased tilt of the pelvis during movement occurs with stiffness of the spine. Loss of pelvic mobility forces hip motion to increase to accommodate postural change. Increased hip motion combined with change in the opening of the acetabulum increases the risk of impingement.* Hip stiffness can also reduce pelvic mobility because pelvic mobility is affected by both the spine and the hip. Relief of hip stiffness with total hip replacement can improve pelvic mobility postoperatively.* For hip surgeons, the clinical consequences of changes in the mobility of the spine and pelvis (spinopelvic mobility) can be impingement after total hip replacement, with the most obvious complication being dislocation. The reported increased dislocations in patients with surgical spine fusions is a clinical example of this consequence.
The Impact of Electronic Medical Record Implementation on Labor Cost and Productivity at an Outpatient Orthopaedic Clinic
Authors: Scott Daniel J. , Labro Eva , Penrose Colin T. , Bolognesi Michael P. , Wellman Samuel S. , Mather Richard C. 
Published: September 2018

Background:
Widespread adoption of electronic medical record (EMR) systems is increasing. EMR implementation can be costly and typically requires workflow redesign. To our knowledge, no studies to date have examined the impact of EMR implementation using advanced cost accounting methods or the impact of its implementation on orthopaedic surgeons in an outpatient setting.

Methods:
Time-driven activity-based costing (TD-ABC) was used to evaluate the effect of EMR implementation in an outpatient adult reconstruction clinic. One hundred and forty-three patients were prospectively timed throughout their visit to clinics, before implementation of a hospital system-wide EMR system and then again 2 months, 6 months, and 2 years after implementation. Data were analyzed to investigate the effects of EMR implementation on labor cost and provider time.

Results:
Total labor costs per patient visit significantly increased at 2 months after EMR implementation (from $36.88 to $46.04; p = 0.05). Drivers of this change included increases in the amount of time that attending surgeons spent per patient (from 9.38 to 10.97 minutes, with the cost increasing from $21.10 to $27.01), as well as increased time that certified medical assistants spent assessing patients (from 3.4 to 9.1 minutes; p < 0.001). Two months after EMR implementation, providers were spending more than twice as long documenting patient encounters (7.6 compared with 3.3 minutes; p < 0.001). However, by 6 months after implementation, total labor costs were similar to those before implementation ($38.75 compared with $36.88; p = 0.689) and they remained similar at 2 years after implementation ($36.88 compared with $37.73; p = 0.84). After the initial learning period following EMR implementation, providers spent more time documenting encounters (8.43 compared with 3.28 minutes; p < 0.001) but less time interacting with patients (10.03 compared with 14.65 minutes; p = 0.013).

Conclusions:
Using TD-ABC, we observed the EMR implementation learning period, returning to pre-introduction efficiency at 6 months. Cost increases because of increased certified medical assistant time spent with patients and physician time on documentation were offset by less patient-physician interaction. Health-care systems and policymakers should be aware that the length of the implementation period is approximately 6 months and that implementation may alter the time that providers spend with patients.

Clinical Relevance:
This article offers insight into the impact of EMR implementation on the orthopaedic surgeon’s clinic efficiency and workflows.
The Demographic and Geographic Trends of Meniscal Procedures in New York State
Authors: Suchman Kelly I. , Behery Omar A. , Mai David H. , Anil Utkarsh , Bosco Joseph A. 
Published: September 2018

Background:
The purpose of this study was to examine the geographic and demographic variations and time trends of different types of meniscal procedures in New York State to determine whether disparities exist in access to treatment.

Methods:
The New York Statewide Planning and Research Cooperative System (SPARCS) outpatient database was reviewed to identify patients who underwent elective, primary knee arthroscopy between January 1, 2003, and December 31, 2015, for 1 of the following diagnosis-related categories: Group 1, meniscectomy; Group 2, meniscal repair; and Group 3, meniscal allograft transplantation, with or without anterior cruciate ligament reconstruction (ACLR). The 3 groups of meniscal procedures were compared on geographic distribution, patient age, insurance, concomitant ACLR, and surgeon and hospital volume over the study period.

Results:
A total of 649,470 patients who underwent knee arthroscopy between 2003 and 2015 were identified for analysis. Both meniscectomies and meniscal repairs had a scattered distribution throughout New York State, with allograft volume concentrated at urban academic hospitals. The majority of patients who underwent any meniscal procedure had private insurance, with Medicaid patients having the lowest rates of meniscal surgery. At high-volume hospitals, meniscal repairs and allografts are being performed with increasing frequency, especially in patients <25 years of age. Meniscal repairs are being performed concomitantly with ACLR with increasing frequency.

Conclusions:
Meniscal repairs and allografts are being performed at high-volume hospitals for privately insured patients with increasing frequency. Geographic access to these treatments, particularly allografts, is limited.

Clinical Relevance:
Disparities in the availability of advanced meniscal treatment require further investigation and understanding to improve access to care.
A Dedicated Pediatric Spine Deformity Team Significantly Reduces Surgical Time and Cost
Authors: Flynn John M. , Striano Brendan M. , Muhly Wallis T. , Kraus Blair , Sankar Wudbhav N. , Mehta Vaidehi , Blum Michael , DeZayas Barbara , Feldman Jeffrey , Keren Ron 
Published: September 2018

Background:
As high-quality health care becomes increasingly expensive, improvement projects are focused on reducing cost and increasing value. To increase value by reducing operating room (OR) utilization, we studied the effect of a dedicated team approach for posterior spinal fusion (PSF) for scoliosis.

Methods:
With institutional support, an interdisciplinary, dedicated team was assembled. Members developed standardized protocols for anesthetic management and patient transport, positioning, preparation, draping, imaging, and wake-up. These protocols were initially implemented with a small interdisciplinary team, including 1 surgeon (Phase 1), and then were expanded to include a second surgeon and additional anesthesiology staff (Phase 2). We compared procedures performed with a dedicated team (the Dedicated Team cases) and procedures performed without a such a team (the Casual Team cases). Because of the heterogeneous nature of PSF for scoliosis, we developed a case categorization system: Category 1 was relatively homogeneous and indicated patients with fusion of ≤12 levels, no osteotomies, and a body mass index (BMI) of <25 kg/m2, and Category 2 was more heterogeneous and indicated patients with fusion of >12 levels and/or ≥1 osteotomy and/or a BMI of ≥25 kg/m2.

Results:
In total, 89 Casual Team and 78 Dedicated Team cases were evaluated: 71 were in Category 1 and 96 were in Category 2. Dedicated Team cases used significantly less OR time for both Categories 1 and 2 (p < 0.001). In Category-1 cases, the average reduction was 111.4 minutes (29.7%); in Category-2 cases, it was 76.9 minutes (18.5%). The effect of the Dedicated Team was scalable: the reduction in OR time was significant in both Phase 1 and Phase 2 (p < 0.001). The Dedicated Team cases had no complications. Cost reduction averaged approximately $8,900 for Category-1 and $6,000 for Category-2 cases.

Conclusions:
By creating a dedicated team and standardizing several aspects of PSFs for scoliosis, we achieved a large reduction in OR time. This increase in team efficiency was significant, consistent, and scalable. As a result, we can routinely complete 2 Category-1 PSFs in the same OR with the same team without exceeding standard block time.
Staggered Rather Than Staged or Simultaneous Surgical Strategy May Reduce the Risk of Acute Kidney Injury in Patients Undergoing Bilateral TKA
Authors: Koh Won Uk , Kim Ha-Jung , Park Hee-Sun , Jang Min-Jeong , Ro Young-Jin , Song Jun-Gol 
Published: September 2018

Background:
The strategy for bilateral total knee arthroplasty (TKA) depends on the timing of surgery for each knee. The purpose of this study was to determine whether the type of surgical strategy for bilateral TKA (staggered, staged, or simultaneous) influences the incidence of acute kidney injury (AKI) and related complications.

Methods:
Enrolled patients from a single tertiary teaching hospital were divided into 3 groups according to the surgical strategy for bilateral TKA: staggered (≤7 days between the first and second procedure; n = 368), staged (8 days to 1 year between the first and second procedure; n = 265), or simultaneous (n = 820). The incidence of AKI as defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria was assessed. The rates of major postoperative complications, major adverse cardiovascular and cerebral events, intensive care unit (ICU) admissions, and mortality were also evaluated. To reduce the influence of possible confounding factors, inverse probability of treatment weighting based on propensity-score analysis was used.

Results:
The primary outcome was the incidence of AKI according to surgical strategy. The staggered group had a lower rate of AKI compared with the other 2 groups (p < 0.001): 2.4% (9 of 368 patients), 6.0% (16 of 265), and 11.2% (92 of 820) in the staggered, staged, and simultaneous groups, respectively.

Conclusions:
The type of bilateral TKA strategy was an independent risk factor for the development of AKI. The assessment of additional risk factors for the development of AKI is essential before deciding on surgical strategy.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.