bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Method of Cleft Earlobe Repair with an Intact Inferior Margin
Authors: Herron Joel Bain , Patterson Cynthia , Bisaccia Emil , Scarborough Dwight A. 
Published: June 2017

Introduction: Body art has become an increasingly popular and mainstream trend. Often, patients who chose to modify their bodies at an early age discover later that their ideas and perceptions have changed. Piercing of the earlobe is a common practive that can develop into a partial or complete tear of the earlobe. A challenge presented to cosmetic surgeons is to repair or revise a body modification and to restore a cosmetically acceptable physical appearance. Case Report: We present the case of a 23-year-old patient who pierced his earlobe. Over the course of several years, he increasingly stretched the pierced hole. The resultant dilated incomplete cleft produced a redundant drooped and lax free-hanging lobe. He presented seeking cosmetic repair of the altered lobe. The incomplete cleft was converted to a complete cleft by excision of redundant tissue near the medial attachment of the free-hanging lobe. A small ellipse was used to excise the expanded cleft and scar to de-epithelialize the margins. A Burrow's triangle was excised from the lateral base of the defect to facilitate a rotational flap created with the inferior border of the free-hanging lobe. With the method, the balance between the 2 sides was restored, and an intact inferior rim was produced with the incision line discretely concealed at the medial margin of the free-hanging lobe. Results: Postoperative follow up revealed a well-healed reconstructed earlobe closely approximating the natural lobe of the opposite ear. In addition to the symmetry produced, there is the advantage of an intact, uninterrupted inferior rim. Conclusions: Cosmetic surgeons are presented with increasingly complicated revisions of body alterations that are not fully addressed in the present surgical literature. With this case, we describe a unique approach that resulted in a positive cosmetic outcome with the advantage of avoiding any notching along the inferior rim of the earlobe. The rotational flap used in this case adds to the repertoire of repairs indicated when approaching repair of a similar earlobe defect.
Full-Crown Castings Made with Water-Saturated and Dry Casting Ring Liners
Authors: Keyf Filiz , Erman Gökhan 
Published: June 2017

The carcinogenic potential of asbestos has led to the development of non-asbestos materials for use as casting ring liners. Cellulose paper are replacing asbestos paper. The brass die and crown were made to produce full crowns. The standardized wax pattern was replicated twenty-nine times. Two grooves were marked on the die and wax patterns. The marginal gaps between wax pattern and die shoulder were measured. Then, the wax specimens were divided into three groups. The dry ring liner and the water-saturated ring liner were used, in the third group, any liner was used. The castings were fabricated and were fitted on the die. Measurements were made of the distance separating the gingival margin of the castings from the shoulder on the die. Measurement points (X and Y) were the same points used for wax pattern measurement. The difference between wax pattern and casting was found to be statistically significant in all the groups ( p = 0.0051). There was no statistically significant difference between groups on the comparative fit of the castings. The mean marginal space in the water-saturated liner group was 0.51 ± 0.12 mm (X), 0.51 ± 0.11 mm (Y), and in the dry liner group, the mean marginal space was 0.47 ± 0.09 mm (X), 0.49 ± 0.08 mm (Y). In the unlined group, they were 0.52 ± 0.18 mm (X), 0.55 ± 0.17 mm (Y). Use of dry ring lining material resulted in smaller marginal spaces between castings and the die than use of water-saturated cellulose ring lining material. The results demonstrated that the use of dry liners may improve the fit of castings to dies.
In Vitro and in Vivo Biodurability of a Compliant Microporous Vascular Graft
Authors: Edwards A. , Carson R. J. , Szycher M. , Bowald S. 
Published: June 2017

Polyurethanes have unique mechanical and biologic properties that make them ideal for many implantable devices. However, certain polyurethanes are affected by some in vivo degradation mechanisms. For example, poly(ester)urethanes are subject to hydrolytic degradation and are no longer used in long-term implanted devices. Poly(ether)urethanes while hydrolytically stable, are subject to oxidative degradation in several forms, including environmental stress cracking and metal ion oxidation. We have developed a second-generation poly(carbonate)urethane with superior biostability. This material has been fabricated by our patented method into small diameter microporous vascular grafts. We evidenced the biodurability of our vascular graft by in vitro qualification tests which compared the poly(carbonate)urethane with a traditional poly(ether)urethane. This poly(carbonate)urethane graft has also proven to be biodurable in in vivo experimental implants up to twenty months duration with no evidence of hydrolysis or Environmental Stress Cracking (ESC).
Cytomegalovirus Disease in AIDS: The Edinburgh Experience
Authors: Cheong I , Flegg P J , Brettle R P , Welsby P D , Burns S M , Dhillon B , Leen C L S , Gray J A 
Published: June 2017

Retrospective analysis of medical records of 557 HIV positive patients (including 113 with AIDS) revealed 17 patients with an antemortem clinical diagnosis of cytomegalovirus (CMV) disease. This group comprised 7 injection drug users (2 male and 5 female) and 10 homosexual men. Males were significantly older than females, and homosexual men were significantly older than drug users at the time of diagnosis of CMV. All 17 patients had evidence of retinitis, and 6 also had evidence of extraocular disease. CMV retinitis was the AIDS defining diagnosis in two patients, and the attack rate of CMV in all AIDS patients progressively increased with time, with a 3-year CMV-free survival of 57%. Fifteen patients with CMV disease had evidence of previous CMV infection (CMV IgG positive), with 7 also having a positive CMV IgM and 10 a positive viral culture. The mean CD4+ lymphocyte count at diagnosis of CMV was 17 cells/mm3, compared with 68 cells/mm3 at diagnosis of AIDS. Therapy was unsatisfactory, often being complicated by marrow suppression. Relapse occurred in 11 patients after initial improvement but despite this only 3 patients died with severe visual impairment. The mean survival after a diagnosis of CMV was 10.5 months. This study confirms that disease caused by CMV is usually a late manifestation of AIDS, and the increasing prevalence among patients with AIDS implies that, the longer the survival, the greater the risk of disease. Frequent fundoscopy in HIV positive patients is of paramount importance particularly in patients who have a CD4+ lymphocyte count of less than 100 cells/mm3.
Clinical Pharmacy and Unit Dose for the Small Hospital
Authors: Wilson Clifford 
Published: June 2017

Nursing service wanted a system that would reduce the work load of nursing personnel and place the medication responsibilities on the pharmacist. After a study was completed, we found that the nurse was spending the majority of her time preparing medications to be given. The unit dose system gives the medication responsibility to the pharmacist and gives the nurse more time for patient care. In the pharmacy, medications are prepared by technicians and checked by a pharmacist, then rechecked by a nurse before they are issued to the patient. One nurse gives routine medications throughout the hospital. A nurse for each unit is assigned to give the PRN's and also to give patient care. The patients have noticed a change in our distribution of medications. The patients get their PRN medications when they ask for them, not five or ten minutes later, and routine medications are given on schedule. The business office has noticed a reduction in their work load, because the pharmacy charges are turned in every third day and credits are almost eliminated. The business office has fewer complaints on medication charges because patients are charged for medication they receive, not a three- to five-day supply of medications that are sent to the nursing station.
Possible Interaction of Indomethacin and Warfarin
Authors: Self Timothy H. , Soloway Mark S. , Vaughn Don 
Published: June 2017

A case report of a possible interaction between indomethacin and warfarin is presented. The effect of warfarin on the prothrombin time (PT) was enhanced while indomethacin was given concurrently. Substitution of Ibuprofen for indomethacin resulted in the desired control of the prothrombin time. Based on the results of controlled clinical trials and on the rarity of case reports, there is probably an extremely low incidence of enhancement of warfarin-induced hypoprothrombinemia by indomethacin.
Proposing a Model to Assist Indian Micro, Small and Medium Scale Enterprises in Their ERP Implementation
Authors: Upadhyay Parijat 
Published: June 2017

Purpose The purpose of this article is to present the findings of a study based on analysis of ERP implementation issues in context to Indian micro, small and medium scale enterprises with the objective of highlighting the key issues confronting them. Design/Methodology/Approach The research study is based on wide variety of literature review focusing on issues influencing ERP adoption. Responses were collected on the basis of questionnaires and personal interviews given by officials who were closely involved in the implementation process. Initially, factor analysis has been performed on SPSS with principal component analysis using Varimax rotation and the factors were grouped on the basis of factor loading. Further to this, the researchers developed a model by SEM. Findings The analysis showed statistically significant relationship between the predictor and the outcome variables for the four hypotheses. Research Limitations/Implications Besides the identified issues, there may be other factors that need to be explored. There is also a scope to enhance this research study by taking different industries into consideration and also by factoring the state of the economy and by increasing the number of respondents. Practical Implications This study will help information system managers who plan to implement ERP systems in their organisations. It will help those with useable but less than satisfactory ERP implementations to understand the underlying issues why they had problems and it will help them to avoid facing problems in future projects. It will also help those who failed to implement their planned ERP system when they try again; it will help those who have not yet tried. Even ERP vendors can take input from this study in their implementation approach while targeting SME sector. Originality/Value There is no published literature that followed a similar approach in identification of critical issues in implementing ERP projects in small and mid-sized organisation in India or any other developing economy.
Liquidity Management: A Multivariate Analysis of Financial Indicators of Two Steel Plants
Authors: Mukherjee Paroma Mitra , Roy Dilip 
Published: June 2017

Private and public organisations have experienced significant changes in recent years. To develop the core competencies greater skills are required in planning, analysis and control nowadays. This article develops a multivariate statistical model for the analysis to compare the short-term liquidity management of two giant steel companies in India. Durgapur Steel Plant (DSP; a sister plant of Steel Authority of India Ltd.) under public sector firm and Tata Steel plant as a whole is selected, which is the biggest private sector firm of India. Simultaneously, we have selected three financial ratios (current ratio (CR), inventory turnover ratio (ITR) and debtors turnover ratio (DTR)) describing liquidity position of a firm. These measures are interdependent and thus it can be considered to be a vector measure. Our objective is to verify whether the two sectors differ or not in respect of the mean vector measures. This hypothesis is examined with the help of Hotelling’s T2—statistic under the assumption of equal dispersion. Significant differences have been observed in respect of liquidity position of these two firms. Along with that individual ratios have been checked for any significant difference or not for the said firms.
People, Places, Power: Medicaid Concentration and Local Political Participation
Authors: Michener Jamila D. 
Published: June 2017

AbstractThe geographic concentration of disadvantage is a key mechanism of inequity. In the United States, the spatial patterning of disadvantage renders it more than the sum of its individual parts and disproportionately harms economically and racially marginalized Americans. This article focuses specifically on the political effects of Medicaid beneficiaries being concentrated in particular locales. After offering a framework for conceptualizing the community-wide consequences of such policy concentration, I analyze aggregate multiyear data to examine the effect of Medicaid density on county-level voter turnout and local organizational strength. I find that, as the proportion of county residents enrolled in Medicaid increases, the prevalence of civic and political membership associations declines and aggregate rates of voting decrease. These results suggest that, if grassroots political action is to be part of a strategy to achieve health equity, policy makers and local organizations must make efforts to counteract the sometimes demobilizing “place-based” political effects of “people-based” policies such as Medicaid.
Missed Opportunity? Leveraging Mobile Technology to Reduce Racial Health Disparities
Authors: Ray Rashawn , Sewell Abigail A. , Gilbert Keon L. , Roberts Jennifer D. 
Published: June 2017

Abstract
Blacks and Latinos are less likely than whites to access health insurance and utilize health care. One way to overcome some of these racial barriers to health equity may be through advances in technology that allow people to access and utilize health care in innovative ways. Yet, little research has focused on whether the racial gap that exists for health care utilization also exists for accessing health information online and through mobile technologies. Using data from the Health Information National Trends Survey (HINTS), we examine racial differences in obtaining health information online via mobile devices. We find that blacks and Latinos are more likely to trust online newspapers to get health information than whites. Minorities who have access to a mobile device are more likely to rely on the Internet for health information in a time of strong need. Federally insured individuals who are connected to mobile devices have the highest probability of reliance on the Internet as a go-to source of health information. We conclude by discussing the importance of mobile technologies for health policy, particularly related to developing health literacy, improving health outcomes, and contributing to reducing health disparities by race and health insurance status.
Lumboperitoneal shunt insertion without fluoroscopy guidance: Accuracy of placement in a series of 107 procedures
Authors: Al-Rashed Sabah , Kareem Haider , Kalra Neeraj , D’Antona Linda , Obeidat Mouness , Patel Bhavesh , Toma Ahmed 
Published: June 2017

Background: Lumboperitoneal (LP) shunts were the mainstay of cerebrospinal fluid diversion therapy for idiopathic intracranial hypertension (IIH). The traditionally cited advantage of LP shunts over ventriculoperitoneal (VP) shunts is the ease of insertion in IIH. This needs to be placed at the level of L3/4 to be below the level of the spinal cord. The objective of this study was to analyse the position of LP shunts inserted without portable fluoroscopy guidance. Methods: A retrospective analysis of radiology was performed for patients who underwent lumboperitoneal shunts between 2006 and 2016 at the National Hospital for Neurology and Neurosurgery. Patients who had insertion of a LP shunt without fluoroscopy guidance were selected. Patients without post-procedural imaging were excluded. A retrospective analysis of the clinical notes was also performed. Results: Between 2006 and 2016, 163 lumboperitoneal shunts were inserted in 105 patients. A total of 56 cases were excluded due to lack of post-procedural imaging; therefore, 107 post-procedural x-rays were reviewed. In 17 (15.8%) cases the proximal end of the LP shunt was placed at L1/L2 level or above. Conclusions: Insertion of LP shunts without portable fluoroscopy guidance gives a 15.8% risk of incorrect positioning of the proximal end of the catheter. We suggest that x-ray is recommended to avoid incorrect level placement. Further investigation could be carried out with a control group with fluoroscopy against patients without.
Service evaluation of the implementation of a digitally-enabled care pathway for the recognition and management of acute kidney injury
Authors: Connell Alistair , Montgomery Hugh , Morris Stephen , Nightingale Claire , Stanley Sarah , Emerson Mary , Jones Gareth , Sadeghi-Alavijeh Omid , Merrick Charles , King Dominic , Karthikesalingam Alan , Hughes Cian , Ledsam Joseph , Back Trevor , Rees Geraint , Raine Rosalind , Laing Christopher 
Published: June 2017

Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians. It is uncertain, however, whether ‘alerting’ alone improves care quality. We have thus developed a digitally-enabled care pathway as a clinical service to inpatients in the Royal Free Hospital (RFH), a large London hospital. This pathway incorporates a mobile software application - the “Streams-AKI” app, developed by DeepMind Health - that applies the NHS AKI algorithm to routinely collected serum creatinine data in hospital inpatients. Streams-AKI alerts clinicians to potential AKI cases, furnishing them with a trend view of kidney function alongside other relevant data, in real-time, on a mobile device. A clinical response team comprising nephrologists and critical care nurses responds to these AKI alerts by reviewing individual patients and administering interventions according to existing clinical practice guidelines. We propose a mixed methods service evaluation of the implementation of this care pathway. This evaluation will assess how the care pathway meets the health and care needs of service users (RFH inpatients), in terms of clinical outcome, processes of care, and NHS costs. It will also seek to assess acceptance of the pathway by members of the response team and wider hospital community. All analyses will be undertaken by the service evaluation team from UCL (Department of Applied Health Research) and St George’s, University of London (Population Health Research Institute).
Connecting Medical Records: An Evaluation of Benefits and Challenges for Primary Care Practices
Authors: Compeau Deborah Ruth , Terry Amanda 
Published: June 2017

Background: Implementation of systems to support health information sharing has lagged other areas of healthcare IT, yet offers a strong possibility for benefit. Clinical acceptance is a key limiting factor in health IT adoption.Objectives: To assess the benefits and challenges experienced by clinicians using a custom-developed health information exchange system, and to show how perceptions of benefits and challenges influence perceptions of productivity and care-related outcomes.Methods: We used a mixed methods design with two phases. First, we conducted interviews with stakeholders who were familiar with the health information exchange system to inform the development of a measure of benefits and challenges of the use of this system. Second, using this measure we conducted a survey of current and former users of the health information exchange system using a modified Dillman method.Results: 105 current and former users completed the survey. The results showed information quality, ease of completing tasks and clinical process improvement as key benefits that reduced workload and improved patient care. Challenges related to system reliability, quality of reports and service quality increased workload and decreased impact on care, though the effect of the challenges was smaller than that of the benefits.Conclusions: Even very limited health information exchange capabilities can improve outcomes for primary care users. Improving perceptions of benefits may be even more important the removing challenges to use, though it is likely that a threshold of quality must be achieved for this to be true.
AVALIAÇÃO DA UNIFORMIDADE DE PESO E DE DOSES DE RANITIDINA EM CÁPSULAS MAGISTRAIS
Authors: Barquette Bruna do Carmo , Belo Mariana Coleta Campolina , Silva Rafaela Mafia da Cruz , Costa André Lima de Oliveira 
Published: June 2017

Para garantir a eficácia, a segurança e a credibilidade aos medicamentos dispensados à população, as farmácias magistrais devem aplicar as Boas Práticas de Manipulação, de acordo com a Anvisa. Ainda que limitada a aplicação integral das análises farmacopeicas nas farmácias de manipulação, a resolução estabelece os ensaios mínimos exigidos aocontrole da qualidade das preparações magistrais e oficinais. Demais testes são aplicáveis nos casos de manipulação de estoque mínimo ou análises trimestrais como forma de monitoramento do processo magistral. Neste estudo, a uniformidade de peso e de conteúdo foram avaliadas em cápsulas de ranitidina de seis diferentes farmácias magistrais em Belo Horizonte, MG, Brasil. As preparações foram Analisadas de acordo com os procedimentos de determinação de peso e de uniformidade de doses unitárias preconizados na Farmacopeia Brasileira e no Formulário Nacional. Apenas uma farmácia apresentou cápsulas com resultado insatisfatório no teste de determinação de peso. Em relação à uniformidade de doses, os produtos de todas as farmácias foram reprovados nos critérios do teste. Os resultados mostram que as cápsulas com uniformidade de peso não apresentam, necessariamente, uma distribuição homogênea do princípio ativo. O controle rigoroso do processo de manipulação é essencial para a garantia de produtos de qualidade, eficazes e seguros.
FOTOPROTETOR: DESENVOLVIMENTO, ESTUDO DE ESTABILIDADE PRELIMINAR E AVALIAÇÃO IN VITRO DO FATOR DE PROTEÇÃO SOLAR (FPS).
Authors: GONÇALVES TAMARA , De Almeida Aline Cordeiro , Louchard Bianca Oliveira 
Published: June 2017

O uso de protetor solar é uma das medidas de fotoproteção mais utilizadas pela população, portanto esses produtos devem oferecer eficácia na proteção contra as radiações solares além de garantir segurança e qualidade da formulação desenvolvida. Os autores tiveram como objetivo desenvolver, avaliar a estabilidade preliminar e determinar o FPS in vitro de emulsões fotoprotetoras. Foram preparadas cinco formulações, pelo método de inversão de fases, utilizando diferentes concentrações de base autoemulsionante não iônica, tensoativo não iônico e agente de consistência. O Fator de Proteção Solar (FPS) foi determinado in vitro por método espectrofotométrico, e as formulações armazenadas a 25 e 37°C durante quinze dias. Foram realizados os ensaios de centrifugação, análise visual, medidas de pH e viscosidade. Os resultados demonstraram que duas formulações (F4 e F5), apresentaram estabilidade, porém a formulação F4 apresentou alta viscosidade. Em conclusão, a formulação F5 (FPS 24.32±0.025) apresentou estabilidade e adequadas propriedades sensoriais.