bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary urethral reconstruction results in penile fracture
Authors: Barros R , Silva MIS , Antonucci V , Schulze L , Koifman L , Favorito LA 
Published: September 2017

Objective This study assessed primary urethral reconstruction results in patients with a penile fracture. Materials and methods Between January 2005 and April 2016, patients who underwent primary urethral reconstruction due to penile fracture were called for a follow-up. Epidemiological and clinical presentation data and operative findings were reviewed retrospectively. Partial urethral lesions were primarily treated with interrupted absorbable sutures over urethral catheter. In cases of complete urethral lesion, tension-free end-to-end anastomosis was performed. From the third month after surgery, all patients were interviewed using the International Prostate Symptom Score questionnaire and uroflowmetry. Retrograde urethrocystography was used in patients with urinary symptoms or altered uroflowmetry to rule out or confirm urethral stenosis. Results Of 175 patients with penile fractures, 27 (15.4%) had associated urethral injury. All patients were diagnosed with penile fracture by means of clinical history and physical examination. No subsequent examinations were conducted. Ages varied from 30 years to 58 years old (mean 39.2 years). All fractures resulted from sexual activity. Reported sexual positions were ‘doggy style’ position in eight cases (61.5%) and with the ‘man on top’ in five cases (38.4%). Ten patients (76.9%) experienced haematuria, ten (76.9%) had urethral bleeding and four (30.7%) suffered urinary retention. Unilateral and bilateral injury of the corpus cavernosum was observed in four (30.7%) and nine (69.2%) patients, respectively; partial injury was found in nine cases (69.3%) and complete urethral injury was noticed in four cases (30.7%). All cases of complete urethral injury were associated with bilateral lesion of the corpus cavernosum. Six patients who had uroflowmetry with maximum urinary flow rate below 15 ml/s and/or had IPSS above 7 underwent retrograde urethrocystogram, and this was normal in all cases, excluding the possibility of urethral stenosis. Two patients (15.3%) experienced surgical postoperative complications represented by an urethrocutaneous fistula and a subcutaneous abscess adjacent to the end-to-end anastomosis area. Conclusions Penile fracture is a rare urological emergency, especially when it is associated with a urethral lesion. This must be suspected when the clinical picture is suggestive or in cases of high-energy trauma, especially in bilateral lesions of the corpus cavernosum. Complementary imaging methods are not needed in these cases and immediate exploration should not be delayed. Primary urethroplasty produces satisfactory results with low complication levels. Nonetheless, prospective studies with larger samples should be conducted.
Local recurrence after ‘standard’ abdominoperineal resection: do we really need ELAPE?
Authors: Xanthis A , Greenberg D , Jha B , Olafimihan O , Miller R , Fearnhead N , Davies J , Hall N 
Published: September 2017

Introduction Low rectal cancers requiring abdominoperineal resection tend to have a worse prognosis than higher tumours, which may be treated by anterior resection. One of the reasons for this may be inadequate local surgery, in particular the narrow waist of the resection specimen of a standard abdominoperineal resection may be associated with a high positive circumferential resection margin. The extralevator abdominoperineal excision (ELAPE) aims to improve the R0 resection rate but carries significant morbidity. We examined our own results of standard abdominoperineal resection to assess the need for a change of policy. Methods We operformed a retrospective analysis of consecutive standard abdominoperineal resections for rectal cancer in a single centre from June 2002 to December 2011. Results A total of 102 patients underwent standard abdominoperineal resection with curative intent; 19 had no preoperative treatment, 42 had short course radiotherapy, 9 had long course radiotherapy and 32 had neoadjuvant chemotherapy followed by long course chemoradiotherapy. In 17/102(16.6%), there was a positive circumferential resection margin. Over a median follow up of 32 months, 20 patients developed recurrence of any type. Local recurrence occurred in five patients (two of which also had distant recurrence), of whom two had a positive circumferential resection margin (P = 0.10). Actuarial two-year local only recurrence was 3.4% and any recurrence was 17.7%. Overall five-year cancer specific survival was 77%. Conclusions In this series we found low rates of local recurrence after standard abdominoperineal resection even with a circumferential margin rate positivity of 16.6%.Performing an ELAPE in selected cases may improve these results further but is not necessarily required for all patients.
Surgery performed by supervised registrars does not adversely affect medium-term functional outcomes after total knee replacement
Authors: Beattie N , Maempel JF , Roberts S , Waterson HB , Brown G , Brenkel IJ , Walmsley PJ 
Published: September 2017

Introduction Although total knee arthroplasty (TKA) is an index procedure for orthopaedic registrars, there is a lack of published research as to the effects of surgery when performed by supervised trainees. The aim of this study was to compare functional outcomes up to five years after primary TKA performed by consultants and trainee surgeons. Methods A retrospective analysis was conducted of prospectively collected data for 609 consecutive patients (339 female, 270 male) undergoing TKA. Patients were assessed preoperatively as well as at 18 months, three years and five years postoperatively, and American Knee Society objective knee and functional scores (AKSK and AKSF) were recorded. Results Surgery was performed by a consultant in 465 cases and a supervised trainee in 144 cases. There were no significant differences between the two groups in preoperative patient characteristics, operative time (p=0.15), transfusion rates (p=0.84), length of stay (p=0.98), manipulation under anaesthesia (p=0.69), or mortality rates at one year (p=0.73) or five years (p=0.81). Postoperatively, the median magnitude of improvement in AKSK (48 points for consultant group vs 45 points for trainee group, p=0.74) and in AKSF (both groups 15, p=0.995) was similar between the groups. AKSK and AKSF scores were similar at all timepoints up to five years following surgery, and there was no difference in the median range of motion (both groups 100°, IQR: 18°) at five years (p=0.43). Conclusions TKA performed by supervised registrars gives functional outcomes that are equivalent to consultant performed TKA, without affecting postoperative range of movement, or increasing operative time, length of stay or transfusion rates. Rates of postoperative MUA and mortality are also comparable.
Análise de eficiência dos serviços de hospitais públicos nas capitais brasileiras
Authors: Silva Vanderléia de Souza da , Kakihara Alessandra Ayumi S. B. de S. , Poker Johan Hendrik , Milani Filho Marco Antonio , Belli Márcio Marcelo 
Published: September 2017

O objetivo do presente estudo foi analisar a eficiência dos serviços de hospitais públicos das 26 capitais estaduais brasileiras e do Distrito Federal no tratamento de doenças em clinica médica com maior taxa de mortalidade dos capítulos da CID-10 em 2014. A metodologia aplicada foi a Análise Envoltória de Dados (DEA), com o modelo VRS (Variable Returns of Scale), orientado aos inputs. Os dados utilizados neste foram as internações nos capítulos I, IX e X; taxa de mortalidade; média de permanência e AIH médio. Assim, seis capitais foram eficientes: Porto Velho, Rio Branco, Boa Vista, Palmas, São Paulo e Vitória. Como diferencial propôs-se neste artigo um método para se levar em conta os fatores intervenientes na eficiência observada, promovendo uma análise mais aprofundada dos resultados encontrados, onde os resultados observados foram comparados aos esperados pela relação com as variáveis intervenientes. Identificando-se a influência do percentual de população rural, IDH do município e quantidade de hospitais SUS na eficiência alcançada nos serviços de hospitais públicos nas capitais estudadas.
The classical theory of calculus of variations for generalized functions
Authors: Lecke Alexander , Luperi Baglini Lorenzo , Giordano Paolo 
Published: September 2017

Abstract
We present an extension of the classical theory of calculus of variations to generalized functions.
The framework is the category of generalized smooth functions, which includes Schwartz distributions, while sharing many nonlinear properties with ordinary smooth functions.
We prove full connections between extremals and Euler–Lagrange equations, classical
necessary and sufficient conditions to have a minimizer, the necessary
Legendre condition, Jacobi’s theorem on conjugate points and Noether’s
theorem. We close with an application to low regularity Riemannian
geometry.
Effective Policies for Transportation and Pollution Reduction on North America’s International Borders
Authors: Fernandez Linda , Das Monica 
Published: September 2017

Abstract
We examine policies of transportation, vehicle technology, environment and trade by impact on air quality along North America’s international borders where trade moves in trucks. Panel data analysis helps account for temporal variation in the implementation of different policies by start date and also enables comparisons between ports on the same border as well as between borders. Data on commercial trucks, private vehicles, border wait times and air pollution are utilized to compare pollution across time and space. We estimate Zellner’s SUR model and Swamy’s random coefficients model to capture heterogeneity in the impact of policies across ports. We find the impact of vehicle technology; trade, security and environmental policies vary across pollutants and ports. Econometric results show trade and security policy are statistically significant in reducing ozone and particulate pollution. Vehicle technology and fuel policy are statistically significant for reducing ozone pollution.
Making sense of a haemolysis monitoring and reporting system: a nationwide longitudinal multimethod study of 68 Australian laboratory participant organisations
Authors: Li Ling , Vecellio Elia , Gay Stephanie , Lake Rebecca , Mackay Mark , Burnett Leslie , Chesher Douglas , Braye Stephen , Badrick Tony , Westbrook Johanna I. , Georgiou Andrew 
Published: September 2017

Abstract

Background:
The key incident monitoring and management systems (KIMMS) quality assurance program monitors incidents in the pre- and postanalytical phases of testing in medical laboratories. Haemolysed specimens have been found to be the most frequent preanalytical error and have major implications for patient care. The aims of this study were to assess the suitability of KIMMS for quality reporting of haemolysis and to devise a meaningful method for reporting and monitoring haemolysis.

Methods:
A structured survey of 68 Australian KIMMS laboratory participant organisations was undertaken. Quarterly haemolysis reports (2011–2014) were analysed.

Results:
Among 110 million accessions reported, haemolysis rates varied according to the reporting methods that participants used for assigning accessions (16% of participants reported haemolysis by specimen and 83% reported by episode) and counting haemolysis rejections (61% by specimen, 35% by episode and 3% by test). More than half of the participants (56%) assigned accessions by episode and counted rejections by specimen. For this group, the average haemolysis rate per 100,000 episodes was 177 rejected specimens with the average rate varying from 100 to 233 over time. The majority of participants (91%) determined rejections using the haemolysis index. Two thirds of participants (66%) recorded the haemolysis manually in laboratory information systems.

Conclusions:
KIMMS maintains the largest longitudinal haemolysis database in the world. However, as a means of advancing improvements in the quality of the preanalytical laboratory process, there is a need to standardise reporting methods to enable robust comparison of haemolysis rejection rates across participant laboratories.
Scolding the Skald: The Construction of Cultural Memory in Morkinskinna’s Sneglu-Halla þáttr
Authors: Tirosh Yoav 
Published: September 2017

AbstractAround the year 1060, the misbehaving Icelandic skald Sneglu-Halli arrives at the court of king Haraldr harðráði and manages to provoke the king and his fellow courtiers, yet he leaves a richer and more successful man as a result. A literary analysis of
What did the Future hold for them? Different Types of Foreshadowing in Various Saga Genres
Authors: Králová Kristýna 
Published: September 2017

AbstractThe aim of this article is to show that foreshadowing in various types of Old Norse saga differs in both content and form. In the individual chapters typical features of foreshadowing in family, king’s and legendary sagas are described. These features are shown through the following categories: the form in which the given foreshadowing occurs (a dream, premonition, curse, etc.), the content of the given foreshadowing, the time extent of the foreshadowing (how far into the future the given foreshadowing extends) and geographical range (to what places the given foreshadowing is bound). The subsequent comparison of foreshadowing in various saga genres reveals great differences between these four categories. In the article’s conclusion, possible causes of these differences are suggested.
Beundring og opposisjon. Forholdet mellom Knut Hamsun og Johannes V. Jensen
Authors: Nesby Linda H. 
Published: September 2017

AbstractIn this article, I will discuss Knut Hamsun’s connection to the Danish capital Copenhagen, and his lifelong acquaintance with the famous Danish author, Johannes V. Jensen. By the end of the 19th century, Copenhagen was the cultural capital of the Nordic countries. Together with many other eminent Nordic artists, Knut Hamsun spent considerable time in Copenhagen and experienced personal and professional growth during his stays there. Johannes V. Jensen and Hamsun knew each other for years and held each other in high esteem, yet their acquaintance was marked by both fascination and critique. Johannes V. Jensen, in particular, had mixed feelings and opinions about Hamsun. This article focusses on the similarities and differences between Knut Hamsun and Johannes V. Jensen, and discusses how an initially shared value system could lead them in two opposite political directions.
Changierender Artist. Zu Carl Larssons Positionierung im bildkünstlerischen und literarischen Feld
Authors: Wischmann Antje 
Published: September 2017

AbstractTaking the exhibition entitled “Carl Larsson – friends and enemies“ (Stockholm 2013) as its starting point, this study seeks to shed new light on the interplay of selected people in Larsson’s personal networks. It examines an issue, which has to date received little attention, the interaction between Larsson’s artistic and literary work. Drawing on Pierre Bourdieu’s field theory, the study explores a range of personal relationships expressed both cooperatively and antagonistically, but is concerned less to demonstrate any conscious strategies on the part of Larsson than to reveal gradually evolving patterns of interaction. Indeed, in the fight for symbolic capital, Larsson’s combined genre of literature and art reproductions in the form of albums (1895–1910) is increasingly growing in importance.
‘Á Kálfskinni’: Sagas and the Space of Literature
Authors: Tulinius Torfi H. 
Published: September 2017

AbstractThe “space of literature” is a metaphor for literature introduced by the French writer and critic Maurice Blanchot to express the specificity of literary discourse, which says what otherwise cannot be said. In this it produces a community around the unsayable. This ability to say something previously unsaid makes literature to some extent akin to scientific inquiry. In the last decades, research in Old Norse-Icelandic studies has not focussed on this aspect of the saga literature. The study of the sociological conditions for literary production in medieval Iceland can explain why the self-conscious pursuit of literary expression resulted in the emergence of a unique literary genre, the Saga about early Icelanders (
Runes and Verse: The Medialities of Early Scandinavian Poetry
Authors: Jesch Judith 
Published: September 2017

AbstractThe paper discusses a number of versified runic inscriptions, mainly from Scandinavia, and from ca. 400 to 1400 AD, to explore what they reveal about the forms and functions of early Scandinavian poetry outside the manuscript tradition. With a particular focus on ‘authors’ and ‘audiences’, as defined by Bredehoft in his work on Anglo-Saxon inscriptions, the paper elucidates the potential oral contexts of Scandinavian runic verse and concludes that, although runic writing is a form of literacy, the examples show that for most of its history it is associated with various kinds of oral context. Runic verse shows that inscriptions provide one of the best ways into understanding the Scandinavian oral tradition, not only before the arrival of manuscript literacy, but also during its infancy.
Mythical and Metaphorical Landscapes in Skaldic Poetry
Authors: Marold Edith 
Published: September 2017

AbstractIt is in vain that one looks for realistic descriptions of landscapes in skaldic poetry. There is no interest in the landscapes where the actions which are the only concerns of this genre take place. However, landscape features such as mountains, the sea, trees, caves or the sky are perceptible in the system of the kennings, yet only as more or less abstract ideas. They mostly lack congruence within their semantic and situational contexts as is shown by the examples of kennings for ‘earth’ and ‘sea’. However, a more inclusive research shows that there are images of landscapes that may be called metaphorical or mythical. These may be conceptualized as different types: (1) The emotional state of individual characters can be projected on to landscapes (e.g. Hallfreðr,
Chemical constituents from the genusSaussureaand their biological activities
Authors: Zhao Ting , Li Shao-Jing , Zhang Zhao-Xin , Zhang Man-Li , Shi Qing-Wen , Gu Yu-Cheng , Dong Mei , Kiyota Hiromasa 
Published: September 2017

AbstractThe genusSaussurea(Asteraceae) contains about 400 species distributed around Asia and Europe and used in the traditional medicines of many cultures. The main compounds isolated fromSaussureaspecies are terpenoids, in particular, sesquiterpenoids are dominant. This review lists 404 chemical constituents as well as their biological activity (111 references).
Repair Welding of the Tunnel Defect in Friction Stir Weld
Authors: Li Weipo , Liang Zhimin , Cai Congwei , Wang Dianlong 
Published: September 2017

Abstract
The tunnel defect formed in friction stir weld would dramatically push the mechanical properties of joints into deterioration. In this study, friction stir welding process was adopted to repair the joints of 7N01 aluminum alloy with tunnel defect. The effects of friction stir repair welding process on the microstructure and mechanical properties were comprehensively investigated. Microstructure of the repaired joints shows that the grain size in nugget zone decreases slightly while the recrystallization in the retreating side of thermo-mechanically affected zone is intensified as the joints are repaired. The microhardness of the repaired joints declined slightly compared with the defective joint. However, the yield strength and tensile strength increase and recover to the values of the joints free of defect. The longitudinal residual stress in weld zone increased remarkably as the repair times increase. Compared with the once repaired joint, yield strength and tensile strength of the twice repaired joint reduced slightly, and the throat thickness also reduced during the repeated repair welding process. Therefore, the times of repair welding applied should be limited actually.
Raising awareness on cyber safety: adolescents’ experience of a primary healthcare professional-led, school-based, multi-center intervention
Authors: Tsimtsiou Zoi , Drosos Evangelos , Drontsos Anastasios , Haidich Anna-Bettina , Dantsi Fotini , Sekeri Zafiria , Dardavesis Theodoros , Nanos Panagiotis , Arvanitidou Malamatenia 
Published: September 2017

Abstract

Purpose
Although safe Internet use is an emerging public health issue, there is a scarcity of published work describing relevant school-based interventions. The objective of this study was to explore the impact of a health professional-led, school-based intervention in raising awareness on cyber-safety in adolescents, Therefore, the aim of this study was to investigate adolescents’ evaluation of this school-based intervention, 6 months after its implementation, as well as the impact of adolescents’ school class and gender on their evaluation.

Methods
A student sample was selected using a multistage stratified random sampling technique, according to the location and school grade level (middle, high school). The students – aged from 12 to 18 years old experienced an interactive presentation in their classrooms on the amount of time spent online, the use of social networks and the available support services. An evaluation tool was completed anonymously and voluntarily 6 months after the intervention.

Results
Four hundred and sixty-two students (response rate 90.7%, 246 middle, 216 high school) completed the evaluation tool. Younger students, especially the ones in the first year of middle school, scored significantly higher in all six parameters used in the evaluation of this intervention compared with all the older participants: (a) they had kept the presented information on Safeline and Saferinternet websites and the helpline Ypostirizo (70.2% vs. 33.7%, p < 0.001) (b) they had already used it (32.5% vs. 12.3%, p < 0.001), (c) they had learned new information on cyber safety (66.4% vs. 34%, p < 0.001), (d) they rated the intervention as more interesting (median 8 vs. 7, p < 0.05), (e) they had reconsidered the way they use Internet (median 7 vs. 6, p < 0.05) and (f) they had changed their cyber behavior (median 7 vs. 5, p < 0.05).

Conclusion
The active involvement of students in a discussion on cyber-safety based on their experiences was highly evaluated. The impact of the intervention on the youngest students underlines the need for raising awareness on cyber-safety and support services, earlier in the students’ life.