bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chiari type 1 malformation presenting as an atypical benign paroxysmal positional vertigo in a 16 year old patient
Authors: Kelkar Ajinkya A. , Yates Philip D. 
Published: December 2017

<p>Dizziness and vertigo are very common symptoms and can be difficult to distinguish clinically. Vertigo is a specific subtype of dizziness in which a patient experiences the illusion of motion (often rotatory) of either themselves or their surroundings. Vertigo can be either peripheral (arising within the labyrinth) or central (brain). It is important to identify central aetiologies as they can be fatal if missed. This case report narrates a 16-year-old male who presented complaining of vertigo related to changes in head position which was initially misdiagnosed as a benign paroxysmal positional vertigo (BPPV). It was several years before he was correctly diagnosed as having Chiari type 1 malformation on MRI scan. He underwent a surgical decompression with complete alleviation of his symptoms. All cases of atypical vertigo should be evaluated in detail. Patients with failure of initial management should undergo imaging to identify any central pathology. </p>
A novel technique in the treatment of post traumatic parotid duct sialocele
Authors: Gujrathi Atishkumar B. , Ambulgekar Vijayalaxmi 
Published: December 2017

<p>Stenson's duct of parotid gland is a major duct which drains saliva into the oral cavity. Deep penetrating wound in the form of cut or crush injury to the buccal area carries the risk of parotid duct injury. It is in the form of ductal exposure, laceration, total severing, or crushing of the duct. These conditions are difficult to diagnose because of complex anatomy and variable nature of injury. Successful management of parotid duct injury depends on early diagnosis and appropriate intervention, failing of which may lead to complications like sialocele or salivary fistula. Many techniques have been proposed for diagnosis and management of parotid duct injuries. This article presents an easy and an innovative technique to diagnose and manage the parotid duct injuries using an "epidural catheter" which is often used for inducing spinal anesthesia. The technique of epidural catheter usage, its advantages, and limitation over other techniques proposed for the management of parotid duct injury are discussed. </p>
Dysphagia following total laryngectomy: a myth or a reality? How can we help
Authors: Jagtap Mansi A. , Sheth Mansi Bhavesh 
Published: December 2017

<p class="Default">Total laryngectomy leads to drastic anatomical changes in the swallowing and breathing mechanism. Reduced tongue base retraction, poor pharyngeal clearance, stricture and prominence in the posterior pharyngeal wall have been reported to cause swallowing difficulties in individuals with total laryngectomy. The present case study describes the swallowing characteristics in an individual with total laryngectomy and discusses efficacy of swallowing maneuvers in total laryngectomy. A 55 yr/male, operated case of total laryngectomy using TEP reported with complaint of food getting stuck in the throat and vomiting sensation. He was fed orally and could tolerate only thick liquids. Swallowing assessment was carried out by clinical and instrumental tools (modified barium swallow) which revealed cricopharyngeal prominence, poor pharyngeal clearance and significant post swallow residue. Effortful swallow was attempted to explore the change in swallowing mechanism. Relaxation of pharyngeal wall with better pharyngeal clearance was seen with the maneuver. Clinically, the case reported of ability to swallow semisolids and solids well with the maneuver. At 3 month follow up, the case reported no difficulty in swallowing semisolids and solids orally. The above case study highlights on radiological evidence of swallowing abnormalities following total laryngectomy and further on the efficacy of maneuver on mechanism of swallowing. Hence, it can be noted that swallowing intervention has strong implications in patients with total laryngectomy. </p>
A observância do princípio da proporcionalidade no direito comparado quanto à interceptação de dados digitais / The observance of the principle of proportionality in comparative law on digital data interception
Authors: Fedato Matheus Arcangelo , Kazmierczak Luiz Fernando 
Published: December 2017

RESUMOO artigo se propõe a analisar como o princípio da proporcionalidade está sendo utilizado no contexto das interceptações informáticas, estando o tema ligado à vigilância digital para a garantia da segurança pública e a proteção da privacidade. A análise se dá pela observância de como ordenamentos jurídicos estrangeiros (EUA, Alemanha, Portugal) tratam a matéria, tendo em vista os programas de interceptação americanos e sua declarada guerra ao terrorismo, a jurisprudência alemã e a sua visão de proporcionalidade e Portugal pela regulamentação do tema por determinação da União Europeia. Constatou-se que a proporcionalidade tem sido utilizada como modo de balizar o conflito de interesses gerados pela colisão dos direitos fundamentais. A preservação da privacidade mostrou-se privilegiada, restando, como exceção, os programas de espionagem do governo norte-americano. Para atingir o objetivo do estudo, foi utilizado o método dedutivo, além de meios de pesquisa eletrônicos e bibliográficos.Palavras-chave: Princípio da Proporcionalidade; Colisão de Direitos; Segurança Pública; Privacidade; Interceptação de dados. ABSTRACTThe article proposes to analyze how the principle of proportionality is being used in the context of computer intercepts, linked the subject to the digital surveillance to guarantee public safety and the privacy protection. The analysis is based on observance of how foreign legal systems (USA, Germany, Portugal) deal with the matter, because of the American interception programs and their declaration of war on terrorism, the German jurisprudence and their view of proportionality and Portugal by regulating the subject by determination of the European Union. It has been observed that proportionality has been used as a means of assessing the conflict of interests generated by the collision of fundamental rights. The preservation of privacy has been privileged, with the exception of the espionage programs of the US government. To reach the study objective, the deductive method was used, as well as electronic and bibliographic research resources.Keywords: Principle of Proportionality; Collision of Rights; Public Safety; Privacy; Data Interception.
LOW CD4 LYMPHOCYTE COUNT RELATED RISK TO Pneumocystis jiroveci PNEUMONIA IN HIV/AIDS PATIENTS FROM BRONCHOALVEOLAR LAVAGE SPECIMENS USING REAL TIME PCR DETECTION
Authors: Widya Alicia Margaretta , Mertaniasih Ni Made , Kawilarang Arthur Pohan , Marhana Isnin Anang 
Published: December 2017

HIV and opportunistic infections remain a big problem especially in developing country. Pneumocystis jiroveci pneumonia is a prevalent infection in HIV infected patient with high mortality rate. Diagnosis of Pneumocystis jiroveci pneumonia is mainly based on clinical evidence. Microbiological diagnosis is quite challenging since this microorganism cannot be cultured and is mainly based on microscopic examination. Microscopic examination with special staining is still a gold standard diagnosis for P. jiroveci infection.The objectives of this study was to describe CD4 lymphocyte profile and establish microbiological diagnosis with recent molecular method in PJP suspected HIV positive patients. Fiberoptic bronchoscopy of HIV infected patients with lower respiratory tract infection in Dr. Soetomo general hospital Surabaya were performed to collect bronchoalveolar lavage specimens from December 2016 to April 2017 for identification of Pneumocystis jiroveci using real time PCR assay. Positive samples were then evaluated for microscopic examination with Gommori Methenamine Silver staining for comparison. Patient’s CD4 lymphocyte count were gathered prior of admission. CD4 lymphocyte count from this study were very low with 61% of the patients were below 50 cells/ µL. There were five of total thirteen patients (38,5%) with positive real time PCR assay (MSG gene) and one patient was also positive with GMS staining showing characteristic cysts shape with dark centered area of P. jiroveci. Patient with positive microscopic examination showed no history of prophylactic therapy. Low CD4 lymphocyte count remains a strong risk factor of P. jiroveci pneumonia in HIV/AIDS patients. Real time PCR assay shows high value in detection of P. jiroveci regarding patient’s prophylactic status.
ESTIMATIVA DAS EROSIVIDADES ANUAIS E MAPEAMENTO PARA O ESTADO DO CEARÁ/ Estimation of erosivity annual and mapping for the State of Ceará
Authors: Filho Jacques Carvalho Ribeiro , Dos Santos Júlio Cesar Neves , Neto José Ribeiro de Aruajo , Lemos Filho Luis Cesar de Aquino , Brasil Jose Bandeira 
Published: December 2017

A erosão hídrica tem apresentado elevado potencial de redução na capacidade produtiva dos solos além de ocasionar problemas ambientais relacionados ao assoreamento e poluição dos recursos hídricos. Entre os diversos fatores ligados à erosão, a erosividade das chuvas é um dos mais importantes. O potencial da chuva para gerar erosão do solo é conhecido como erosividade, sendo sua estimativa fundamental para a compreensão da vulnerabilidade do recurso solo de uma determinada região. Nesse sentido, o trabalho objetiva especializar as informações de erosividade anual das chuvas para o Estado do Ceará-Brasil. O Estado do Ceará está subdividido em 12 bacias hidrográficas, para uma melhor gestão dos recursos hídricos de cada região. Com área total de 148.825,6 km², o estado apresenta a 1,75% do território nacional. O uso da geoestatística mostrou-se adequado para a mensuração da dependência espacial da chuva e erosividade para o Estado do Ceará, tendo o modelo teórico exponencial apresentadou melhor resultado. Constatou-se que as maiores alturas pluviométricas e índices de erosividade foram registrados nas bacias do litoral, já as menores, na área mais central do Estado do Ceará. Quanto. à erosividade, nota-se que a região litorânea classifica-se como alta (7.000 < R < 9.000 MJ mm ha-1 h-1 ano-1), já o restante do estado classifica-se como média (5.000 < R < 7.000 MJ mm ha-1 h-1 ano-1).
Gas Lift Valve R-Ratios
Authors: Decker K. L. 
Published: December 2017

Summary
The R-ratio is considered a constant, equal to the area of the port (Ap) divided by the bellows effective area. When gas lift valves are tested for both opening and closing pressures, it is possible to calculate the R-ratio. The calculated R-ratio from test data is consistently larger than the manufacturers’ published R-ratios. This paper presents a discussion of the factors affecting the R-ratio and an explanation for the difference between published and tested R-ratios. The R-ratio is not a constant but varies with dome pressure, port-material strength, bellows size, and port size. A method is proposed to calculate or test the true R-ratio.
The use of the area of the port (Ap) in the R-ratio is not completely accurate. The area should be the seal area (As) defined by the outer-sealing diameter of the ball (Ds) on the port. It is possible to test valve behavior to determine the seal area, and it is recommended that the tests be conducted in order to use the correct R-ratio when designing gas lift wells. A method to apply the use of the measured R-ratio is also provided.
Climate Change Impacts on Yields and Soil Carbon in Row Crop Dryland Agriculture
Authors: Robertson Andy D. , Zhang Yao , Sherrod Lucretia A. , Rosenzweig Steven T. , Ma Liwang , Ahuja Lajpat , Schipanski Meagan E. 
Published: December 2017

Dryland agroecosystems could be a sizable sink for atmospheric carbon (C) due to their spatial extent and level of degradation, providing climate change mitigation. We examined productivity and soil C dynamics under two climate change scenarios (moderate warming, representative concentration pathway [RCP] 4.5; and high warming, RCP 8.5), using long‐term experimental data and the DayCent process‐based model for three sites with varying climates and soil conditions in the US High Plains. Each site included a no‐till cropping intensity gradient introduced in 1985, with treatments ranging from wheat–fallow (Triticum aestivum L.) to continuous annual cropping and perennial grass. Simulations were extended to 2100 using data from 16 global circulation models to estimate uncertainty. Simulated yields declined for all crops (up to 50% for wheat), with small changes after 2050 under RCP 4.5 and continued losses to 2100 under RCP 8.5. Of the cropped systems, continuous cropping had the highest average productivity and soil C sequestration rates (78.1 kg C ha−1 yr−1 from 2015 to 2045 under RCP 4.5). Any increase in soil C for cropped rotations was realized by 2050, but grassland treatments increased soil C (up to 69%) through 2100, even under RCP 8.5. Our simulations indicate that reduced frequency of summer fallow can both increase annualized yields and store more soil C. As evapotranspiration is likely to increase, reducing fallow periods without live vegetation from dryland agricultural rotations may enhance the resilience of these systems to climate change while also increasing soil C storage and mitigating carbon dioxide emissions.Core Ideas
Soil C sequestration rates increased with cropping intensity.
Water‐limited systems will see increased yield losses under climate change.
Intensive systems retained soil C but with more variability under climate change.
Grasslands are likely to sequester more soil C than annual cropping systems.
Beyond the Edge: Linking Agricultural Landscapes, Stream Networks, and Best Management Practices
Authors: Kreiling R. M. , Thoms M. C. , Richardson W. B. 
Published: December 2017

Despite much research and investment into understanding and managing nutrients across agricultural landscapes, nutrient runoff to freshwater ecosystems is still a major concern. We argue there is currently a disconnect between the management of watershed surfaces (agricultural landscape) and river networks (riverine landscape). These landscapes are commonly managed separately, but there is limited cohesiveness between agricultural landscape‐focused research and river science, despite similar end goals. Interdisciplinary research into stream networks that drain agricultural landscapes is expanding but is fraught with problems. Conceptual frameworks are useful tools to order phenomena, reveal patterns and processes, and in interdisciplinary river science, enable the joining of multiple areas of understanding into a single conceptual–empirical structure. We present a framework for the interdisciplinary study and management of agricultural and riverine landscapes. The framework includes components of an ecosystems approach to the study of catchment–stream networks, resilience thinking, and strategic adaptive management. Application of the framework is illustrated through a study of the Fox Basin in Wisconsin, USA. To fully realize the goal of nutrient reduction in the basin, we suggest that greater emphasis is needed on where best management practices (BMPs) are used within the spatial context of the combined watershed–stream network system, including BMPs within the river channel. Targeted placement of BMPs throughout the riverine landscape would increase the overall buffering capacity of the system to nutrient runoff and thus its resilience to current and future disturbances.Core Ideas
Managing agricultural landscapes should integrate land and river network concerns.
An ecosystems approach and resilience are combined with strategic adaptive management.
BMPs should be implemented across the integrated landscape.
Omega-3 Hastens and Omega-6 Delays the Progression of Neuropathology in a Murine Model of Familial ALS
Authors: Boumil Edward F. , Vohnoutka Rishel Brenna , Liu Yuguan , Lee Sangmook , Shea Thomas B 
Published: December 2017

Background:
Amyotrophic lateral sclerosis (ALS) is a progressive disease of motor neurons that has no cure or effective treatment. Any approach that could sustain minor motor function during terminal stages would improve quality of life.

Objective:
We examined the impact of omega-3 (Ω-3) and Ω-6, on motor neuron function in mice expressing mutant human superoxide dismutase-1 (SOD-1), which dominantly confers familial ALS and induces a similar sequence of motor neuron decline and eventual death when expressed in mice.

Method:
Mice received standard diets supplemented with equivalent amounts of Ω-3 and Ω-6 or a 10x increase in Ω-6 with no change in Ω-3 commencing at 4 weeks of age. Motor function and biochemical/histological parameters were assayed by standard methodologies.

Results:
Supplementation with equivalent Ω-3 and Ω-6 hastened motor neuron pathology and death, while 10x Ω-6 with no change in Ω-3 significantly delayed motor neuron pathology, including preservation of minor motor neuron function during the terminal stage.

Conclusion:
In the absence of a cure or treatment, affected individuals may resort to popular nutritional supplements such as Ω-3 as a form of “self-medication”. However, our findings and those of other laboratories indicate that such an approach could be harmful. Our findings suggest that a critical balance of Ω-6 and Ω-3 may temporarily preserve motor neuron function during the terminal stages of ALS, which could provide a substantial improvement in quality of life for affected individuals and their caregivers.
Prospective, Cluster-Randomized Trial to Implement the Ottawa Model for Smoking Cessation in Diabetes Education Programs in Ontario, Canada
Authors: Reid Robert D. , Malcolm Janine , Wooding Evyanne , Geertsma Amy , Aitken Debbie , Arbeau David , Blanchard Chris , Gagnier Jo-Anne , Gupta Anil , Mullen Kerri-Anne , Oh Paul , Papadakis Sophia , Tulloch Heather , LeBlanc Allana G. , Wells George A. , Pipe Andrew L. 
Published: December 2017

OBJECTIVE
To test whether a practice-level intervention to promote the systematic identification, treatment, and follow-up of smokers (the Ottawa Model for Smoking Cessation [OMSC]) would improve long-term abstinence rates among smoker-patients with type 2 diabetes or prediabetes receiving care from diabetes education programs in Ontario, Canada.

RESEARCH DESIGN AND METHODS
The Tobacco Intervention in Diabetes Education study was a matched-pair, cluster-randomized clinical trial. Within each pair, sites were randomly allocated to either an OMSC intervention (n = 7) or a wait-list control (WLC) condition (n = 7). Diabetes education programs in the OMSC group introduced standardized processes to identify smokers and routinely provided smoking cessation interventions and follow-up. Smokers in the OMSC group received counseling, a discount card to partially cover the cost of smoking cessation medication, and follow-up telephone calls over a 6-month period. Diabetes education programs in the WLC condition were offered the OMSC intervention after a 1-year waiting period. Smokers in the WLC group received usual care for smoking cessation from their diabetes educator. The primary end point was carbon monoxide (CO)–confirmed 7-day point prevalence abstinence from smoking at 6-month follow-up.

RESULTS
A total of 313 smokers (OMSC group n = 199, WLC group n = 114) with diabetes or prediabetes were enrolled. The CO-confirmed abstinence rate at 6 months was 11.1% in the OMSC group versus 2.6% in the WLC group (odds ratio 3.73 [95% CI 1.20, 11.58]; P = 0.02).

CONCLUSIONS
Implementation of the OMSC in diabetes education programs resulted in clinically and statistically significant improvements in long-term abstinence among smokers with diabetes or prediabetes.
Validation of Risk Equations for Complications of Type 2 Diabetes (RECODe) Using Individual Participant Data From Diverse Longitudinal Cohorts in the U.S.
Authors: Basu Sanjay , Sussman Jeremy B. , Berkowitz Seth A. , Hayward Rodney A. , Bertoni Alain G. , Correa Adolfo , Mwasongwe Stanford , Yudkin John S. 
Published: December 2017

OBJECTIVE
We sought to validate Risk Equations for Complications of Type 2 Diabetes (RECODe) among diverse populations.

RESEARCH DESIGN AND METHODS
We compared risk predictions from RECODe equations and from two alternative risk models (UK Prospective Diabetes Study Outcomes Model 2 [UKPDS OM2] and American College of Cardiology/American Heart Association Pooled Cohort Equations) to observed outcomes in two studies: the Multi-Ethnic Study of Atherosclerosis (MESA, n = 1,555 adults with type 2 diabetes, median follow-up 9.1 years) and the Jackson Heart Study (JHS, n = 1,746 adults with type 2 diabetes, median follow-up 8.0 years). Outcomes included nephropathy by multiple measures (microalbuminuria, macroalbuminuria, renal failure, end-stage renal disease, and reduction in glomerular filtration rate), moderate to severe diabetic retinopathy by Airlie House classification, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, congestive heart failure, and all-cause mortality.

RESULTS
RECODe equations for microvascular and cardiovascular outcomes had C-statistics for discrimination ranging from 0.71 to 0.85 in MESA and 0.64 to 0.91 in JHS for alternative outcomes. Calibration slopes in MESA ranged from 0.62 for a composite nephropathy outcome, 0.83–1.04 for individual nephropathy outcomes, 1.07 for retinopathy, 1.00–1.05 for cardiovascular outcomes, and 1.03 for all-cause mortality. Slopes in JHS ranged from 0.47 for retinopathy, 0.97–1.16 for nephropathy, 0.72–1.05 for cardiovascular outcomes, and 1.01 for all-cause mortality. The alternative models had C-statistics 0.50–0.72 and calibration slopes 0.07–0.60.

CONCLUSIONS
RECODe equations improved risk estimation for diverse patients with type 2 diabetes, as compared with two commonly used alternatives.
Restructuring companies under crisis. A real case study
Authors: SHAYB Hezi Aviram 
Published: December 2017

Nobody is planning to fail, but many companies are failing because of lack of planning.Real business experience showed during the years that crisis can be prevented, avoided or limited. If detected in time, the risks associated with the crisis can be mitigated and the effects can be diminished, with the condition that the actions required are done fast, in a sharp and accurate manner. When it comes, a crisis brings intense level of pressure and under these conditions there is no time or room for mistakes. Delays, losing focus and lack of planning will bring a company one step away from failure. The right way to deal with crisis, if required measures are not done in time, is to minimize the losses and reposition in the best way possible. Analyzing the success stories of some of the biggest and strongest companies in the world, led to an important conclusion: the majority of these companies were in the situation to face huge crises that threatened their ability to survive in certain moments on their way to success. With the right planning and by setting a proper organizational structure, the negative aspects of the crisis can be turned into benefits and opportunities for the company. The most critical challenge for management is to assess the level of exposure to risk of the company and identify the key points to focus on in order to overcome the crisis and create value. In order to set up a strong plan in dealing with crisis, a business organization needs reliable, efficient and effective tools and this is what this article is all about.