bluuebunny/crossref_metadata_2025_split huggingface dataset:
Step advancement flap technique of ear lobe repair
Authors: M. O. Harish , R. Chethana 
Published: December 2017

<p class="abstract"><strong>Background:</strong> Ear piercing and ornament wearing is a historical tradition. Dilated ear lobe and torn earlobe usually results from sudden trauma or continuous use of heavy earrings. Various surgical techniques have been described for the correction of the same. Each procedure has its own pros and cons. The choice will depend on individual preferences and the defect, partial or total, and should offer a lower chance of recurrence. The corrections can be made with or without preservation of the earring orifice. The aim and objectives of this study was to present and discuss a novel technique of repairing the partial and complete cleft ear practiced at Karwar Institute of Medical Sciences Hospital, Karnataka, India.</p><p class="abstract"><strong>Methods:</strong> A prospective study was done on the use of a novel technique “Step advancement flap” in the repair of partial and complete cleft ear lobe in 18 patients. </p><p class="abstract"><strong>Results:</strong> A good post-operative results were achieved in all the patients with maintained ear lobe thickness and a sutured skin scar away from the center.</p><p><strong>Conclusions:</strong> Our technique has an advantage of maintaining the normal ear lobe thickness and the sutured skin scar away from the center on either side of the ear lobule compared to other techniques. Thus the neo piercing can be done at a fresh central skin avoiding the skin scar.</p>
Evaluation of efficacy of Ultrasound in diagnosis of Neck Swellings
Authors: Rastogi Akriti , Sharma Karan , Gauba Neelam 
Published: December 2017

<p class="abstract"><strong>Background:</strong> Neck swellings are a common cause of dilemma to clinicians. Accurate diagnosis of neck swellings is of paramount importance. This study evaluated patients with neck swellings to study their ultrasonographic features and correlated the ultrasound findings with the final diagnosis.</p><p class="abstract"><strong>Methods:</strong> 100 patients with neck swellings were evaluated clinically and divided into four groups– congenital, inflammatory, benign and malignant. Thereafter, they underwent high-resolution Ultrasound (US) and the ultrasonographic features of each type of swelling were studied. A final diagnosis was established after further evaluation using FNAC, further imaging, surgical intervention in the form of incision and drainage or excision/incisional biopsy with histopathological examination or successful non-surgical treatment. Ultrasound findings were compared with final diagnosis. </p><p class="abstract"><strong>Results:</strong> For swellings of inflammatory nature, this study showed the sensitivity, specificity, PPV and NPV of US to be 87.2%, 96.6%, 94.4%, 91.9% respectively. For benign swellings, sensitivity, specificity, PPV and NPV was 97.5%, 91.3%, 88.6% and 98.1% respectively. Sensitivity of US in diagnosing malignant lesions of the neck was 87.5% with a specificity of 98.7%, PPV 93.3% and NPV 97.5%. Sensitivity of US in detecting thyroid malignancy in the present study was 83.3% and in diagnosing malignant lymph nodes was 87.5%.</p><p><strong>Conclusions:</strong> Ultrasound is the ideal modality for initial imaging for neck swellings. Later on, as per the need and Ultrasound findings, one can go in for further haematological investigations, Fine Needle Aspiration Cytology and Radiological investigations. </p>
Orbital complications of ENT diseases
Authors: Kumar Abhay , Chauhan Jitendra P. S. , Bhadouriya Sunil K. S. , Bharti Bhartendu , Narain Prem , Singh Jaypal 
Published: December 2017

<p class="abstract"><strong>Background:</strong> Orbital complications are fairly common in Otorhinolaryngology practice because of close proximity of orbit to adjacent ENT regions. Orbital complications must be suspected whenever ENT patients present with complaints of proptosis, diplopia, vision loss and epiphora. Early diagnosis and treatment is necessary to prevent morbidity and mortality in these patients.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in the ENT department for a period of 1 year from August 2016 to July 2017 and comprised of 38 cases. This study was conducted to see the incidence, etiology, clinical, radiological and histopathological profile in relation to ophthalmic complications in ENT diseases. </p><p class="abstract"><strong>Results:</strong> Male to female ratio was 1.71:1. Patients mean age at presentation in present study was 39.71±19.86 (SD) years and maximum number of cases 10 (26.32%) were between 41-50 years of age. Among 38 patients of our series, most common clinical presentation was proptosis followed by nasal obstruction. Commonest ENT diseases responsible for orbital complications were the different sinonasal tumours comprising 18 cases, in which carcinoma maxilla constituted 6 cases.</p><p><strong>Conclusions:</strong> In conclusion, correct diagnosis, adequate antibiotic therapy, and surgical intervention are important for management of orbital and ophthalmic complications. Cooperation between Ophthalmologist and the Otolaryngologist is clearly desirable for proper management of these cases.</p>
Bifurcación de Hopf en un modelo de desarrollo sostenible
Authors: Granada Díaz Héctor Andrés , A.G Miguel Angel , Moreno A D.K , Canchila M J.A 
Published: December 2017

Se presenta un sistema conformado por tres ecuaciones diferenciales ordinarias de primer orden que permiten estudiar la interacción dinámica entre los recursos renovables, la población y la contaminación ambiental de una región. El modelo se obtiene acoplando una ecuación dinámica de contaminación al sistema formulado por Simone D’alessandro y se muestra que bajo la bifurcación de Hopf se puede alcanzar el desarrollo sostenible bajo la definición dada en el informe de Brundtland 1987. Es decir, cuando se alcanza un balance armónico entre las variables de estado del modelo.
Microalgal luxury uptake of phosphorus in waste stabilization ponds – frequency of occurrence and high performing genera
Authors: Crimp A. , Brown N. , Shilton A. 
Published: December 2017

Abstract
Microalgae commonly found in waste stabilization ponds (WSPs) are able to accumulate elevated phosphorus levels within their cells in a process known as luxury uptake. However, there are few studies focused on luxury uptake in full scale WSPs. In order to comprehensively quantify the occurrence of this phenomenon, eight different WSP sites comprising seven primary facultative, six maturation and two high rate algal ponds (HRAPs) spread over several climatic regions were monitored over four seasons. Of the 15 ponds studied, 13 of these exhibited elevated levels of biomass phosphorus content at some point; however, the occurrence in HRAPs was limited. More than half of the samples tested had elevated phosphorus contents and this occurred in all climatic zones surveyed. The phosphorus content of the biomass was significantly correlated to decreasing rainfall and increasing total dissolved phosphorus. Microscopic analysis revealed that nearly all the 17 microalgal and five cyanobacterial genera identified performed luxury uptake, but at varying frequencies. This is the first time that the genera of algae responsible for luxury uptake in full scale WSPs has been studied. Chlamydomonas/Cryptomonas, Micractinium/Microcystis and Scenedesmus were the only microalgal genera found to both commonly occur in WSPs and consistently perform luxury uptake.
The use of vertical flow constructed wetlands for the treatment of hyper-eutrophic water bodies with dense cyanobacterial blooms
Authors: Zhong Fei , Liu Wei , Lv Mengdan , Deng Zifa , Wu Juan , Ji Hongjiu , Cheng Shuiping 
Published: December 2017

Abstract
Eutrophication often leads to the periodic proliferation of harmful cyanobacterial blooms (HCBs), which threaten the sustainability of freshwater ecosystems and lead to serious environmental, health and economic damage. Hence, it is vitally important to take effective measures to manage HCBs and associated problems. In this study, vertical flow constructed wetlands (CWs) were operated under different hydraulic loading rates (HLRs) to treat a hyper-eutrophic water body with HCBs. Six sampling ports (representing different layers) were evenly distributed along the water flow direction to study the purification processes of CWs. With HLRs ranging from 0.2 m/d to 0.8 m/d, total nitrogen (TN), total phosphorus (TP), COD, total suspended solid (TSS) and Chlorophyll a (Chl.a) were efficiently treated by CWs, and they were mainly removed at the second layer of CWs. The concentrations of two cyanobacterial metabolites (geosmin and β-cyclocitral) in the effluent were mostly below their odorous threshold concentrations. As the HLRs increased, the treatment efficiencies of the CWs decreased gradually. There was no removal of TP, Chl.a, geosmin, or β-cyclocitral at an HLR of 1.0 m/d. Under suitable HLRs, this type of CW could provide a promising way to control HCBs and associated odorous problems in hyper-eutrophic water bodies.
Factors Associated with Outsourcing Support Services by General Hospitals in Uganda
Authors: Mujasi Paschal N. , Nkosi Zerish Z. 
Published: December 2017

Background:
The objective of this study was to identify factors associated with the decision, process and practices of outsourcing support services by general hospitals in Uganda.

Methods:
A cross sectional survey design was used; 32 hospitals were sampled using stratified random sampling. Trained research assistants distributed self-administered questionnaires to managers in the sampled hospitals. Wilcoxon-Mann-Whitney tests were performed on the collected data using SAS 9.3.

Results:
Majority (59%) of hospitals surveyed were rural; 41% were urban. More than half (n=23; 72%) reported to be outsourcing at least one support service. There was a significant difference in the proportion of rural and urban hospitals outsourcing and those not outsourcing (p=0.0033). While outsourcing, rural hospitals were more likely to report challenges with the availability of vendors (p= 0.0152); urban hospitals were more likely to report challenges with contractual issues (p=0.0056). Ministry of Health owned hospitals were more likely to report political interference in the outsourcing process (p= 0.0065). Rural hospitals were more likely to monitor the continued need for outsourcing compared to their urban counterparts (p=0.0358). We found no significant differences (p>0.05) in the hospital managers’ perceptions about the benefits of outsourcing, outsourcing risks, characteristics of services that need to be outsourced and outsourcing barriers among outsourcing and non-outsourcing hospitals.

Conclusion:
Hospital location and ownership have an influence on aspects of the outsourcing decision, process and practices by general hospitals in our study. However, the perceptions of the hospital managers regarding outsourcing have no influence on the hospital’s outsourcing decision and practices.
Judicial Review and Merits Review: Are the Boundaries Being Eroded?
Authors: Creyke Robin 
Published: December 2017

AbstractCourts and tribunals have distinct roles within the Australian administrative law system at the federal level, and to a lesser extent, in the states and territories. Questions of law are for the courts, and questions of fact are for the executive and tribunals. From time to time this orthodoxy is questioned. Suggestions are made that the courts are increasingly tending to intrude into the province of tribunals. Using cases as illustrations, this article explores five relevant jurisdictional areas —from appeals on a question of law to deference under the Administrative Decisions (Judicial Review) Act 1977 (Cth) s 10(2)(b)(ii)—to test the accuracy of the suggestion.
Judicial Review of Legislators’ Motives
Authors: Van Wees Nathan 
Published: December 2017

AbstractAre legislators’ subjective motives relevant to the constitutional validity of an Act? In the USA, an Act may be found to be unconstitutional because legislators were motivated by a desire to discriminate against religion or interstate trade. The High Court has rejected such an enquiry in cases concerning ss 92 and 116 of our own Constitution. This article examines how, with substantially similar constitutional protections, the courts of these two countries have arrived at opposing views on the relevance of ‘motive evidence’. The High Court can avoid recourse to motive evidence because, when compared with its US counterpart, it applies a clearer test in the religion cases, and a more nuanced approach to proportionality testing in the interstate trade cases. This is the preferable approach.
Exu: sagrado e profano
Authors: Fernandes Alexandre De Oliveira 
Published: December 2017

Nosso estudo retoma contribuições de Georges Bataille, Pierre Verger, Edgar Morin, Ronilda Iyakemi Ribeiro, Stefania Capone, Monique Augras com vistas a discutir Exu, deus nagô e dos terreiros de umbanda, ambíguo e paradoxal, macho e fêmea, sagrado e profano. Responsável pela ordem do universo tem caráter virulento, atrevido e sem vergonha. Vindo ao mundo com um porrete mágico, metonímia de seu falo ereto, choca o decoro, a moral e a cristandade. Constrange os proscritos e as normas, embaralha as dicotomias bem marcadas do Ocidente. Rompe com os tabus e estabelece nova (des)ordem, ação erótico-sagrada que remete à árvore da vida e ao gozo fértil de Exu. Quem incita (excita) à Vida é Exu, deus trickster a convidar: vem. Trabalharemos com textos de gêneros diversos, a saber, conto, poema, tela, fotografia para que deles salte um perigoso ambivalente como Madame Satã, Maria Navalha, Zé Pelintra, faces de Exu: travesti, travesso, erótico-sagrado, híbrido, cujas metamorfoses continuas plagiam a si mesmo, podendo até ser visto em calendário trans.
STRATEGI DIVERSIFIKASI DAN KOMITMEN TATAKELOLA PERUSAHAAN BERDASARKAN KINERJA DAN KEBERLANJUTAN PADA PERBANKAN SYARIAH DI KOTA MAKASSAR
Authors: Sumail La Ode , Mappamiring Mappamiring 
Published: December 2017

Studi ini bertujuan (1) merumuskan strategi diversifikasi terhadap keberlanjutan perusahaan perbankan Syariah; (2) mengungkap tatakelola perusahaan terhadap keberlajuntan keberlajuntan perusahaan perbankan Syariah; (3) mendeskripsikan peran strategi diversifikasi terhadap keberlajuntan melalui kinerja perusahaan perbankan Syariah; dan (4) mendeskripsikan peran tatakelola perusahaan terhadap keberlajuntan melalui kinerja perusahaan perbankan Syariah. Pendekatan studi ini adalah kuantitatif. Teknik pengambilan sampel dilakukan secara proporsional yaitu 30 para pimpinan perbankan Syariah di Kota Makassar. Analisis data dilakukan dengan generalized structured component analysis (GSCA). Hasil studi ini menemukan bahwa (1) strategi diversifikasi tidak signifikan terhadap keberlajuntan perusahaan perbankan Syariah; (2) tatakelola perusahaan berpengaruh positif dan signifikan terhadap keberlajutan perusahaan perbankan Syariah; (3) kinerja perusahaan berperan positif dan signifikan memediasi pengaruh diversifikasi terhadap keberlajuntan perbankan Syariah; dan (4) kinerja perusahaan berperan positif dan signifikan memediasi pengaruh tatakelola perusahaan terhadap keberlajuntan perbankan Syariah. Keterbaruan studi ini adalah: (1) menggunakan landasan teori keagenan perspektif Islam yakni teori keagenan mudharabah dan (2) indikator tatakelola perusahaan diukur melalui konsep Syariah. This study aims to (1) formulate the company's strategy of diversification towards sustainability Islamic banking; (2) reveal the corporate governance of the company keberlajuntan keberlajuntan Islamic banking; (3) describe the role of a diversification strategy to keberlajuntan through the performance of Islamic banking companies; and (4) describe the role of corporate governance on corporate performance keberlajuntan through Islamic banking. This study is a quantitative approach. The sampling technique is done in proportion of 30 leaders of Islamic banking in Makassar. Data was analyzed using generalized structured component analysis (GSCA). Results of the study found that (1) the diversification strategy is not significant to the company keberlajuntan Islamic banking; (2) governance, positive and significant impact on the continuity of Islamic banking companies; (3) the company's performance and a significant positive role in mediating the effects of diversification towards keberlajuntan Islamic banking; and (4) the performance of the company and a significant positive role in mediating the effects of corporate governance on Islamic banking keberlajuntan. Freshness of this study are: (1) using the foundation of Islam that agency theory agency theory perspective mudaraba and (2) indicators of corporate governance is measured through the concept of Sharia.
PENGARUH KOMPENSASI DAN KOMPETENSI DENGAN MOTIVASI SEBAGAI INTERVENING DALAM MENINGKATKAN KINERJA
Authors: Meutia Meutia , Sari Ika , Ismail Tubagus 
Published: December 2017

The objective of this research was to test the impact of system financial and nonfinancial compensation, competency on the employee performance and on the motivation as intervening variable. The research used partial least square method for the hypotesis testing and produced 100 respondent for the sample by using nonprobability samples with the convinience method. The result of the research revealed that the system of financial and nonfinancial compensation have significance impacts on employee performance and motivation but the competency does not significance impacts on employee performance and motivation. However, further result revealed that motivation have significance impacts on employee performance.In order to improve the employee performance, the training is a needed and should be conducted in accordance with the job position. Moreover, the fair compensation with the range not far from the employee expectation.
Dermatoscopia no Granuloma Facial – Relato de 2 casos
Authors: Gatti Rafael Figueiredo 
Published: December 2017

O granuloma facial é uma patologia cutânea rara, idiopática e benigna, com predomínio em homens caucasianos entre a terceira e quinta décadas de vida.Caracteriza-se clinicamente como uma vasculite leucocitoclástica, com predomínio em face, de curso crônico e lentamente progressivo. Seu diagnóstico baseia-se na história clinica, exame físico e histopatológico, com recente destaque para a dermatoscopia, que revela aspectos que podem possibilitar uma diferenciação inicial com outros diagnósticos (sarcoidose, lúpus eritematoso cutâneo, carcinoma de células basais, dentre outros). Existem várias opções terapêuticas propostas, porém com resultados pouco satisfatórios.Neste trabalho, relatamos 2 casos de pacientes com lesões eritematosas faciais em que a dermatoscopia teve grande valor como ferramenta diagnóstica. O uso dessa modalidade deve crescer nos próximos anos em relação à essa patologia, já que, além de fornecer características importantes da doença, consiste em uma maneira simples e fácil de identificar o granuloma facial.
Disconnection of the pathological connectome for multifocal epilepsy surgery
Authors: Kamada Kyousuke , Ogawa Hiroshi , Kapeller Christoph , Prueckl Robert , Hiroshima Satoru , Tamura Yukie , Takeuchi Fumiya , Guger Christoph 
Published: December 2017

OBJECTIVERecent neuroimaging studies suggest that intractable epilepsy involves pathological functional networks as well as strong epileptogenic foci. Combining cortico-cortical evoked potential (CCEP) recording and tractography is a useful strategy for mapping functional connectivity in normal and pathological networks. In this study, the authors sought to demonstrate the efficacy of preoperative combined CCEP recording, high gamma activity (HGA) mapping, and tractography for surgical planning, and of intraoperative CCEP measures for confirmation of selective pathological network disconnection.METHODSThe authors treated 4 cases of intractable epilepsy. Diffusion tensor imaging–based tractography data were acquired before the first surgery for subdural grid implantation. HGA and CCEP investigations were done after the first surgery, before the second surgery was performed to resect epileptogenic foci, with continuous CCEP monitoring during resection.RESULTSAll 4 patients in this report had measurable pathological CCEPs. The mean negative peak-1 latency of normal CCEPs related to language functions was 22.2 ± 3.5 msec, whereas pathological CCEP latencies varied between 18.1 and 22.4 msec. Pathological CCEPs diminished after complete disconnection in all cases. At last follow-up, all of the patients were in long-term postoperative seizure-free status, although 1 patient still suffered from visual aura every other month.CONCLUSIONSCombined CCEP measurement, HGA mapping, and tractography greatly facilitated targeted disconnection of pathological networks in this study. Although CCEP recording requires technical expertise, it allows for assessment of pathological network involvement in intractable epilepsy and may improve seizure outcome.
Outcomes following cerebrospinal fluid shunting in high-grade glioma patients
Authors: Rinaldo Lorenzo , Brown Desmond , Lanzino Giuseppe , Parney Ian F. 
Published: December 2017

OBJECTIVEThe clinical course of high-grade central nervous system gliomas is occasionally complicated by hydrocephalus. The risks of shunt placement and clinical outcome following CSF diversion in this population are not well defined.METHODSThe authors retrospectively reviewed the outcomes of patients with pathologically confirmed WHO grade III or IV gliomas with shunt-treated hydrocephalus at their institution. Outcomes of patients in this cohort were compared with those of patients who underwent shunt treatment for normal pressure hydrocephalus (NPH). Hospital-reported outcomes in a national database for malignant primary brain tumor patients undergoing a ventricular shunt procedure were also reviewed.RESULTSForty-one patients undergoing CSF shunting between 2001 and 2016 at the authors’ institution were identified. Noncommunicating and communicating hydrocephalus occurred at similar rates (51.2% vs 48.8%). Symptomatic improvement after shunting was observed in 75.0% of patients. A major complication occurred in 17.1% of cases, with 2 patients suffering an intracranial hemorrhage. Prior administration of bevacizumab was significantly associated with the incidence of hemorrhage (p = 0.026). Three patients (7.3%) died during admission, and 8 (19.5%) died within 30 days of shunt placement. The presence of ependymal or leptomeningeal enhancement was more common in patients who died within 30 days (75.0% vs 11.1%, p = 0.001). Six patients (18.1%) required readmission to the hospital within 30 days of discharge. Revision surgery was necessary in 7 patients (17.1%). The median time from shunt placement to death was 150.5 days. In comparison with patients with NPH, shunt-treated high-grade glioma patients had increased in-hospital (7.3% vs 0.5%, p = 0.008) and 30-day (19.5% vs 0.8%, p < 0.001) mortality but no difference in the incidence of revision surgery (17.1% vs 17.5%, p = 0.947). Similarly, in the national Vizient Clinical Database Resource Manager, shunt-treated patients with malignant primary brain tumors had an increased length of stay (6.9 vs 3.5 days, p < 0.001), direct cost of admission ($15,755.80 vs $9871.50, p < 0.001), and 30-day readmission rates (20.6% vs 2.4%, p < 0.001) compared with patients without brain tumors who received a shunt for NPH.CONCLUSIONSShunting can be an effective treatment for the symptoms of hydrocephalus in patients with high-grade gliomas. However, the authors’ results suggest that this procedure carries a significant risk of complications in this patient population.