bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pitfalls in Diffusion-Weighted and Diffusion Tensor Imaging of the Pediatric Brain
Authors: Agarwal Nivedita , Tekes Aylin , Poretti Andrea , Meoded Avner , Huisman Thierry 
Published: July 2017

AbstractDiffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are advanced magnetic resonance imaging (MRI) techniques that are based on differences in the diffusion rate of water molecules in brain tissue. DWI and DTI are widely used in pediatric neuroradiology to evaluate a wide spectrum of brain diseases. The interpretation of DWI and DTI images requires a basic knowledge of the underlying physics to detect potential pitfalls and avoid misinterpretation. Several DWI pitfalls are related to the dependency of DWI images not only on the diffusivity of water molecules, but also on various additional MRI phenomena such as the T1- and T2- relaxation characteristics and MRI-related artifacts. In addition, knowledge about the age of the child and interval between the onset of injury and acquisition of DWI/DTI images is important. Finally, qualitative evaluation (“eye-balling”) maybe misleading, and the application of quantitative measurements of DTI scalars may avoid misdiagnosis.
Decreased Rac1 Cardiac Expression in Nitrofen-Induced Diaphragmatic Hernia
Authors: Nakamura Hiroki , Zimmer Julia , Puri Prem 
Published: July 2017

Aim The high incidence of cardiac malformations in humans and animal models with congenital diaphragmatic hernia (CDH) is well known. The hypoplasia of left heart is common among fetuses with CDH and has been identified as a poor prognostic factor. However, the precise mechanisms underlying cardiac maldevelopment in CDH are not fully understood. Ras-related C3 botulinum toxin substrate 1 (Rac1) plays a key role in cardiomyocyte polarity and embryonic heart development. Deficiency of Rac1 is reported to impair elongation and cytoskeletal organization of cardiomyocytes, resulting in congenital cardiac defects. We designed this study to test the hypothesis that Rac1 expression is downregulated in the developing hearts of rats with nitrofen-induced CDH.
Materials and Methods Following ethical approval (REC1103), time-pregnant Sprague Dawley rats received nitrofen or vehicle on gestational day 9 (D9). Fetuses were sacrificed on D18 and D21 and divided into CDH and control (CTRL) (n = 6 for each group and time point). Quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting, and confocal–immunofluorescence microscopy were performed to detect cardiac gene and protein expression of Rac1.
Main Results qRT-PCR and Western blot analysis revealed that Rac1 expression was significantly decreased in the CDH group compared with controls (p < 0.05). Confocal–immunofluorescence microscopy revealed that Rac1 cardiac expression was markedly decreased in the CDH group compared with controls.
Conclusion Decreased cardiac Rac1 expression in the nitrofen-induced CDH suggests that Rac1 deficiency during morphogenesis may impair structural cardiac remodeling, resulting in congenital cardiac defects.
Feasibility of transnasal endoscopy in screening for esophageal and gastric varices in patients with chronic liver disease
Authors: de Faria Anderson , Dias Carlos , Dias Moetzsohn Luciana , de Castro Carvalho Silas , Ferrari Tereza , Nunes Arantes Vitor 
Published: July 2017

Abstract
Background and study aims Screening for esophageal and gastric varices is indicated for patients with portal hypertension or cirrhosis. Typically, conventional endoscopy is used; however, the need for sedation increases the costs and risks, especially in cirrhotic patients. Use of transnasal endoscopy with an ultrathin endoscope enables study of the upper gastrointestinal tract without the need for sedation. The objective of this study is to evaluate the feasibility of transnasal endoscopy in screening for esophageal and gastric varices in patients with chronic liver disease.
Patients and methods This was a prospective study in which transnasal endoscopy was carried out in patients with cirrhosis or portal hypertension who had indications for screening of esophageal and gastric varices. The following variables were evaluated: demographical data, duration of procedure, patient tolerance and acceptance, adverse events (AEs), endoscopic findings and interobserver agreement related to portal hypertension alterations (kappa index).
Results A total of 50 patients entered the study. The most common cause of liver disease was chronic viral hepatitis (66 %). Among the cirrhotic patients, most of the patients were Child-Pugh A (74 %). In 5 patients (10 %), nasal intubation was not possible. Two patients (4 %) experienced minor epistaxis. Tolerance was excellent or good in 92 % according with a visual analogic scale. In 16 patients (32 %), esophageal varices were detected and in 2 patients (4 %) gastric varices were detected. The mean duration of the procedure was 7 minutes.
Conclusions Transnasal endoscopy is feasible, effective and well tolerated for screening of esophageal and gastric varices in patients with chronic liver disease. It can be performed in outpatient clinics safely and without the use of sedation.
Performance report cards increase adenoma detection rate
Authors: Sey Michael , Liu Andy , Asfaha Samuel , Siebring Victoria , Jairath Vipul , Yan Brian 
Published: July 2017

Abstract
Background and study aims Adenoma detection rate (ADR) is an important measure of colonoscopy quality, as are polyp, advanced ADR, and adenocarcinoma detection rates. We investigated whether performance report cards improved these outcome measures.
Patients and methods Endoscopists were given report cards comparing their detection rates to the institutional mean on an annual basis. Detection rates were evaluated at baseline, 1 year after report cards (Year 1), and 2 years after report cards (Year 2). Endoscopists were unaware of the study and received no other interventions. The primary outcome was ADR and secondary outcomes were polyp detection rate (PDR), advanced ADR, and adenocarcinoma detection rate. Multivariate regression was performed to adjust for temporal trends in patient, endoscopists, and procedural factors.
Results Seventeen physicians performed 3,118 screening colonoscopies in patients with positive FOBT or family history of colon cancer. The ADR increased from 34.5 % (baseline) to 39.4 % (Year 1) and 41.2 % (Year 2) (P = 0.0037). The PDR increased from 45 % (baseline) to 48.8 % (Year 1) and 51.8 % (Year 2) (P = 0.011). There was no significant improvement in advanced ADR or adenocarcinoma detection rates. On multivariate analysis, the ADR increased by 22 % in Year 1 (P = 0.03) and 30 % in Year 2 (P = 0.008). Among physicians with a baseline ADR < 25 %, improvement in ADR was even greater, increasing 2.2 times by the end of the study (P = 0.004). Improvements in ADR were not correlated with specialty although gastroenterologists were 52 % more likely to find an adenoma than general surgeons.
Conclusions Annual performance report cards increased adenoma detection rates, especially among physicians with low ADR < 25 %.
English in Pakistani public education
Authors: Channa Liaquat Ali 
Published: July 2017

Abstract
The article reviews the past, present, and future position of English in the Pakistani language-in-education policy for the Pakistani government schools. The article first traces how the English language came to Pakistan, and underlines the social domains in which English is commonly used at the present time. The article highlights the fact that English has enjoyed the highest social position in Pakistan since the country’s establishment in 1947. Taking this fact into account, the article traces historically the status of the English language in the language-in-education policy for the government schools since 1947 to the present time. I argue that students from the elite and non-elite English medium schools end up being more literate in English and having better access to social mobility than the students from the Pakistani government schools because of the low quality education and the poor instruction of English as a subject taught through traditional teaching methods of imitation and memorization. In order to reduce the gap, although the recent National Education Policy (NEP 2009) of Pakistan has recommended not only teaching English as a compulsory subject in grade one onward but also using it as a medium of instruction in grade four onward for the content subjects such as science and mathematics in the Pakistani government schools, the current predicament of Pakistani public education raises questions and controversies about the successful implementation of the policy. The main suggestion of the paper is the fact that since teachers are the major agents of change in realizing such curriculum reforms at their classroom level (Fullan & Stiegelbauer, 1991), their perspectives, perceptions and attitudes must be sought as well as included in such policy making processes. Because the voices of Pakistani government teachers are overlooked in such top-down language policies, this paper implies that the their experiences, attitudes, and perspectives about the present and future role of English in public language-in-education policies need to be explored to better understand the potential future implications for Pakistani teachers and their education. Such steps not only make policies inclusive but also gauge how far such English initiatives are facilitative in raising the quality of education and developing English language literacy in Pakistan.
Education, language policy and language use in the Philippines
Authors: Symaco Lorraine Pe 
Published: July 2017

Abstract
The roles of language policy and language practice and use in education have been regarded to influence the efficacy of teaching and learning in the school setting. With the rise of globalisation and internationalisation of services in education, the objective of producing manpower that is equipped to the demands of the knowledge-based economy has realigned government policies worldwide to put education at the forefront of its development plans. From the rise of English language as ‘the’ language for globalisation calls for a more inclusive and locally- oriented mother-tongue based multilingual education (MTB-MLE), this article will discuss broadly the dynamics of language, access and influence, and will look at the Philippines as a country case study of explicit and implicit declarations in language policy and use, as affecting the education sector, and access to the labour market.
The light within
Authors: Koller Veronika 
Published: July 2017

Abstract
This paper contributes to the study of religious metaphor by combining discourse analysis with cognitive semantics. In particular, it engages in a diachronic study of 30 pamphlets written by British Quakers and addressed to the general public to investigate the consistency of metaphor use in that genre across three and a half centuries. Consistency is seen as metaphors recording the same source domains and/or scenarios and/or lexical realisations across time, with maximum consistency meeting all three criteria.
Utilising the notions of genre and discourse community along with metaphor domains and scenarios, the analysis shows that among 19 metaphor domains that occur in texts from at least two different centuries, just under 60 per cent are highly or maximally consistent, with domains of maximum consistency being the largest group. The changing purposes of the pamphlet genre and the evolving social and historical contexts do not diminish this long-term metaphor consistency.
This overall finding is explained with recourse to the dual-processing/representation theory of religious cognition, which posits a difference between theological and basic everyday representations and processing of God concepts. Quakerism shows an overall lack of abstract theology, with Quakers instead establishing various metaphors for God to express their lived experience of the divine. The remarkable consistency of metaphors in Quaker pamphlets suggests that Quakerism makes God concepts intuitively meaningful and relevant.
The Renewable Fuel Standard in Competitive Equilibrium: Market and Welfare Effects
Authors: Moschini GianCarlo , Lapan Harvey , Kim Hyunseok 
Published: July 2017

AbstractWe construct a tractable multi‐market equilibrium model designed to evaluate alternative biofuel policies. The model integrates the U.S. agricultural sector with the energy sector and it explicitly considers both U.S. ethanol and biodiesel production. The model provides a structural representation of the renewable fuel standard (RFS) policies, and it uses the arbitrage conditions defining the core value of renewable identification number prices to identify the relevant competitive equilibrium conditions. The model is parameterized, based on elasticities and technical coefficients from the literature, to represent observed 2015 data. The model is simulated to analyze alternative scenarios, including repeal of the RFS, projected 2022 RFS mandates, and optimal (second‐best) mandates. The results confirm that the current RFS program considerably benefits the agriculture sector, but also leads to overall welfare gains for the United States (mostly via beneficial terms of trade effects). Implementation of projected 2022 mandates, which would require further expansion of biodiesel production, would lead to a considerable welfare loss (relative to 2015 mandate levels). Constrained (second‐best) optimal mandates would entail more corn‐based ethanol and less biodiesel than currently mandated.
Activity Engagement Among Older Adult Spousal Caregivers
Authors: Queen Tara L , Butner Jonathan , Berg Cynthia A , Smith Jacqui 
Published: July 2017

Abstract

Objective
Spousal caregiving can have strong implications for health and wellbeing given the strain and burden associated with the role. Maintaining activity engagement is important for late-life health and wellbeing, and may be a possible contributing mechanism to caregiver health and wellbeing. This paper examined longitudinal changes in activity engagement and asks how spousal caregiving status and caregiver age related to longitudinal activity engagement in a sample of older adults.

Method
Data from four waves of the Health and Retirement study were used to model associations between periods of being a spousal caregiver, age, and engagement in physical, social, self-care, passive, and novel information processing activities over a 6-year period.

Results
Caregiving status was associated with declines in physical activity engagement over time. Older age was associated with fewer physical and more self-care and passive activities.

Discussion
Caregivers’ declines in participation in physical activities may be an important indicator for preservation of health and management of caregiving stress.
Posterior Upper Rib Excision for Neurogenic Thoracic Outlet Syndrome---Feasibility and Early Outcomes
Authors: Aghayev Kamran , Ciklatekerlio Ozcan 
Published: July 2017

Abstract

BACKGROUND
There are several surgical treatment options for neurogenic thoracic outlet syndrome (n-TOS). However, the first rib has been shown to be the common denominator of all TOS forms and the degree of its resection has been shown to correlate with the long-term success.

OBJECTIVE
To demonstrate the feasibility of posterior upper rib excision (PURE) and report early outcomes.

METHODS
Nine patients presented with signs and symptoms of n-TOS. Preoperative evaluation involved physical and neurological examination, arm visual analog score (VAS), cervical X-ray, magnetic resonance imaging (MRI) of the cervical spine, and brachial plexus MRI. All patients were operated at a single institution by a single surgeon. Postoperatively, clinical and radiological data were collected.

RESULTS
There were 2 men and 7 women in the study with 10 procedures performed. The age range was 18 to 45 with mean of 36.6 yr. Mean preoperative arm visual analog scale score was 7.8. The patients underwent posterior upper rib excision (PURE) by a single surgeon. One patient had bilateral surgery. The causes of TOS were fibrous bands, enlarged C7 transverse processes, narrow scalene triangle, and accessory ribs. All patients improved after surgery in terms of arm pain and quality of life. Postoperative mean visual analog scale score was 1.1 at 6 mo. In addition, neurological examination was normal at 6 mo postoperatively and all patients returned to their previous full-time jobs.

CONCLUSION
Posterior upper rib excision is a feasible surgical option for n-TOS.
Selective Cervical Denervation for Cervical Dystonia: Modification of the Bertrand Procedure
Authors: Wilson Thomas J , Spinner Robert J 
Published: July 2017

Abstract

BACKGROUND
Cervical dystonia, commonly referred to as spasmodic torticollis, is a neurological disorder characterized by aberrant, involuntary contraction of the muscles of the neck and shoulders. One surgical option that can be considered is selective cervical denervation.

OBJECTIVE
To report our modification of the Bertrand procedure for selective cervical denervation.

METHODS
Our modification of the Bertrand procedure for selective cervical denervation is reported with intraoperative photographs and schematic depictions of the operative steps.

RESULTS
We report our modification of the Bertrand procedure for selective cervical denervation, which consists of a combination of C2-6 denervation, myectomy of the splenius capitis and/or semispinalis capitis, myotomy of the levator scapulae when indicated, and myotomy and selection denervation of the sternocleidomastoid. The combination of techniques utilized depends on the subtype and severity of cervical dystonia.

CONCLUSION
Our modification of the original Bertrand procedure for selective cervical denervation represents an alternative surgical strategy for the treatment of cervical dystonia, with the potential advantages and disadvantages discussed.
Combatting the opioid epidemic: Baltimore’s experience and lessons learned
Authors: Wen Leana S , Warren Katherine E 
Published: July 2017

Abstract
In the midst of a national opioid crisis, Baltimore City witnessed 393 deaths from drug and alcohol overdose in 2015. With an estimated 25 000 residents who are addicted to heroin or other opioids, Baltimore has been profoundly affected by the opioid epidemic. Other resources have commented on federal, state-based, and provider responses to the opioid crisis. This article examines what may be done at the city level based on the experiences of the Baltimore City Health Department. Local jurisdictions must play a critical role in addressing the U.S. opioid crisis through public health coalitions, overdose prevention, treatment expansion, and anti-stigma education.
Posterior Tibial Artery as an Alternative to the Radial Artery for Arterial Cannulation Site in Small Children
Authors: Kim Eun-Hee , Lee Ji-Hyun , Song In-Kyung , Kim Jin-Tae , Lee Won-Jong , Kim Hee-Soo 
Published: July 2017

Abstract

Background
We evaluated the posterior tibial artery as an alternative arterial cannulation site to the radial artery in small children.

Methods
A two-stage study was conducted. First, we evaluated the anatomical characteristics of the posterior tibial artery compared with the radial and dorsalis pedis arteries. Next, a parallel-arm single-blind randomized controlled study compared the initial success rate of ultrasound-guided arterial cannulation among three arteries as a primary outcome.

Results
Sixty patients were analyzed in the observational study. The diameter of the posterior tibial artery (1.5 ± 0.2 mm) was similar to that of the radial artery (1.5 ± 0.2 mm) and larger than that of the dorsalis pedis artery (1.2 ± 0.2 mm; P < 0.001). The posterior tibial artery has a larger cross-sectional area (2.8 ± 1.1 mm2) compared with the radial (2.3 ± 0.8 mm2; P = 0.013) and dorsalis pedis arteries (1.9 ± 0.6 mm2; P = 0.001). In total, 234 patients were analyzed in the randomized study. The first-attempt success rate of the posterior tibial artery (75%) was similar to that of the radial (83%; P = 0.129; odds ratio, 1.53; 95% CI, 0.69 to 3.37) and higher than that of the dorsalis pedis artery (45%; P < 0.001; odds ratio, 3.95; 95% CI, 1.99 to 7.87). Median cannulation time of the posterior tibial artery (21 s; interquartile range, 14 to 30) was similar to that of the radial artery (27 s; interquartile range, 17 to 37) and shorter than that of the dorsalis pedis artery (34 s; interquartile range, 21 to 50).

Conclusions
The posterior tibial artery is a reasonable alternative to the radial artery for ultrasound-guided arterial cannulation in small children.
Comparison of Different Hearing Aid Prescriptions for Children
Authors: Marriage Josephine E. , Vickers Deborah A. , Baer Thomas , Glasberg Brian R. , Moore Brian C. J. 
Published: July 2017

Objectives:
To assess whether there are significant differences between speech scores for different hearing aid prescription methods, specifically DSL i/o, DSL V, and NAL-NL1, using age-appropriate closed- and open-set speech tests with young children, designed to avoid floor and ceiling effects.

Design:
Participants were 44 children with moderate or severe bilateral hearing loss, 8 aged 2 to 3 years, 15 aged 4 to 5 years, and 21 aged 6 to 9 years. Children wore bilateral hearing aids fitted with each prescription method in turn in a balanced double-blind design. The speech tests used with each child (and for some tests the levels) were chosen so as to avoid floor and ceiling effects. For the closed-set tests, the level used was selected for each child based on their hearing loss. The tests used were: (1) The closed-set Consonant Confusion Test of word identification; (2) The closed-set Chear Auditory Perception Test (CAPT) of word identification. This has separate sections assessing discrimination of consonants and vowels and detection of consonants; (3) The open-set Cambridge Auditory Word Lists for testing word identification at levels of 50 and 65 dBA, utilizing 10 consonant–vowel–consonant real words that are likely to be familiar to children aged 3 years or older; (4) The open-set Common Phrases Test to measure the speech reception threshold in quiet; (5) Measurement of the levels required for identification of the Ling 5 sounds, using a recording of the sounds made at the University of Western Ontario.

Results:
Scores for the Consonant Confusion Test and CAPT consonant discrimination and consonant detection were lower for the NAL-NL1 prescription than for the DSL prescriptions. Scores for the CAPT vowel-in-noise discrimination test were higher for DSL V than for either of the other prescriptions. Scores for the Cambridge Auditory Word Lists did not differ across prescriptions for the level of 65 dBA, but were lower for the NAL-NL1 prescription than for either of the DSL prescriptions for the level of 50 dBA. The speech reception threshold measured using the Common Phrases Test and the levels required for identification of the Ling 5 sounds were higher (worse) for the NAL-NL1 prescription than for the DSL prescriptions.

Conclusions:
The higher gains prescribed by the DSL i/o and DSL V prescription methods relative to NAL-NL1 led to significantly better detection and discrimination of low-level speech sounds.