bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neoplastic Fever
Authors: Johnson Miriam 
Published: November 2015

Neoplastic fever, that is fever arising solely as a manifestation of malignancy, is not as common as was thought but still constitutes a troublesome symptom and is difficult to manage. The mechanism of neoplastic fever production involves cytokines such as tumour necrosis factor (TNF), interleukins 1 and 6 (IL-I, IL-6) and interferon (IFN), produced either by host macrophages in response to tumour, or sometimes by the tumour itself. The cytokines stimulate production of prostaglandins which act on the hypothalamus causing a change in the thermostatic set point. This mechanism is similar to that of infective fever. Paracetamol (acetaminophen) will often only partially lyse neoplastic fever but nonsteroidal anti-inflammatory drugs have been shown to be effective. On the basis of small studies, naproxen has been proposed as a useful test to discriminate between neoplastic and infective fever. If this is so, it must be acting through a pathway hitherto undescribed and specific to neoplastic fever. Other work shows that this group of drugs effectively lyses both types of fever. Therefore larger studies are needed to confirm or refute the “Naproxen test” and neoplastic fever remains a diagnosis of exclusion. In the future, cytokine antagonists may have a role in managing neoplastic fever, but, until their actions are better understood, nonsteroidal anti-inflammatory drugs remain the medication of choice if standard antipyretics have failed.
Face to Face with the Dead Man: Ethical Responsibility, State-Sanctioned Killing, and Empathetic Impossibility
Authors: Molloy Patricia 
Published: November 2015

The image of the death house with its polished tiles and gleaming oak chair is fading. I turn my attention to where life is. Although I have decided that I will not be going to death row again, I cannot bear to think that there are some men there now who are facing death alone. The other man's death calls me into question, as if, by my possible future indifference, I had become the accomplice of the death of the other, who cannot see it; and as if, even before vowing myself to him, I had to answer for this death of the other, and to accompany the Other in his mortal solitude. The Other becomes my neighbour precisely through the way the face summons me, calls for me, begs for me, and in so doing recalls my responsibility, and calls me into question.
Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy
Authors: Seng Chusheng , Mohan P. Chandra , Koh Suang Bee Joyce , Howe Tet Sen , Lim Yee Gen , Lee Brian P. , Morrey Bernard F. 
Published: November 2015

Background: A previously published study found positive outcomes for a novel technique for ultrasound-guided percutaneous ultrasonic tenotomy, showing good tolerability, safety, and early efficacy within an office setting. Purpose: In this follow-up study, all 20 members of the original cohort were contacted after 3 years to explore the sustainability of symptomatic relief, functional improvement, and sonographic soft tissue response for percutaneous ultrasonic tenotomy. Study Design: Case series; Level of evidence, 4. Methods: All 20 subjects of the clinical trial that was performed from June to November 2011 were further assessed at 36 months after the procedure in terms of visual analog scale for pain, Disabilities of the Arm, Shoulder and Hand (DASH)–Compulsory/Work scores, need for adjunct procedures, and overall satisfaction. Importantly, all 20 were reassessed with ultrasound imaging at 36 months, and evidence of the common extensor tendon response was assessed in terms of tendon hypervascularity, tendon thickness, and the progress of the hypoechoic scar tissue. Results: A 100% clinical follow-up was achieved, inclusive of ultrasonographic assessment. None of the subjects required further treatment procedures, and 100% expressed satisfaction. Previous improvements in visual analog scale (current median ± SD, 0 ± 0.9; range, 0-3) and DASH-Work scores (current median, 0 ± 0) were sustained with conformity to a linear pattern on polynomial measures. There was further reduction in DASH-Compulsory scores to a median of 0 ± 0.644 (range, 0-2) with a significant decrease on repeated measures ( P = .008). Tendon hypervascularity was resolved in 94% of patients, and 100% had reduction in tendon thickness. Overall reduction in the hypoechoic scar tissue was observed in all subjects, with a 90% response achieved by 6 months. Between 6 and 36 months, further reduction in the scar was observed in around 60% of patients, with 20% of patients having complete resolution of the hypoechoic scar. Conclusion: Minimally invasive percutaneous ultrasonic tenotomy provided sustained pain relief and functional improvement for recalcitrant tennis elbow at 3-year follow-up. It is one of the few procedures to demonstrate positive sonographic evidence of tissue-healing response and is an attractive alternative to surgical intervention for definitive treatment of recalcitrant elbow tendinopathy.
The Poor, the Periphery, and the State in Metropolitan Rio de Janeiro
Authors: Gondim Linda 
Published: November 2015

This paper analyzes the socio-economic and political factors accounting for the spatial structure of Metropolitan Rio de Janeiro. Urban services and facilities, as well as upper- and middle-class housing are concentrated in the core. The most poor are segregated to poorly equipped peripheral areas. To the extent that access to urban services is considered a component of real income, spatial segregation reinforces income concentration, a feature of the region's process of economic development. The paper analyzes how state intervention has contributed to this pattern by concentrating investments in the core and immediate periphery, and relocating squatter settlers to suburbs. The state has adopted a laissez-faire attitude towards the periphery, where speculative land subdivision had provided a viable, yet inequitable, housing alternative for the poor. Low-income groups have fought to improve their lot, pressuring against favela removal and for urban improvements in their neighborhoods. They have also used the system to their advantage by becoming petty landlords or land speculators. Although these may be viewed merely as “coping strategies,” their conservative or revolutionary potential is a matter to be assessed empirically. Likewise, whether state policies will be repressive, distributive, or even redistributive cannot be stated beforehand. These policies are shaped not only by structural forces, but also by the political context and the views of government employees.
Management of Brain Edema Complicating Stroke
Authors: Rosand Jonathan , Schwamm Lee H. 
Published: November 2015

Ischemic brain edema, the accumulation of fluid within the brain parenchyma following stroke, is a predictable consequence of both ischemic and hemorrhagic strokes. Its development is the result of injury to both brain parenchyma and the blood vessels supplying the parenchyma. Ischemic stroke produces both cytotoxic (intracellular) edema, which develops when cells are damaged, and vasogenic (extracellular) edema, which arises from injury to structures essential to blood-brain barrier integrity. An understanding of the distinction between cytotoxic and vasogenic edema is essential in preventing secondary brain injury, since the treatments for the two entities differ. The development of new brain imaging technologies has advanced our understanding of brain edema. Both computed tomography (CT) and magnetic resonance imaging (MRI) can detect edema. Specific MRI sequences such as diffusion-weighted imaging can distinguish cytotoxic and vasogenic subtypes, and thereby detect ischemic cell injury within minutes of the onset of symptoms. Brain edema causes neurologic deterioration predominantly through its mass effect, which leads to distortion of the intracranial contents and impairment of both regional and global cerebral blood flow (CBF). Edema may also cause local tissue dysfunction. Management of the intracranial hypertension and tissue shifts caused by ischemic brain swelling is based on the fundamental relationship between pressure, flow, and resistance. Interventions are directed at preserving CBF and preventing secondary brain injury. Strategies include reducing intracranial blood volume with hypocapnia, reducing brain volume with osmotic agents, reducing cerebral metabolism with hypothermia and barbiturates, reducing resistance with rheologic agents, increasing blood pressure with vasoconstrictors, and expanding the cranial vault with decompressive surgery. All individual therapies must be used as part of a structured approach that involves frequent serial neurologic assessments, quantitative measures of pressure, flow, and resistance, and prespecified protocols for intervention.
Anesthesia for Cardiac Surgery in Newborns with Congenital Heart Disease
Authors: Kern Frank H. , Hickey Paul R. 
Published: November 2015

The repair of complex congenital heart disease in the neonatal period is an evolving practice that began a decade ago and has resulted in improved survival and reduced long term morbidity. Surgical techniques and anesthetic, management hare evolved to care for these uniquely challenging infants. Optimal anesthetic care requires a sound basis in normal and pathologic neonatal and dedopmental physiology, cardiac and pediatric anesthesia, and cardiopulmonary bypass management. Typical concerns in neonatal congenital heart patients include a reduced myocardial compliance and poorly developed calcium transport systems. This limits stroke volume and increases calcium requirements in the post-bypass patient. Additionally, abnormal blood flow patterns are common and may be adversely affected by inotropes, inspired oxygen concentration, carbon dioxide tension, and mechanical ventilation. The impact of cardiopulmonary bypass on the neonate is extreme. Infants are commonly cooled to 15°C, their blood volume is hemodiluted by 3-4 fold, and periods of total circulatory arrest for up to 60 min are routine. The physiologic impact of these biologic extremes on organ function must be anticipated. Bypass management must assure optimal distribution of pump flow to minimize any impediment to organ protection. High dose narcotics combined with a benzodiazepine have become an integral part of anesthetic management for the neonate with congenital heart disease. Combined intravenous drug therapy provides a complete anesthetic (sedation amnesia and analgesia), hemodgnamic stability, reduced stress hormone release, and control of pulmonary vascular reactivity. Thii reduces the need for multiple inotropic therapy aimed at decreasing pulmonary vascular resistance and improving myocardial contractility. This manuscript provides an in-depth understanding of the anesthetic management of the neonate with complex congenital heart disease. The overall goal of anesthetic management is to deliver a patient to the ICU with stable hemodynamics and a clear management plan based on intraoperative observations and interventions.
Treatment of Hypothermia in Trauma Victims: Thermodynamic Considerations
Authors: Gentilello Larry M. , Moujaes Samir 
Published: November 2015

The relatively high specific heat of the human body makes hypothermia very difficult to treat. Although there are many treatment methods available, most evaluations of rewarming techniques are based on clinically observed rewarming rates, and they do not take into account initial core temperature, ambient temperature, the patient's own heat production, the effects of anesthesia, paralytic agents, and other variables. A heat transfer model is proposed that simulates the flow of heat through the body of a hypothermic patient. The model uses first principles involved in heat transfer and thermodynamics to describe the effects of currently available rewarming techniques. A commercially available routine is used to solve the equations, which also include any heat exchange between the patient's body and the environment, as well as metabolic heat generation as a function of time and core temperature. This thermodynamic analysis of rewarming, based on computer modeling of heat transfer, provides a scientific basis on which to establish guidelines for appropriate selection of treatment strategies for hypothermia, and it indicates that direct blood warming or infusion of warm intravenous fluids are the most effective rewarming techniques.
MEASURING QUALITY OF WORK LIFE - A SIMPLE APPROACH
Authors: Karrir Naval , Khurana Amulya 
Published: November 2015

The study through survey of literature finds that there is neither a consensus on what are to be the dimensions for Quality of Worklife nor there is a standard definition. An analysis of background and motivational variables of 491 managers from 30 organisations in public, private and cooperative sectors of Indian industry, at all the three levels of managerial hierarchy (top, middle and bottom), has been done to simplify measurement of Quality of Worklife (QWL) of managers. Stepwise multiple regression analysis has been done to reach at near efficient predictors for QWL of managers among background and motivational variables.
Does Firm Size Affect Profitability? An Empirical Investigation Of Indian Textile Industry
Authors: Singla Dr. Harish Kumar 
Published: November 2015

The present study examines the relationship of firm’s size and profitability, taking into consideration two size variables i.e. Net sales and Total Assets and three profitability variables i.e. PAT/Net Sales, PAT/Total Assets and ROCE of 142 Indian Textile Companies for a period of 10 years that is, from 2001 to 2010. The hypothesis of firm Size affect profitability was tested using nine regression equations in panel data using fixed effects. The empirical findings suggest that firm’s size emerges as an important factor affecting profitability. In terms of the direction, the results show mixed evidence; firm’s size is negatively affecting the PAT/Net sales variable, whereas affecting positively to other variables. The study concludes that the validity and the generalization of the findings are pending future research in other industries or sector.
Nuclear Non-Proliferation Regime and The Soviet Union
Authors: Kapur K.D. 
Published: November 2015

An international regime may broadly consist of a ‘set of purposes, norms, rules and procedures’, which are intended to affect, channel, contain and shape patterns of behaviour. Such a “‘regime is cither a conscious creation’ of actors or at least is recognised and consciously used by them regardless of its manner of creation.”1 The nuclear non-proliferation regime which the Nuclear Weapons States (NWS)—USA, USSR and UK, had sought to establish ever since the 1960s fulfils most of the parameters of the international regime. The germs of the non-proliferation regime can be traced back to the policy of denial and secrecy adopted by the United States and the Soviet Union in the early phases of the development of nuclear energy and technology. The Western Suppliers’ Group (WSG), a precursor of the 1975 Nuclear Suppliers Group (NSG), formed in 1954 at the initiative of the United States, was meant even at that time to control the sales of uranium to prevent the spread of nuclear capabilities. The WSG consisted of South Africa, Britain, Canada, France, Belgium, Australia and the United States. The International Atomic Energy Agency (IAEA) which was established in 1957 with the concurrence and explicit support of the Soviet Union, was on the one hand meant to provide the peaceful use of nuclear energy and on the other to create an international safeguards system to check and control the diversion of nuclear materials for non-peaceful purposes. Over the years the IAEA with all its safeguard measures has emerged as the key component and instrument of the international non-proliferation regime.
Recovering Motor Performance of the Foot After Achilles Rupture Repair: A Randomized Clinical Study about Early Functional Treatment vs. Early Immobilization of Achilles Tendon in Tension
Authors: Kauranen Kari , Kangas Jarmo , Leppilahti Juhana 
Published: November 2015

The purpose of the study was to examine the recovery of some motor performance aspects of the lower extremity after Achilles tendon (AT) rupture repair by early functional postoperative treatment and early postoperative immobilization of the AT in tension in the early phase of recovery. The measured motor performance aspects were reaction time, speed of movement, foot tapping speed and coordination. The study population comprised 30 patients operated on for an acute, complete, closed AT rupture. The surgical technique was Kessler sutures plus one aponeurosis flap in all cases, and postoperatively the subjects were randomly divided to have immobilization with a plaster cast or an active brace. Measurements were made 12 and 24 weeks after the operation. There were no statistically significant differences in the results between the operated and contralateral nonoperated lower extremities 12 and 24 weeks after the operation in either group. When the results were compared between the plaster cast and active brace groups, no statistically significant differences were seen in reaction times, speed of movement, tapping speed and anterior-posterior coordination on either side, but the lateral coordination value of the operated leg was higher in the plaster cast group than in the active brace group 12 weeks after the operation ( p<0.05). By 24 weeks after the operation, this unique difference had disappeared. It seems that the recovery of the above mentioned motor performance functions of the leg does not depend on whether the leg is in a plaster cast with the AT in tension or in an active brace during the early postoperative period after AT rupture repair. These functions of the operated leg had recovered to the level of the contralateral nonoperated leg by 12 weeks after the operation.
Stress Fractures of the Medial Malleolus—Review of the Literature and Report of a 15-Year-Old Elite Gymnast
Authors: Shabat S. , Sampson K.B. , Mann G. , Gepstein R. , Eliakim A. , Shenkman Z. , Nyska M. 
Published: November 2015

Stress fracture of the medial malleolus is rare and not reported in children. We report a case of a 15-year-old elite gymnast with open physes sustaining a medial malleolar stress fracture. The patient was treated initially by rest and gradually returned to sport with full recovery. Two months later she developed a complete fracture of the medial malleolus of the same side. This was treated surgically by open reduction and internal fixation with a cancellous screw and soon after the operation she returned to full activities. Emphasis is given to the suspected mechanism which led to this unique fracture and to the hormonal aspects in the professional adolescent gymnast. We recommend surgical treatment of stress fracture of the medial malleolus especially for elite athletes, leading to early recovery and return to sports activities.
Nonoperatively Managed Stage 5 Osteochondral Talar Lesions
Authors: Shearer Carl , Loomer Richard , Clement Doug 
Published: November 2015

Thirty-five ankles in 34 subjects with non-surgically managed stage 5 (chronic) osteochondral lesions of the talus (OLT) were reassessed an average of 38 months post diagnosis—88 months post symptom onset. The overall clinical result was rated good or excellent in 54%, fair in 17% and poor in 29%. Six patients opted for surgery—arthroscopic drilling—after a trial of one year of nonsurgical treatment and were therefore rated as poor. Tomogram or CT scans at the time of diagnosis and follow-up were compared in 25 patients. We found no significant change in lesion size and there was a poor correlation between change in lesion size and clinical outcome. X-rays performed at follow-up on 20 patients showed mild degenerative changes in 13 of 20 ankles with OLT. No correlation was found between the presence of degenerative changes and the clinical outcome. We conclude that: Non-surgical management of stage 5 OLT is a viable option with little or no risk of developing significant osteoarthritis. Most lesions remain radiographically stable. There is a poor correlation between changes in lesion size and clinical outcome. However, the few patients with lesions which decrease significantly in size tend to do well and those with lesions which increase significantly in size do poorly. The development of mild radiographic changes of OA does not correlate with clinical outcome. The general course of stage 5 OLT is benign with over half of the patients improving to good or excellent results with non-surgical management. Lateral lesions tend to do better than medial ones. Adult onset lesions tend to do better than juvenile onset lesions.
Mechanical Comparison of Cyclic Loading in Five Different First Metatarsal Shaft Osteotomies
Authors: Acevedo Jorge I. , Sammarco V. James , Boucher Henry R. , Parks Brent G. , Schon Lew C. , Myerson Mark S. 
Published: November 2015

The purposes of the current study were: to analyze the relative fatigue endurance of five different first metatarsal shaft osteotomies (proximal crescentic, proximal chevron, Ludloff, Mau, and Scarf), as performed on sawbone models using the most common fixation techniques (part I); and to compare the two more commonly used techniques (per part I results) in matched-pair cadaver specimens (part II). In part I, the proximal chevron and Mau osteotomies were significantly more stable (P >0.005) than all other osteotomies except the Ludloff. In part II, there was no significant difference in fatigue endurance between the proximal chevron and Ludloff osteotomies.
Evaluation of Compression in Intramedullary Hindfoot Arthrodesis
Authors: Berson Lawrence , McGarvey William C. , Clanton Thomas O. 
Published: November 2015

Compression was evaluated in an intramedullary hindfoot arthrodesis cadaver model using an external fixator and a “second generation” intramedullary compression nail. Four cadaver specimens were used. Four trials were done with each specimen. Trial 1: manual compression with the 1st generation nail. Trial 2: external fixator for compression with the 1st generation nail. Trial 3: external fixator for compression with the 2nd generation nail. Trial 4: nail-mounted compression device with the 2nd generation nail. In Trial 1 it was not possible to obtain or maintain compression. In Trial 2 large values of compression were obtained with the external fixator, however compression was not maintained after the first generation nails were locked and the fixator was removed. In Trial 3 large values of compression were obtained with the external fixator, but minimal compression was maintained after the second-generation nails were locked and the fixator was removed. In Trial 4 large values of compression were obtained with the compression device and greater than 60% of the compression was maintained after the nail was locked and the compression device was released. The study revealed that both the external fixator and the compression device could produce compression. The external fixator is useful as an aid in the O.R. However, in this study significant compression was maintained only with utilization of the compression device.