bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes Mellitus as the Presenting Feature of Friedreich's Ataxia
Authors: Garg Meenal , Kulkarni Shilpa D. , Shah Krishnakumar N. , Hegde Anaita Udwadia 
Published: August 2017

ABSTRACTPatients with Friedreich's ataxia (FA) are at an increased risk of developing diabetes mellitus and glucose intolerance. Diabetes usually develops many years after the initial presentation. We report an 8-year-old girl who initially presented with diabetic ketoacidosis and was treated as a case of insulin-dependent diabetes mellitus. Around a year later, she developed gait problems and ataxia. Cardiac involvement was detected on echocardiography. Genetic testing confirmed the diagnosis of FA. FA should be a diagnostic consideration in children presenting with diabetes and neurological issues, even with early presentation of the former. Early occurrence of diabetes and rapid progression of ataxia in this patient needs a better understanding of underlying genetic mechanisms.
Unilateral Papilledema in Cerebral Venous Sinus Thrombosis
Authors: Kulkarni Girish Baburao , Singh Ravinder Jeet , Gadad Veeranna , Ramakrishnan Subasree , Mustare Veerendrakumar 
Published: August 2017

ABSTRACTIn the majority of patients with raised intracranial pressure, the papilledema is bilateral. Unilateral papilledema is rare in conditions causing intracranial hypertension, and it has been described in Foster–Kennedy syndrome and in some cases of idiopathic intracranial hypertension. It has never been reported in cerebral venous thrombosis. We report a young lady presenting with features of subacute onset of headache with seizures, on evaluation she had superior sagittal and bilateral lateral sinus thrombosis. The risk factors found on evaluation were Vitamin B12 deficiency and hyperhomocysteinemia. On optic fundus examination, she had swollen optic disc on the right side with normal fundus on the left side, confirmed with the orbital ultrasound B-scan and optic coherence tomography. Her magnetic resonance imaging showed features of raised intracranial pressure with thrombosis of the superior sagittal and bilateral lateral sinus thrombosis. She was treated with anticoagulation (heparin followed by oral anticoagulants), antiedema measures, and vitamin supplementation for hyperhomocysteinemia. She improved over time and was asymptomatic during follow-up. We discuss the possible mechanisms described in the literature for unilateral papilledema. This report highlights the need for carefully performing bilateral fundus examination so as not to miss the vision or life-threatening causes of a headache.
Primary Central Nervous System Fibrosarcoma
Authors: VP Vinodh , Harun Rahmat , Sellamuthu Pulivendhan , Kandasamy Regunath 
Published: August 2017

ABSTRACTWe report a rare case of a young female with primary brain fibrosarcoma, and to the best of our knowledge, we believe that only <50 cases have been reported or described worldwide so far. Fibrosarcoma is a malignant neoplasm, in which histologically the predominant cells are fibroblasts that divide excessively without cellular control and they can invade local tissues or metastasize. Primary central nervous system fibrosarcomas are very aggressive neoplasms and generally have a poor prognosis. This tumor is either from sarcomatous transformation of a meningioma or arises de novo within the brain parenchyma. Our patient, a 48-year-old woman, who presented with progressive speech disorder over the period of 4 months, showed a left temporoparietal lesion with surrounding edema and local mass effect. Total surgical resection was achieved. Histopathology revealed classical fibrosarcoma features and secondary screening revealed no other distant lesion as diagnosis of primary brain fibrosarcoma was established. This case is deemed to be extremely rare because most reports claim that recurrence is within 6 months with poor prognosis; however, this patient is currently recurrence-free at 3 years. This would suggest of the possibility for a relook into this disease's course and recurrence rate when complete excision is achieved. Due to extreme rarity of these tumors, more comparative studies will be needed to improve the disease outcome.
Hydrocephalus Associated with Large Vestibular Schwannoma: Management Options and Factors Predicting Requirement of Cerebrospinal Fluid Diversion after Primary Surgery
Authors: Prabhuraj A. R. , Sadashiva Nishanth , Kumar Santhosh , Shukla Dhaval , Bhat Dhananjaya , Devi Bhagavatula Indira , Somanna Sampath 
Published: August 2017

ABSTRACT
Objective: Obstructive hydrocephalus (HCP) related to vestibular schwannoma occurs in large tumors compressing the fourth ventricle. Symptoms related to HCP are expected to alleviate after resection of the tumor and decompression of the cerebrospinal fluid (CSF) pathways. However, some patients may require permanent cerebrospinal diversion even after surgery due to persistent HCP. In this study, the authors try to find out the factors associated with the requirement of CSF diversion after vestibular schwannoma surgery in cases of persistent HCP. Materials and Methods: This was a retrospective study involving 193 cases of vestibular schwannoma operated between 2010 and 2013 in our institute. Cases that underwent ventriculoperitoneal (VP) shunts before surgery were compared to cases which were operated directly. In cases where vestibular schwannomas were operated without prior VP shunts, factors which were associated with persistent postoperative HCP were analyzed. Results: Comparing the group who underwent direct surgery to the group who underwent VP shunt before definitive vestibular schwannoma surgery, the facial nerve preservation rates and surgical morbidity rates were comparable. In cases who underwent direct surgery, 10 out of 75 patients required postoperative permanent CSF diversion. Older age, male gender, duration of symptoms, larger tumor size, solid lesions, severe HCP, and clinical features of HCP were associated with postoperative requirement of CSF diversion but were not statistically significant. The most significant factor that correlated with the need for additional HCP treatment was the presence of postoperative hematoma of volume >10cc. Conclusions: Primary tumor removal is the optimal treatment for vestibular schwannoma associated with HCP. Postoperative hematoma may warrant close observation as these patients are at an increased risk of persistence of HCP.
Twin Middle Cerebral Artery with Aneurysm: A Variant of Early Bifurcation or a Discrete Entity
Authors: Sahoo Sushant , Singh Sunil , Parihar Anit 
Published: August 2017

ABSTRACTThe middle cerebral artery (MCA) usually bifurcates into a superior or frontal and inferior or temporal branch. However, it may have various branching pattern, and there may be additional arteries from the anterior circulation supplying its territory. The majority of them remain asymptomatic. Some cases may have aneurismal dilatation due to turbulent blood flow or the weak arterial wall. The surgical approach in these cases may be challenging due to complex anatomical pattern of MCA. In this report, we have described a distinct pattern of left MCA with an aneurysm which was not clear in computed tomography angiogram and further confirmed on digital subtraction angiography. The different anatomical patterns of MCA and their surgical implications have also been discussed.
Goniometric Assessment of Muscle Tone of Preterm Infants and Impact of Gestational Age on Its Maturation in Indian Setting
Authors: Farmania Rajni , Sitaraman S. , Das Rashmi Ranjan 
Published: August 2017

ABSTRACTContext: The normative data on muscle tone of preterm infants by goniometric assessment in Indian setting are scarce. Aim: The aim of this study it to provide a normative objective data of muscle tone of preterm infants by gestation using goniometer. Settings and Design: This was a prospective, observational study including preterm infants admitted in a tertiary care hospital from North India. Subjects and Methods: The objective dimension of muscle tone assessment of 204 healthy preterm infants was done; 61 infants completed follow-up till 40 weeks' postconceptional age (PCA) and were compared to term infants. Statistical Analysis Used: SPSS (version 16.0) was used. The intergroup comparison was done through ANOVA, and the localization of differences between the groups was determined through multiple comparisons by post hoc test. Results: Mean gestational age was 34.3 ± 1.7 weeks. Angles were as follows: adductor = 100.1 ± 8.7, popliteal = 118.9 ± 8.6, dorsiflexion = 39.0 ± 9.0, heel to ear = 121.90 ± 7.90, wrist flexion = 46.0 ± 10.2, and arm recoil = 122.2° ± 16.6°. The evolution of muscle tone as indicated by heel-to-ear angle shows progressive maturation from 32 weeks' gestation while adductor angle, popliteal angle, and arm recoil mature predominantly after 36 weeks' gestation. Comparison of preterm infants to term at 40 weeks' PCA demonstrated significantly less tone in all except posture and heel to ear. Conclusions: Goniometric assessment provides a objective normative data of muscle tone for preterm infants. Maturation of heel to ear and posture evolves from 32 weeks onwards and are the earliest neurologic marker to mature in preterm infants independent of the gestational age at birth.
Knowledge and Attitude of Nursing Students toward Electroconvulsive Therapy
Authors: Sharma Nitasha , Ghai Sandhya , Grover Sandeep 
Published: August 2017

ABSTRACT
Background: Electroconvulsive therapy (ECT) is one of the commonly used treatment modalities for patients with severe mental disorders. However, acceptance of ECT by the patient and relatives often depends on how the health-care professionals themselves present the treatment modality to the patients and their relatives. There is a lack of information about the knowledge and attitude toward ECT among health professionals. Aim: This study aimed to evaluate the knowledge about and attitude toward ECT among nursing students. Methodology: Knowledge of and attitudes toward ECT among nursing students were assessed using ECT knowledge and attitude questionnaires. Results: The study included 183 nursing students. Majority (n = 62; 60.8%) of the participants obtained information about ECT from media (movies, television, print media, etc.). None of the students had full knowledge about ECT. Although a significant proportion of students had knowledge about the ECT procedure and consent procedure, majority of them had poor knowledge about the effectiveness, mechanism of action, indications, and side effects of ECT. Negative attitudes were also highly prevalent, with more than two-thirds of the participants having negative attitudes toward ECT on more than half of the attitude items of the scale. Total knowledge score positively correlated with total attitude score, suggesting that higher knowledge was associated with more positive attitude. Conclusions: Although nursing students have knowledge about basic ECT procedure and consent, they lack knowledge about the effectiveness, mechanism of action, indications, and side effects of ECT. Negative attitude toward ECT is also highly prevalent among nursing students. Accordingly, there is a need to improve the knowledge and address the negative attitude of nursing students, which may ultimately lead to better acceptance of the treatment.
Delayed-onset Reversible Cortical Blindness after Resuscitation from Cardiac Arrest
Authors: de Souza Aaron , de Souza Rainha J. , Pai Kakode Varun R. 
Published: August 2017

ABSTRACTWe present a patient who presented with cortical blindness (CB) 1 week after repeated cardiac arrest while undergoing treatment for an acute myocardial infarction. He had been revived within 5 min in each instance and was apparently neurologically normal until presentation. Magnetic resonance imaging showed subtle hyperintensities on fluid-attenuated inversion recovery and diffusion-weighted imaging in both temporooccipital cortices. A rapid recovery over the next 2 weeks was remarkable for the appearance of metamorphopsia. CB may present even days to weeks after hypoxic-ischemic encephalopathy following cardiac arrest, even in patients apparently without immediate neurological sequelae. The pathogenesis of this phenomenon remains to be fully elucidated, but is likely to be due to delayed effects of anoxia on the occipital cortex and may be analogous to the previously described syndrome of delayed posthypoxic leukoencephalopathy. Prognosis for visual recovery appears to be good.
Aligning In-Service Training Examinations in Plastic Surgery and Orthopaedic Surgery With Competency-Based Education
Authors: Ganesh Kumar Nishant , Benvenuti Michael A. , Drolet Brian C. 
Published: August 2017

ABSTRACT

Background
In-service training examinations (ITEs) are used to assess residents across specialties. However, it is not clear how they are integrated with the Accreditation Council for Graduate Medical Education Milestones and competencies.

Objective
This study explored the distribution of specialty-specific milestones and competencies in ITEs for plastic surgery and orthopaedic surgery.

Methods
In-service training examinations were publicly available for plastic surgery (PSITE) and orthopaedics (OITE). Questions on the PSITE for 2014–2016 and the OITE for 2013–2015 were mapped to the specialty-specific milestones and the 6 competencies.

Results
There was an uneven distribution of milestones and competencies in ITE questions. Nine of the 36 Plastic Surgery Milestones represented 52% (341 of 650) of questions, and 3 were not included in the ITE. Of 41 Orthopaedic Surgery Milestones, 7 represented 51% (201 of 394) of questions, and 5 had no representation on the ITE. Among the competencies, patient care was the most common (PSITE = 62% [403 of 650]; OITE = 59% [233 of 394]), followed by medical knowledge (PSITE = 34% [222 of 650]; OITE = 31% [124 of 394]). Distribution of the remaining competencies differed between the 2 specialties (PSITE = 4% [25 of 650]; OITE = 9% [37 of 394]).

Conclusions
The ITEs tested slightly more than half of the milestones for the 2 specialties, and focused predominantly on patient care and medical knowledge competencies.
Exchange rate movements and export market dynamics: evidence from China
Authors: Huang Xiaobing 
Published: August 2017

Abstract
This paper highlights the relationship between foreign exchange rate fluctuations and firms’ export market dynamics using a Chinese firm-level production data and a firm-level trade data over the period of 2000–2006. This study adopts a discrete-time survival model in our empirical investigation and further executes several extensions and robustness checks to the baseline results. The main results of the paper can be summarized as follows: First, an exchange rate appreciation increases the likelihood of export market exit and decreases the probability of export market entry. Second, high productivity firms are less likely to exit from export markets and more likely to enter export markets in the period of exchange rate appreciation. Third, exchange rate appreciation decreases the likelihood of export market entering and increases the likelihood of export market exiting more for private-owned firms, young firms and non-eastern firms. Finally, other sources of heterogeneity, such as extensive margins, import demand elasticity, different destinations, U.S. dollar peg, and the liberalization of trading rights is also important to the effects of exchange rate changes.
Net ecosystem carbon exchange of a dry temperate eucalypt forest
Authors: Hinko-Najera Nina , Isaac Peter , Beringer Jason , van Gorsel Eva , Ewenz Cacilia , McHugh Ian , Exbrayat Jean-François , Livesley Stephen J. , Arndt Stefan K. 
Published: August 2017

Abstract. Forest ecosystems play a crucial role in the global carbon cycle by sequestering a considerable fraction of anthropogenic CO2, thereby contributing to climate change mitigation. However, there is a gap in our understanding about the carbon dynamics of eucalypt (broadleaf evergreen) forests in temperate climates, which might differ from temperate evergreen coniferous or deciduous broadleaved forests given their fundamental differences in physiology, phenology and growth dynamics. To address this gap we undertook a 3-year study (2010–2012) of eddy covariance measurements in a dry temperate eucalypt forest in southeastern Australia. We determined the annual net carbon balance and investigated the temporal (seasonal and inter-annual) variability in and environmental controls of net ecosystem carbon exchange (NEE), gross primary productivity (GPP) and ecosystem respiration (ER). The forest was a large and constant carbon sink throughout the study period, even in winter, with an overall mean NEE of −1234 ± 109 (SE) g C m−2 yr−1. Estimated annual ER was similar for 2010 and 2011 but decreased in 2012 ranging from 1603 to 1346 g C m−2 yr−1, whereas GPP showed no significant inter-annual variability, with a mean annual estimate of 2728 ± 39 g C m−2 yr−1. All ecosystem carbon fluxes had a pronounced seasonality, with GPP being greatest during spring and summer and ER being highest during summer, whereas peaks in NEE occurred in early spring and again in summer. High NEE in spring was likely caused by a delayed increase in ER due to low temperatures. A strong seasonal pattern in environmental controls of daytime and night-time NEE was revealed. Daytime NEE was equally explained by incoming solar radiation and air temperature, whereas air temperature was the main environmental driver of night-time NEE. The forest experienced unusual above-average annual rainfall during the first 2 years of this 3-year period so that soil water content remained relatively high and the forest was not water limited. Our results show the potential of temperate eucalypt forests to sequester large amounts of carbon when not water limited. However, further studies using bottom-up approaches are needed to validate measurements from the eddy covariance flux tower and to account for a possible underestimation in ER due to advection fluxes.
O comprometimento organizacional segundo o perfil dos colaboradores de cooperativas de crédito.
Authors: Stecca Jaime Peixoto , Von Ende Marta , Stecca Fabiana Letícia Pereira Alves , Bento Márcia Helena dos Santos 
Published: August 2017

O estudo do comprometimento organizacional, nas mais diferentes organizações, e seus antecedentes e consequentes, tem ocupado um espaço importante na agenda de pesquisas. É conveniente nesta agenda incluir as sociedades cooperativas devido sua importância na geração e distribuição de riquezas. O objetivo deste trabalho foi identificar o comprometimento organizacional dos colaboradores de acordo com o seu perfil. Para o alcance deste, realizou-se uma investigação junto aos colaboradores de cooperativas de crédito dos estados do Rio Grande do Sul, Paraná e Santa Catarina pertencentes a três representativos sistemas brasileiros de crédito cooperativo – Sicredi, Sicoob e Unicred. Um total de 388 pessoas responderam a 6 questões de perfil e 23 questões relativas ao comprometimento organizacional, com base no modelo validado por Medeiros (2003). Os resultados indicam que o comprometimento organizacional não se altera quando são considerados a faixa etária, a escolaridade e o tempo de atuação na cooperativa. Porém, ao se considerar o gênero, a área de atuação e o sistema onde se atua, é possível perceber alterações no comprometimento de acordo com o perfil. Conclui-se que em diferentes perfis é possível encontrar diferentes comprometimentos.
Allele specific expression analysis identifies regulatory variation associated with stress-related genes in the Mexican highland maize landrace Palomero Toluqueño
Authors: Aguilar-Rangel M. Rocío , Chávez Montes Ricardo A. , González-Segovia Eric , Ross-Ibarra Jeffrey , Simpson June K. , Sawers Ruairidh J.H. 
Published: August 2017

BackgroundGene regulatory variation has been proposed to play an important role in the adaptation of plants to environmental stress. In the central highlands of Mexico, farmer selection has generated a unique group of maize landraces adapted to the challenges of the highland niche. In this study, gene expression in Mexican highland maize and a reference maize breeding line were compared to identify evidence of regulatory variation in stress-related genes. It was hypothesised that local adaptation in Mexican highland maize would be associated with a transcriptional signature observable even under benign conditions.MethodsAllele specific expression analysis was performed using the seedling-leaf transcriptome of an F1individual generated from the cross between the highland adapted Mexican landrace Palomero Toluqueño and the reference line B73, grown under benign conditions. Results were compared with a published dataset describing the transcriptional response of B73 seedlings to cold, heat, salt and UV treatments.ResultsA total of 2,386 genes were identified to show allele specific expression. Of these, 277 showed an expression difference between Palomero Toluqueño and B73 alleles under benign conditions that anticipated the response of B73 cold, heat, salt and/or UV treatments, and, as such, were considered to display a prior stress response. Prior stress response candidates included genes associated with plant hormone signaling and a number of transcription factors. Construction of a gene co-expression network revealed further signaling and stress-related genes to be among the potential targets of the transcription factors candidates.DiscussionPrior activation of responses may represent the best strategy when stresses are severe but predictable. Expression differences observed here between Palomero Toluqueño and B73 alleles indicate the presence ofcis-acting regulatory variation linked to stress-related genes in Palomero Toluqueño. Considered alongside gene annotation and population data, allele specific expression analysis of plants grown under benign conditions provides an attractive strategy to identify functional variation potentially linked to local adaptation.
Communities of Style: Portable Luxury Arts, Identity, and Collective Memory in the Iron Age Levant. By Marian H. Feldman
Authors: Foster Karen Polinger 
Published: August 2017

Communities of Style: Portable Luxury Arts, Identity, and Collective Memory in the Iron Age Levant.
By Marian H. Feldman. Chicago: University of Chicago Press, 2014. Pp. xvii + 250, illus. $70.
Steady 10Be‐derived paleoerosion rates across the Plio‐Pleistocene climate transition, Fish Creek‐Vallecito basin, California
Authors: Oskin M. E. , Longinotti N. E. , Peryam T. C. , Dorsey R. J. , DeBoer C. J. , Housen B. A. , Blisniuk K. D. 
Published: August 2017

Rates of erosion over time provide a valuable tool for gauging tectonic and climatic drivers of landscape evolution. Here we measure 10Be archived in quartz sediment from the Fish Creek‐Vallecito basin to resolve a time series of catchment‐averaged erosion rates and to test the hypothesis that aridity and increased climate variation after approximately 3 Ma led to an increase in erosion rates in this semiarid, ice‐free setting. The Fish Creek‐Vallecito basin, located east of the Peninsular Ranges in Southern California, is an ideal setting to derive a Plio‐Pleistocene paleoerosion rate record. The basin has a rapid sediment accumulation rate, a detailed magnetostratigraphic age record, and its stratigraphy has been exposed through recent, rapid uplift and erosion. A well‐defined source region of uniform lithology and low erosion rate provides a high, reproducible 10Be signal. We find that paleoerosion rates were remarkably consistent between 1 and 4 Ma, averaging 38 ± 24 m/Myr (2σ). Modern catchment‐averaged erosion rates are similar to the paleoerosion rates. The uniformity of erosion over the past 4 Myr indicates that the landscape was not significantly affected by late Pliocene global climate change, nor was it affected by a local long‐term increase in aridity.