bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and treatment of concurrent dermal malignant melanoma and melanocytomas in a pygmy hippopotamus (Choeropsis liberiensis)
Authors: Saunders Richard A. , Killick Rowena S. , Barrows Michelle G. , Bowlt Kelly A. , Denk Daniella 
Published: June 2017

BackgroundDermal melanocytic neoplasms are common in some even‐toed ungulates (Artiodactyla), yet this entity has not been reported in the pygmy hippopotamus to date. Concurrent occurrence of multiple benign and malignant melanocytic neoplasms is unusual. Malignant transformation occurs in a small percentage of benign melanocytic tumours in people but this phenomenon has not been well documented in animals.ObjectivesTo report the diagnosis and treatment of concurrent dermal melanocytomas and malignant melanomas in a pygmy hippopotamus.AnimalsA 36‐year‐old intact male pygmy hippopotamus, part of a zoological collection, housed with a 10‐year‐old female of the same species, presented with multiple raised and pigmented skin masses.MethodsInitial impression smears of one ulcerated lesion were consistent with inflammation; subsequent histopathological findings from a skin biopsy revealed an underlying malignant melanoma. The animal was anaesthetised, ultrasonographic imaging of the local lymph nodes indicated no local involvement and all skin lesions were removed. Recovery from anaesthesia was unremarkable, skin healing was within normal limits for the species. There was no sign of recurrence 34 months post‐surgery.ResultsA diagnosis of malignant melanomas and concurrent melanocytomas was made on histopathological evaluation.Conclusion and clinical importanceTo the best of the authors' knowledge, this is the first reported case of melanocytic neoplasia in the pygmy hippopotamus. The occurrence of both benign and malignant melanocytic skin tumours should be considered in this species.
Clinical findings and management of 153 horses with large colon sand accumulations
Authors: Kilcoyne Isabelle , Dechant Julie E. , Spier Sharon J. , Spriet Mathieu , Nieto Jorge E. 
Published: June 2017

AbstractObjectiveTo determine the influence of radiographic quantification of sand accumulation on the medical versus surgical management of large colon sand accumulations. To compare short‐ and long‐term outcomes and complications associated with medical and surgical management of these horses.Study designRetrospective.Sample populationA total of 153 horses.MethodsMedical records and abdominal radiographs of horses presented for colic between 2004 and 2014 were reviewed. Severity of sand accumulation was quantified by tracing and measuring a region of interest with a commercial software program. Breed, weight, amount of sand, presence of diarrhea at presentation, treatment, and the development of complications were recorded.ResultsRecords from 153 horses were reviewed. The mean cross‐sectional area of sand accumulation was 692.9 cm2 (median = 658.7 cm2, 84.6‐1780.7 cm2). Increased accumulation of gas on radiographs and abnormal transrectal examination findings were associated with an increased likelihood of surgery. The most common complication was the development of diarrhea (20.3%) with only 4 (2.6%) horses positive for Salmonella spp. Horses had a favorable prognosis, with 94.8% of horses treated medically and 94.7% of those treated surgically surviving to discharge.ConclusionIncreased accumulation of gas on radiographs and transrectal palpation of impaction or intestinal gas distension increase the likelihood of surgery. Both medical and surgical treatments carry a good prognosis.Clinical relevanceThe sheer quantity of sand is not a factor when determining surgical intervention. Attention should be paid to the presence of increased gas accumulation on rectal or radiographic examination.
The ‘surprise’ question in paediatric palliative care: A prospective cohort study
Authors: Burke Kimberley , Coombes Lucy Helen , Menezes Antoinette , Anderson Anna-Karenia 
Published: June 2017

Background: The question ‘would you be surprised if this patient died in the next 12-months’ is widely used for identifying adult patients in the last year of life. However, this has not yet been studied in children. Aim: To assess the prognostic accuracy of the surprise question when used by a multidisciplinary team to predict survival outcomes of children with life-limiting conditions over a 3 and 12 month period. Design: A prospective cohort study. Setting/participants: Six multidisciplinary team members working in a children’s hospice answered a 3 and 12 month surprise question about 327 children who were either newly referred or receiving care at the hospice between 2011 and 2013. Results: The prognostic accuracy of the multidisciplinary team for the 3 (and 12)month surprise question were: sensitivity 83.3% (83.3%), specificity 93.2% (70.7%), positive predictive value 41.7% (23.6%), negative predictive value 99% (97.5%) and accuracy 92.6% (71.9%). Patients with a ‘no’ response had an increased risk of death at 3 (hazard ratio, 22.94, p ⩽ 0.001) and 12 months (hazard ratio, 6.53, p ⩽ 0.001). Conclusion: The surprise question is a highly sensitive prognostic tool for identifying children receiving palliative care who are in the last 3 and 12 months of life. The tool is accurate at recognising children during stable periods demonstrated through a high negative predictive value. In practice, this tool could help identify children who would benefit from specialist end of life care, act as a marker to facilitate communications on advance care planning and assist in resource allocation.
Moving on: Factors associated with caregivers’ bereavement adjustment using a random population-based face-to-face survey
Authors: Burns Emma , Prigerson Holly G , Quinn Steve J , Abernethy Amy P , Currow David C 
Published: June 2017

Background: Providing care at end of life has consequences for caregivers’ bereavement experience. ‘Difficulty moving on with life’ is an informative and unbiased symptom of prolonged grief disorder. Predictors of bereaved caregivers’ ability to ‘move on’ have not been examined across the population. Aim: To identify the characteristics of bereaved hands-on caregivers who were, and were not, able to ‘move on’ 13–60 months after the ‘expected’ death of someone close. Design: The South Australian Health Omnibus is an annual, random, cross-sectional community survey. From 2000 to 2007, respondents were asked about providing care for someone terminally ill and their subsequent ability to ‘move on’. Multivariable logistic regression models explored the characteristics moving on and not moving on. Setting: Respondents were aged ⩾15 years and lived in households within South Australia. They had provided care to someone who had died of terminal illness in the preceding 5 years. Results: A total of 922 people provided hands-on care. In all, 80% of caregivers (745) had been able to ‘move on’. Closeness of relationship to the deceased, increasing caregiver age, caregiver report of needs met, increasing time since loss, sex and English-speaking background were significantly associated with ‘moving on’. A closer relationship to the deceased, socioeconomic disadvantage and being male were significantly associated with not ‘moving on’. Conclusion: These results support the relevance of ‘moving on’ as an indicator of caregivers’ bereavement adjustment. Following the outcomes of bereaved caregivers longitudinally is essential if effective interventions are to be developed to minimise the risk of prolonged grief disorder.
Maternal Psychological Distress and Perceived Impact on Child Feeding Practices in South Kivu, DR Congo
Authors: Emerson Jillian A. , Tol Wietse , Caulfield Laura E. , Doocy Shannon 
Published: June 2017

Background: Maternal mental health problems are associated with poor child growth and suboptimal child feeding practices, yet little qualitative research has been conducted to understand mothers’ perceptions about how maternal mental ill health and child nutrition are related. Objective: The objective of the study was to understand maternal perceptions on sources of psychological distress, and how distress impacts functioning, especially related to childcare and feeding practices among mothers of young children in South Kivu, DR Congo. Methods: Mothers of young children who were participating in a larger study were eligible. Using purposive sampling, participants were selected if they had high or low levels of psychological distress, based on their mean item score on measures of symptoms of depression, anxiety, and post-traumatic stress. Twenty in-depth interviews and 2 focus group discussions were conducted, with a total of 35 mothers. Key informant interviews were conducted with 5 local health workers. Audio recordings were transcribed and coded, and the analysis was guided by Grounded Theory methodology. Results: Major themes to emerge were that women’s husbands were a significant source of distress, with husbands’ infidelity, abandonment, and lack of financial support mentioned by participants. Psychological distress resulted in appetite and weight loss, and poor nutritional status made it difficult to breastfeed. Participants perceived psychological distress caused milk insufficiency and difficulty breastfeeding. Conclusion: Mothers experiencing psychological distress may need greater support for maternal nutrition and breastfeeding, and engaging fathers through responsible parenting interventions may reduce psychological distress and have a positive impact on child health.
The association between supportive relatives and lower occurrence of anxiety and depression in heart patients: Results from a nationwide survey
Authors: Hansen Camilla , Zinckernagel Line , Schneekloth Nanna , Zwisler Ann-Dorthe Olsen , Holmberg Teresa 
Published: June 2017

Background: Approximately 30–40% of heart patients develop anxiety and/or depression, which might influence recovery and long-term survival. Research has suggested that support from relatives may decrease anxiety and depression among heart patients; however, the results are inconsistent and often based on small study populations. Aim: The paper aimed to investigate the association between having supportive relatives and the occurrence of anxiety and depression in heart patients. Methods: A population-based cross-sectional study among Danish patients diagnosed with ischemic heart disease, atrial fibrillation, heart failure, or heart valve disease. Presence of supportive relatives was measured as the degree to which the patients felt that they had relatives they could count on, while symptoms of anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Multiple logistic regression analyses accounting for confounders were used to examine the association between supportive relatives and anxiety/depression. Results: The questionnaire was answered by 2496 heart patients, corresponding to 50% of the invited population. Patients with low or some degree of supportive relatives had a higher odds ratio (OR) of anxiety than patients with a high degree (OR = 2.20, 95% confidence interval (CI): 1.28–2.37; OR = 1.75, 95% CI: 1.57–3.08, respectively). Likewise, patients with low or some degree of supportive relatives had a higher OR of depression than patients with a high degree (OR = 1.96, 95% CI: 1.40–2.66; OR = 1.93, 95% CI: 1.37–2.60, respectively). Conclusions: The presence of supportive relatives was found to be associated with lower occurrence of anxiety and depression. Health professionals should focus on including relatives in the treatment and rehabilitation of heart patients.
Toward the Development of a Glucose Dehydrogenase-Based Saliva Glucose Sensor Without the Need for Sample Preparation
Authors: Lin Chi , Pratt Breanna , Honikel Mackenzie , Jenish Alaina , Ramesh Bhavna , Alkhan Amnah , La Belle Jeffrey T. 
Published: June 2017

Background: Strict glycemic control is known to be a vital key in the management of diabetes mellitus (DM). However, traditional methods face limitations in their efficacy due to the pain and invasiveness of needle pricking which often discourages DM patients from performing the required number of tests per day. Saliva glucose (SG) sensing has long been considered a noninvasive alternative to blood glucose monitoring for diabetes management, however the sample preparation and sensor detection limit have been deemed as challenges to overcome. Herein, we describe a preliminary clinical validation of a disposable SG sensor without any requirement for sample preparation. Methods: The sensor utilizes glucose dehydrogenase flavine-adenine dinucleotide (GDH-FAD) in conjunction with disposable screen printed electrodes to measure glucose levels in saliva collected directly from 9 healthy subjects. Cyclic voltammetry and amperometric-time (Amp-it) assays were used to develop calibration curves and test subjects. Sensor calibration was performed using simulated saliva at 6.5 pH and 37ºC. Results: The lower limit of detection was determined to be 0.11 mg/dL. A lag time of 15 minutes with a positive correlation between SG and BG levels was found, which agrees with literature results. The detected SG ranges from 2.38 to 3.40 mg/dL over a BG range of 90 to 143 mg/dL. Conclusion: This is the first reported use of measuring SG with GDH-FAD without prior sample preparation. Upon optimization, the sensor has the potential to serve as a supplement to blood glucose monitoring.
Association of Competition Volume, Club Sports, and Sport Specialization With Sex and Lower Extremity Injury History in High School Athletes
Authors: Post Eric G. , Bell David R. , Trigsted Stephanie M. , Pfaller Adam Y. , Hetzel Scott J. , Brooks M. Alison , McGuine Timothy A. 
Published: June 2017

Background: High school athletes are increasingly encouraged to participate in 1 sport year-round to increase their sport skills. However, no study has examined the association of competition volume, club sport participation, and sport specialization with sex and lower extremity injury (LEI) in a large sample of high school athletes. Hypothesis: Increased competition volume, participating on a club team outside of school sports, and high levels of specialization will all be associated with a history of LEI. Girls will be more likely to engage in higher competition volume, participate on a club team, and be classified as highly specialized. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: High school athletes completed a questionnaire prior to the start of their competitive season regarding their sport participation and previous injury history. Multivariable logistic regression analyses were used to investigate associations of competition volume, club sport participation, and sport specialization with history of LEI, adjusting for sex. Results: A cohort of 1544 high school athletes (780 girls; grades 9-12) from 29 high schools completed the questionnaire. Girls were more likely to participate at high competition volume (23.2% vs 11.0%, χ2 = 84.7, P < 0.001), participate on a club team (61.2% vs 37.2%, χ2 = 88.3, P < 0.001), and be highly specialized (16.4% vs 10.4%, χ2 = 19.7, P < 0.001). Athletes with high competition volume, who participated in a club sport, or who were highly specialized had greater odds of reporting a previous LEI than those with low competition volume (odds ratio [OR], 2.08; 95% CI, 1.55-2.80; P < 0.001), no club sport participation (OR, 1.50; 95% CI, 1.20-1.88; P < 0.001), or low specialization (OR, 2.58; 95% CI, 1.88-3.54; P < 0.001), even after adjusting for sex. Conclusion: Participating in high sport volume, on a club team, or being highly specialized was associated with history of LEI. Girls were more likely to participate at high volumes, be active on club teams, or be highly specialized, potentially placing them at increased risk of injury. Clinical Relevance: Youth athletes, parents, and clinicians should be aware of the potential risks of intense, year-round participation in organized sports.
Surgical technique and early outcomes of intramedullary nailing of displaced proximal humeral fractures in an Asian population using a contemporary straight nail design
Authors: Hao Toon Dong , Huat Andy Wee Teck 
Published: June 2017

Background: Despite being a common orthopedic injury, the optimal management of proximal humeral fractures remains a topic of debate. Although intramedullary nails have been used to treat these fractures, several complications have been reported with older nail devices. We describe our surgical technique and aim to evaluate the early functional and radiological outcomes of displaced Neer’s two- to four-part proximal humeral fractures undergoing fixation with a contemporary straight intramedullary nail. Methods: A prospective cohort study of 22 consecutive patients (mean age 55.7 ± 18.0) with acute displaced proximal humeral fractures underwent intramedullary nailing (Depuy Synthes MultiLoc Humeral Nail) by a single surgeon in a single institution. According to Neer’s classification, 11 had two-part fractures, 9 had three-part fractures, and 2 had four-part fractures. Functional and radiological outcomes, as well as occurrence of complications, were assessed at 12 months postoperatively. Results: The mean Constant–Murley score and American Shoulder and Elbow Surgeons score at 12 months were 75.5 ± 12.1 and 81.7 ± 6.2, respectively. Mean range of motion was forward flexion 144.3 ± 28.4, abduction 141.3 ± 30.5, external rotation 58.0 ± 13.9, and internal rotation 62.0 ± 15.2. Mean visual analog scale score was 1.7 ± 0.8. Radiographic fracture union was achieved at a mean of 3 months post-op. One patient underwent a second surgery for screw removal due to a proximal screw backing out. No other complications were found in our cohort. Notably, no patients had clinical signs and symptoms of subacromial impingement and/or rotator cuff tear. Conclusion: Our study demonstrated that intramedullary nailing using the contemporary straight nail design is well suited for Neer’s two- and three-part proximal humeral fractures, with good early outcomes and low rates of complications. Results for four-part fractures were, however, inferior in our cohort, suggesting that further studies with larger patient numbers are needed to determine the role of intramedullary nailing for four-part fractures.
Stochastic forecasting of project streams for construction project portfolio management
Authors: Shojaei Alireza , Flood Ian 
Published: June 2017

AbstractBackgroundConstruction companies typically work on many projects simultaneously each with its own objectives and resource demands. Consequently, a key managerial function is to allocate financial, equipment, and human resources between these concurrent projects in a way that satisfies the individual project constraints while optimizing the company’s overall objectives.Project portfolio management is concerned with managing multiple projects to accomplish strategic goals. The main concentrations of research so far have been project selection, prioritization and alignment of a portfolio with strategic goals among a pool of awarded projects. The objective of this research is to develop a model capable of generating representative future streams of projects that can be used to assist in strategic planning and portfolio management.MethodsThis paper reports on an on-going research project aimed at developing and validating a stochastic model of streams of uncertain and unknown future projects and to demonstrate the significance and implications of such uncertainties on project portfolio and strategic planning. The scope of the research is Florida Department of Transportation (FDOT) projects. Records of the past 12 years letting information combined with a pool of candidate variables is analyzed to capture characteristics of the time series data and to determine any project characteristic correlations with macroeconomic factors.ResultsThe performances of the various model components presented indicate the viability of an integrated project stream forecaster that predicts, within a simulation environment, the frequencies of projects and empirical distributions of project duration and cost.ConclusionThe gap in the current body of knowledge is a lack of consideration of the effects of uncertainties associated with future projects, both known (but yet to be awarded to a contractor) and unknown (although statistically quantifiable). It is evident that companies should not just focus on current known projects but also uncertain and unknown future projects. Such a capability, looking into the future, is key to the effective medium and long-term strategic planning for the company. Contractors can, for example, use these stochastic streams of data to test different bidding strategies and to see how sensitive the performance of their portfolio is to changes in different market factors.
Range-Dependent Utility
Authors: Kontek Krzysztof , Lewandowski Michal 
Published: June 2017

First, this paper introduces and axiomatizes range-dependent utility as a new conceptual framework for decision making under risk. It is a simple and well-defined generalization of expected utility theory in which utility depends on the range of lottery outcomes. Second, a special case of this framework is proposed for prediction. It is based on applying a single utility function (decision utility) to every normalized lottery range. The resultant decision utility model predicts well-known expected utility paradoxes without recourse to probability weighting. Necessary and sufficient conditions for the model to satisfy monotonicity with respect to first-order stochastic dominance are identified. The typical decision utility function, which is confirmed by both experimental data and normative considerations, is S shaped. This paper was accepted by Manel Baucells, decision analysis.
Penentuan Tetapan Keseimbangan Penjerapan Pada Sistem Koloid Dengan Metode Ekstrapolasi Grafik
Authors: Satriadi H. , Bendiyasa I. M. , Rochmadi Rochmadi 
Published: June 2017

Percobaan penjerapan pestisida pada sistem koloid air-tanah telah mendapatkan nilai tetapan keseimbangan penjerapan yang selalu berubah dan dipengaruhi perbandingan antara berat penjerap terhadap volum pelarutnya. Hal ini terjadi karena pemisahan antara penjerap dan pelarut sangat sulit dilakukan, dan pelarut selalu masih mengandung butir penjerap. Akibatnya zat yang terjerap dalam penjerap ikut terbaca ketika menganalisis konsentrasi zat dalam pelarut. Untuk mendapatkan tetapan keseimbangan yang sebenarnya dapat dilakukan dengan modifikasi persamaan keseimbangan dan metode ekstrapolasi secara grafis. Percobaan dilakukan secara batch dengan konsentrasi awal pestisida sumithion 1,1014 ppm, perubahan konsentrasi diamati dengan kromatografi gas yang dilengkapi dengan Flame Photo Detector. Tanah yang digunakan berdiameter butir 8,066. 10-5 cm, diameter pori 20,443 A, serta mengandung 2,86% bahan organic. Nilai tetapan keseimbangan sebenarnya diperoleh 123,936 ml air/g tanah pada 26,5 0C.Kata kunci : ekstrapolasi grafis, sistem koloid, tetapan keseimbangan penjerapan