bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of perforator flaps in head and neck cancer surgery
Authors: Cho Andrew , Hall Francis T. 
Published: August 2016

Purpose of review
Perforator flaps are increasingly being used to reconstruct head and neck defects. They offer several advantages over nonperforator-based flaps with lower donor site morbidity and a versatile range of reconstructive options. The anterolateral thigh flap is well established in the head and neck and is a good example of a reliable perforator free flap. With the increasing use of both free and regional perforator-based flaps, it is timely to review their anatomy, clinical applications, and role in head and neck reconstruction. We also discuss increasingly popular perforator flaps such as the submental flap for the head and neck.

Recent findings
The anterolateral thigh flap is now commonly used to reconstruct a wide variety of head and neck defects. The submental flap fills a niche role for reconstruction of intraoral defects.

Summary
Perforator flaps are now mainstream reconstructive options in the head and neck surgeon's armamentarium.
Incidence of Primary Mitochondrial Disease in Children Younger Than 2 Years Presenting With Acute Liver Failure
Authors: McKiernan Patrick , Ball Sarah , Santra Saikat , Foster Katherine , Fratter Carl , Poulton Joanna , Craig Kate , McFarland Robert , Rahman Shamima , Hargreaves Iain , Gupte Girish , Sharif Khalid , Taylor Robert W. 
Published: August 2016

ABSTRACTBackground:Mitochondrial liver disease (MLD), and in particular mitochondrial DNA (mtDNA) depletion syndrome (MDS) is an important cause of acute liver failure (ALF) in infancy. Early and accurate diagnosis is important because liver transplantation (LT) is often contraindicated. It is unclear which methods are the best to diagnose MLD in the setting of ALF.Objective:The aim of the study was to determine the incidence of MLD in children younger than 2 years with ALF and the utility of routine investigations to detect MLD.Methods:Thirty‐nine consecutive infants with ALF were admitted to a single unit from 2009 to 2011. All were extensively investigated using an established protocol. Genes implicated in mitochondrial DNA depletion syndrome were sequenced in all cases and tissue mtDNA copy number measured where available.Results:Five infants (17%) had genetically proven MLD: DGUOK (n = 2), POLG (n = 2), and MPV17 (1). Four of these died, whereas 1 recovered. Two had normal muscle mtDNA copy number and 3 had normal muscle respiratory chain enzymes. An additional 8 children had low hepatic mtDNA copy number but pathogenic mutations were not detected. One of these developed fatal multisystemic disease after LT, whereas 5 who survived remain well without evidence of multisystemic disease up to 6 years later. Magnetic resonance spectroscopy did not distinguish between those with and without MLD.Conclusions:Low liver mtDNA copy number may be a secondary phenomenon in ALF.Screening for mtDNA maintenance gene mutations may be the most efficient way to confirm MLD in ALF in the first 2 years of life.
Full House: A Retrospective Analysis of High Sexually Transmitted Infection Prevalence among Adult Film Actors at a Singular Residence
Authors: Kendrick Katherine , Brown Veronica , Lords Caleb , Matthias James , Henning Ian , Blackmore Carina , Likos Anna 
Published: August 2016

Background
During a routine human immunodeficiency virus (HIV) investigation, Florida Department of Health staff identified a house (house A) in which over 150 individuals had resided at least briefly. Further investigation revealed that house A is used by the producer of a small adult film production company to board his actors. This report describes sexually transmitted infection (STI) prevalence among male actors in gay adult films residing in a common Florida residence.

Methods
LexisNexis Accurint was used to identify house A residents since October 2002 when the producer arrived. Information on STIs and interview data were obtained from Florida's STI surveillance system. An infection was considered to be associated with residence in house A if the date of diagnosis occurred 6 months before an individual's residence start date through 6 months after his residence end date.

Results
Excluding the producer, 150 men resided in house A starting from September 2003 to July 2015. Forty-six individuals had a reported case of HIV, syphilis, gonorrhea, and/or chlamydia with 92 infections total. Forty-two (46%) infections among 24 men were considered associated with residence in house A.

Conclusions
LexisNexis Accurint was a useful tool for identifying house A residents, a highly mobile and highly sexually active population. There is a high prevalence of STIs among residents, but it is unclear where transmission is occurring. Settings like house A are good candidates for HIV pre-exposure prophylaxis and active STI screenings and may be an opportunity for public health officials to intervene in high-risk groups to reduce STI rates in the community.
Endocrinologic Diseases in Pediatric Cardiac Intensive Care
Authors: Soto-Rivera Carmen L. , Schwartz Steven M. , Sawyer Jaclyn E. , Macrae Duncan J. , Agus Michael S. D. 
Published: August 2016

Objectives:
The objectives of this review are to discuss the pathophysiology, clinical impact and treatment of hyperglycemia, and disturbances in thyroid and adrenal function prior to and following cardiac surgery in children.

Data Source:
MEDLINE and PubMed.

Conclusions:
Disturbances in glucose metabolism and thyroid and adrenal function are common in critically ill children with cardiac disease and in particular in children undergoing cardiac surgery for complex congenital heart disease. An understanding of the pathophysiology, clinical impact and treatment of these disturbances is essential for the management of these at risk patients.
Students' Interaction in the Online Learning Management Systems:
A Comparative Study of Undergraduate and Postgraduate Courses
Authors: Ping Teoh Ai 
Published: August 2016

The quality of interaction between learners and online content is one of the imperative factors in determining the efficacy of web-based teaching-learning towards the creation and maintenance of sustainable learning communities. Interaction with content is an internal dialogue of reflective thought that occurs between learner and the substance. Interaction is often triggered and supported by events in the learning environment – focusing on how the learner interacts with what is to be learned.
This paper looks at the difference in learners' interaction on the online Learning Management System (LMS) of undergraduate and postgraduate courses. Based on a framework developed for investigating learners' interaction with online content in Wawasan Open University, data from the LMS log and activity database was extracted. The data is then analyzed based on the pattern and behavior of learners' interaction with the online content of the courses. Further analysis is done by transcribing the discussions and exchanges of teacher and learners within the online forums, specifically investigating the dimension, depth and category of exchanges that occurred. Based on the findings, several recommendations are made to enhance the design and delivery of web-based content, aiming at maximizing the efficacy of the online learning environment of undergraduate and postgraduate courses in open distance learning (ODL).
Contribution to research when engineering is taught through ODL: A Sri Lankan case study
Authors: Weerasekera Kolita S. 
Published: August 2016

This paper is based on a study that investigated a general conception that academics and students of engineering in ODL institutions conduct less research compared to those teaching and learning in conventional institutions of higher learning. The study first observed the level of research conducted by Sri Lankan researchers, and compared it to similar activities carried out in neighbouring countries. Subsequently, attention was focused on the Open University of Sri Lanka (OUSL), which is the pioneer ODL institution in Sri Lanka. It closely observed the research carried out at OUSL over the last few years and made comparisons between different disciplines.
A tracer study was carried out to identify the research activities at the Faculty of Engineering Technology over the years and compare them with the research done at other OUSL faculties. It was evident from this study that the number of research papers presented at conferences and journal articles generated by the Faculty of Engineering Technology was low compared to the number produced by the other three faculties in the university. The study revealed some interesting reasons for the low level of engineering-based research output when engineering is taught through ODL.
Morphology and acoustic artefacts of copper deposits electroplated using megasonic assisted agitation
Authors: Jones Thomas D.A. , Flynn David , Desmulliez Marc P.Y. , Price Dennis , Beadel Matthew , Strusevich Nadia , Patel Mayur , Bailey Chris , Costello Suzanne 
Published: August 2016

Purpose
This study aims to understand the influence of megasonic (MS)-assisted agitation on printed circuit boards (PCBs) electroplated using copper (Cu) electrolyte solutions to improve plating efficiencies through enhanced ion transportation.

Design/methodology/approach
The impact of MS-assisted agitation on topographical properties of the electroplated surfaces was studied through a design of experiments by measuring surface roughness, which is characterised by values of the parameter Ra as measured by white light phase shifting interferometry and high-resolution scanning electron microscopy.

Findings
An increase in Ra from 400 to 760 nm after plating was recorded for an increase in acoustic power from 45 to 450 W. Roughening increased because of micro-bubble cavitation energy and was supported through direct imaging of the cavitation. Current thieving effect by the MS transducer induced low currents, leading to large Cu grain frosting and reduction in the board quality. Current thieving was negated in plating trials through specific placement of transducer. Wavy electroplated surfaces, due to surface acoustic waves, were also observed to reduce the uniformity of the deposit.

Research limitations/implications
The formation of unstable transient cavitation and variation of the topology of the Cu surface are unwanted phenomena. Further plating studies using MS agitation are needed, along with fundamental simulations, to determine how the effects can be reduced or prevented.

Practical implications
This study can help identify manufacturing settings required for high-quality MS-assisted plating and promote areas for further investigation, leading to the development of an MS plating manufacturing technique.

Originality/value
This study quantifies the topographical changes to a PCB surface in response to MS agitation and evidence for deposited Cu artefacts due to acoustic effects.
Striving for a way out from a rock and a hard place
Authors: Kwan Paula , Li Yuet-man Benjamin 
Published: August 2016

Purpose– The purpose of this paper is to understand the dilemmas facing Hong Kong vice-principals in discharging their roles and to further explore their engagement in informal mentoring as a coping mechanism in the absence of a structured professional development program.Design/methodology/approach– The qualitative study was conducted in the form of in-depth face-to-face, loosely structured individual interviews with ten informants from a variety of personal and school backgrounds, contributing to a set of data that unveiled the basic themes.Findings– Three dilemmas facing Hong Kong vice-principals were identified: juggling administrative work with teaching, standing by management or siding with peer teachers, and forced innovation vs omnipresent conservatism. The findings also suggested that the informants tended toward external resources intentionally with a view to gaining emotional support as well as professional stimulation. They also engaged in informal mentoring, which took the form of observing principals’ behaviors, joining support groups organized by school governing bodies, and enrolling in academic programs offered by universities and/or professional bodies, as a way to resolve the dilemmas.Research limitations/implications– Informal mentoring has been identified as an effective approach for Hong Kong vice-principals to acquire the skills and knowledge needed to overcome workplace challenges and the feelings of loneliness experienced upon changing their role. The findings point to the importance of formalizing mentoring in vice-principal development programs.Originality/value– This study is the first of its kind to explore the impact of informal mentoring on vice-principals in Hong Kong where both dual-career track systems and a structured mentoring programs are missing.
Potential carbon emission abatement cost recovery from carbon emission trading in China
Authors: Wang Ke , Xian Yujiao , Zhang Jieming , Li Yi , Che Linan 
Published: August 2016

Purpose
This study aims to provide an estimation of carbon dioxide (CO2) emission abatement costs in China’s industry sector during the period of 2006-2010, and additionally provide an ex-post estimation of CO2 abatement cost savings that would be realized if carbon emission permits trading among different industry sectors of 30 provinces in China during the same period were allowed, to answer the question that whether the industrial carbon emission abatement cost can (partially) be recovered from carbon emission trading in China.

Design/methodology/approach
The joint production framework associated with the environmental technology is utilized for formulating the models for estimating abatement costs and simulating emission permits trading scheme. Several data envelopment analysis-based models that could deal with both the desirable and undesirable outputs within the above framework are utilized for abatement cost saving estimation. The weak disposability assumption and variable returns to scale assumption are applied in the modelling.

Findings
In China’s industry sector, during 2006-2010, the estimated CO2 emission abatement cost was 1,842 billion yuan, which accounts for 2.45 per cent of China’s total industrial output value; the emission abatement cost saving from emission permits trading would be 315 billion yuan, which accounts for 17.12 per cent of the emission opportunity abatement cost; and additional 1,065.95 million tonnes of CO2 emission reductions would be realized from emission permits trading, and this accounts for 4.75 per cent of the total industrial CO2 emissions.

Research limitations/implications
The estimation is implemented at the regional level, i.e. the emission permits trading subjects are the whole industry sectors in different Chinese provinces, because of the data limitation in this study. Further estimation could be implemented at the enterprise level to provide a deeper insight into the abatement cost recovery from emission permits trading.

Practical implications
The estimation models and calculation process introduced in this study could be applied for evaluating the efficiency and effectiveness of pollutant emission permits trading schemes from the perspective that whether these market-based abatement policy instruments help to realize the potential abatement cost savings.

Originality/value
To the best of the authors’ knowledge, no study has provided the estimation of CO2 emission abatement cost and the estimation of CO2 abatement cost saving effect from emission permits trading for China’s industry sector. This study provides the first attempt to fill this research gap.
Pre-purchase information search: too many sources to choose
Authors: Broilo Patricia Liebesny , Espartel Lélis Balestrin , Basso Kenny 
Published: August 2016

Purpose
Because of the increasing volume of information spread in physical and online environments, a consumer intending to purchase a product or service must choose not only what to buy but also which sources to consult when searching for information that may aid decision-making. This study aims to understand how consumers choose their sources of information in pre-purchase external searches, given the information overproduction scenario.

Design/methodology/approach
Using a qualitative approach, data collected through interviews with consumers were analyzed under the technique of content analysis, and the results were synthesized into a framework.

Findings
Consumers tend to consider few sources of information, based on a previously built perception of which sources are more or less appropriate for consultation. Choice tends to be based on pre-established evaluation criteria involving the use of heuristics in the form of socialized images regarding those sources.

Research limitations/implications
Despite the study’s exploratory nature, the proposed framework sheds light into how consumers respond to information overproduction when choosing their sources, providing interesting venues for future investigations.

Practical implications
The study identified the possible occurrence of consumer confusion associated with information sources, extending the theoretical understanding of such a concept. Moreover, it revealed the need for managers to consider specific aspects related to the sources to be included in marketing communications.

Originality/value
This is the first study to address choice of information sources associated with consumer confusion focusing the offline/online scenario.
Using Action Research and Action Learning (ARAL) to develop a response to the abuse of older people in a healthcare context
Authors: McAlinden Fiona 
Published: August 2016

PurposeThe purpose of this paper is to describe Monash Health’s development of a Policy and Procedure on the abuse of older people in metropolitan Australia. Monash Health is a public healthcare network that consists of six public hospitals and over 40 community health care sites throughout the South East of Melbourne.Design/methodology/approachAn Action Research Action Learning approach was employed to develop a comprehensive set of policy and procedure documents to ensure that Monash Health became compliant with the State Government’s expectations around responding to the abuse of older people in a consistent manner.FindingsAlmost 90,000 Monash Health hospital admissions per year are older people aged over 65 years. Senior Monash Health management recognized that staff did not have adequate information, education and resources to consistently identify and respond to situations of elder abuse. What is more, the existing internal Monash Health document Supporting Older People at Risk did not meet obligations stated in the Victorian Government’s Elder Abuse Strategy (2009).Originality/valueThe project’s emphasis upon participatory action research, cooperative inquiry and action learning further resulted in the identification of an opportunity to develop a strategic response to violence and abuse for all patients of Monash Health, not just older people.
Small lesion size measured by colposcopy may predict absence of cervical intraepithelial neoplasia in a large loop excision of the transformation zone specimen
Authors: Munmany M , Marimon L , Cardona M , Nonell R , Juiz M , Astudillo R , Ordi J , Torné A , del Pino M 
Published: August 2016

ObjectiveTo evaluate whether colposcopic measurement of the lesion size at diagnosis and/or human papillomavirus (HPV) genotyping can predict the absence of dysplasia in a large loop excision of the transformation zone (LLETZ) specimen in women treated for squamous intraepithelial lesions/cervical intraepithelial neoplasia (SIL/CIN).DesignProspective observational study.SettingTertiary university hospital.PopulationA cohort of 116 women who underwent LLETZ because of biopsy‐proven low‐grade SIL/CIN that had persisted for 2 years, or because of a high‐grade SIL/CIN diagnosed in the referral visit and squamocolumnar junction completely visible (types 1 or 2, according to the International Federation of Cervical Pathology and Colposcopy, IFCPC).MethodsAfter LLETZ the women were classified by histology into the study group (absence of SIL/CIN in the surgical specimen, 28/116, 24.1%) and the control group (SIL/CIN in the LLETZ specimen, 88/116, 75.9%).Main outcome measuresThe size of the lesion determined in the diagnostic colposcopy and the HPV genotype were evaluated in all women.ResultsThe lesion size was significantly smaller in the study group (25.7 ± 37.8 versus 84.5 ± 81.7 mm2; P < 0.001). A lesion size of ≤12 mm2 and HPV types other than 16 or 18 were associated with an absence of SIL/CIN in the LLETZ specimen (P < 0.001 and P = 0.016, respectively). On multivariate analysis only a lesion size of ≤12 mm2 predicted the absence of SIL/CIN (odds ratio, OR 10.6; 95% confidence interval, 95% CI 3.6–30.6; P < 0.001). A lesion size of ≤12 mm2 had a specificity of 90.9% (95% CI 83.0–95.3%) and a negative predictive value of 86.0% (95% CI 77.5–91.6%) to predict the absence of SIL/CIN in the surgical specimen.ConclusionsSmall lesion size in diagnostic colposcopy could predict the absence of SIL/CIN in the LLETZ specimen. Colposcopy measurement of lesion size prior to LLETZ may avoid unnecessary treatment.Tweetable abstractSmall lesion size in colposcopic evaluation might predict the absence of SIL/CIN in an LLETZ specimen.
Transversus abdominis plane block or intravenous lignocaine in open prostate surgery: a randomized controlled trial
Authors: Maquoi I. , Joris J. L. , Dresse C. , Vandenbosch S. , Venneman I. , Brichant J.‐F. , Hans G. A. 
Published: August 2016

Background and ObjectivesTransversus abdominis plane block (TAP) and intravenous lignocaine are two analgesic techniques frequently used after abdominal surgery. We hypothesized that these two techniques improve post‐operative analgesia after open prostate surgery and sought to compare their efficacy on immediate post‐operative outcome after open prostate surgery.MethodsAfter ethics committee approval, 101 patients were enrolled in this prospective study and randomly allocated to receive bilateral ultrasound‐guided TAP (n = 34), intravenous lignocaine (n = 33) or placebo (n = 34). In addition, intravenous paracetamol was given every 6 h. The primary endpoint was the cumulative opioid consumption during the first 48 post‐operative hours (median[IQR]). Secondary endpoints included pain scores at rest and upon coughing, need for rescue tramadol, incidence of post‐operative nausea and vomiting (PONV), recovery of bowel function and incidence of bladder catheter‐related discomfort.ResultsCumulative piritramide consumption after 48 h was 28 [23] mg in the control group, 21 [29] mg in the TAP group and 21 [31] mg in the lignocaine group (P = 0.065). There was no significant difference in post‐operative pain scores between groups. The proportions of patients requiring rescue tramadol, experiencing PONV or bladder catheter‐related discomfort were similar in each group. Recovery of bowel function was also similar in the three groups.ConclusionsOur study suggests that TAP block and intravenous lignocaine do not improve the post‐operative analgesia provided by systematic administration of paracetamol after open prostatectomy.