bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distance Education: A Unique Blend of Technology and Pedagogy to Train Future Special Educators
Authors: Johnson Marilyn Kay , Amundsen Cheryl 
Published: January 2017

The geographical distances in Alaska create a unique educational challenge that is shared by other areas in the world. A three-year project at the University of Alaska, Anchorage attempted to integrate the author's experiences in Alaska with the growing technology available in the state. Potential students in regions hundreds of miles away from an on-campus program were able to participate in a graduate level certification program maintaining the same accreditation standards as the on-campus program. The same faculty served both the on-campus and off-campus program employing video production, audioconferencing, audio cassettes and printed materials. Distance teacher education programs need to consider individual student needs such as preparation, motivation and resource assistance. Good instructional practices should be considered along with the potential of technology in order to produce quality programs.
Selective Facial Neurectomy for Spastic Disorders of the Facial Nerve
Authors: Spector Gershon J. 
Published: January 2017

Selective facial neurectomy in combination with bilateral musculocutaneous resection, plication brow lift, upper lid blepharoplasty, and limited rhytidectomy was performed on 18 patients with essential blepharospasm, eight with hemifacial spasm, and two with CNS vascular compression malformations. Microscopy showed the nerve tissues to be normal. Initial results were excellent. At 3 months there was a slight, persistent spastic twitching of the affected muscles in five nerves (a 14% failure rate in correcting blepharospasm). After 13 months there were four additional failures resulting from nerve regrowth in three and from one patient not completing therapy. The overall blepharospasm failure rate was 26%. On repeat neurectomy those with nerve regrowth presented with a diffuse, fine meshwork of nerve fibers reinnervating the mimetic facial musculature. In six of seven patients operated on again, spasticity was eliminated. The initial surgical failure rate has been corrected by resecting the frontal branch and the superior division of the buccal branch of the facial nerve. Only repeat neurectomy can correct long‐term failures resulting from facial nerve regrowth.
Neck dissection with or without postoperative radiotherapy in supraglottic carcinomas
Authors: Suárez Carlos , Llorente Jose Luis , Nuñez Faustino , Diaz Celso , Gomez Justo 
Published: January 2017

A retrospective review of 302 previously untreated patients with primary supraglottic carcinoma was undertaken to ascertain the efficacy of postoperative radiotherapy. The 302 patients underwent a total of 383 functional neck dissections and 45 classic radical neck dissections. Pathological examination revealed nodal involvement in 117 patients (39%). In the histologically N0 group, the incidence of contralateral neck recurrence when a unilateral neck dissection and postoperative radiotherapy were carried out was 8%, rising 21% when no postoperative radiation was given. There was no difference in the ipsilateral recurrence rate in the N0 group, radiated patients (3%) and nonradiated patients (2%). Similar figures were found in the N1 group. Bilateral functional neck dissection in histologically N0, N1, and N2 necks had similar recurrence rates with or without radiotherapy. Distant metastasis appeared in 10% of N0 patients and in 35% of N3 patients. Patients who received postoperative radiotherapy showed a significantly higher rate of distant metastasis (21%) than patients who did not (8%). The number of involved lymph nodes had no relevance both in neck recurrence and distant metastasis.
Enlargement of the cochlear aqueduct: Fact or fiction?
Authors: Jackler Robert K. , Hwang Peter H. 
Published: January 2017

Enlargement of the cochlear aqueduct (CA) is often mentioned in the otologic literature, usually in its purported association with sensory hearing loss, stapes gusher, and transotic cerebrospinal fluid leak. In CT scans of 100 ears, the diameter of the CA medial aperture was found to be highly variable, ranging from 0 to 11 mm, with a mean of 4.5 mm. In contrast, the otic capsule segment was very narrow in every case. It could be visualized in only 56% of cases, none of which exceeded 2 mm in diameter. Several published reports of supposed CA enlargement presented images of a dilated medial aperture that was well within the range of normal variability according to the present study. In a thorough review of the literature on radiology of the CA, we were unable to find a single published image that convincingly demonstrated enlargement of the otic capsule portion. As radiographic CA enlargement has not been convincingly reported to date, it appears to be an exceedingly rare or perhaps even nonexistent malformation. It is important to recognize than even a radiographically normal CA may be hyperpatent. It is theoretically possible for increased fluid flow to result from either deficiencies in intraluminal membrane baffles or subtle canal enlargement beneath the resolution limits of CT scanning. However, as fluid flow through a tube is regulated by its narrowest point, It is extremely improbable that stapes gusher, transotic CSF leak, and vigorous perilymphatic fistula are generated by the CA when CT scans show any portion of it to be very narrow. A substantial body of evidence points to a deficient partition between the internal auditory canal and inner ear as causative in such cases. We propose that the criteria for the diagnosis of CA enlargement on high‐resolution CT scan be a diameter exceeding 2 mm throughout its course from the posterior fossa to the vestibule.
Preoperative differentiation between meningioma of the cerebellopontine angle and acoustic neuroma using MRI
Authors: Lalwani Anil K. , Jackler Robert K. 
Published: January 2017

Preoperative differentiation between acoustic neuroma (AN) and meningioma of the cerebellopontine angle (CPA) is important in selection of the surgical approach, successful tumor removal, and preservation of hearing and facial nerve. We retrospectively reviewed the magnetic resonance imaging (MRI) findings associated with 30 meningiomas involving the CPA (MCPA) encountered between 1987 to 1991 at the University of California, San Francisco. Magnetic resonance imaging was critical in differentiating meningioma from AN in the CPA. Typical findings on MRI associated with MCPA, differentiating them from ANs, Include: Meningiomas are sessile, possessing a broad base against the petrous face, whereas ANs are globular; they are often extrinsic and eccentric to the internal auditory canal (IAC); when involving the IAC, they usually do not erode the IAC; MCPAs demonstrate hyperostosis of the subjacent bone and possess intratumoral calcification; they involve adjacent intracranial spaces and structures; and meningiomas are characterized by a distinctive dural “tail” extending away from the tumor surface. While any one finding may not be diagnostic by itself, taken together the constellation of these findings is strongly Indicative of meningioma. In our experience, MRI with gadolinium enhancement was able to distinguish MCPA from AN in nearly every case.
High‐powered automobile stereos
Authors: Ramsey Kent L. , Simmons F. Blair 
Published: January 2017

We measured the owner‐adjusted acoustic outputs of 10 automobile stereo systems, with power ratings ranging between 150 and 600 watts. The sound levels ranged from 107 to 138 dB SPL and 84 to 108 dBA. Most of the high‐Intensity sound was in the 31, 62, and 125 Hz center‐frequency octave bands. The mean computed noise dose, based on the vehicle owners' reported dally duration of exposure, was 108.5%. While there is clearly a risk of hearing damage in the extreme cases according to OSHA standards, the typical listening durations claimed by the stereo owners would seem to lower the risk for the majority to acceptable margins for the automobiles measured.
The Threshold of Sensation for Infrasound
Authors: Nagai Naoko , Matsumoto Kenji , Takeuchi Hiroichi , Takeda Shintaro 
Published: January 2017

Measuring apparatus was developed to examine the threshold of sensation for whole body exposure to infrasound in a closed chamber, in which pure tone and white noise were produced in the infrasound range. By use of this apparatus, the thresholds of sensation were measured for 62 subjects. The threshold for pure tones rises with decreasing frequency with a slope of −16 dB/octave above 10 Hz and – 2 dB/octave below 10 Hz. The threshold of sensation for white noise, converted into spectrum level, shows a similar pattern for all the subjects with slope of −19 dB/octave. Some subjects respond sensitively for pure tones below 10 Hz. It is suggested that they react in response to a sensation, such as a pressure sensation, other than the sense of hearing. It is also suggested that if those subjects were to become more sensitive, their thresholds of sensation would show similar patterns to those already reported in Japan.
A Continuum Vibrational Analysis for a Tetrahedral Space Platform
Authors: Hollaway L , Farhan A. , Gunn M.J. 
Published: January 2017

Antennas over 50 metres diameter are being considered for use in land mobile communication systems. As the satellite in geostationary orbit has an angular velocity equal to that of the earth, no tracking systems are necessary and low cost fixed ground antennas can be used. In addition, a typical early truss platform could possibly be a geostationary communication one of size up to 300m × 300m. In this paper structural stiffness, strength and dynamic characteristics of large skeletal frameworks for space applications are investigated by analysing the tetrahedral truss which is idealised as an equivalent continuum. Appropriate analytical relationships are presented in terms of the truss member properties which are taken as slender graphite/polyethersulphone composites. Fundamental and harmonic frequencies have been calculated and have been compared with those from a finite element skeletal analysis and a finite element plate analysis. It has been shown that the results of the simplified analysis technique are accurate to within 10 per cent of those of the analytical solutions provided the system is both large and flexible. In addition, the analysis provides a simple methodology for the preliminary assessment of vibration frequencies for large space structures.
Categorisation of tibial artery disease on computer tomography angiography according to the TASC II classification
Authors: Rehman Adeeb , Antonietti Alberto , Burnside Girvan , Torella Francesco 
Published: January 2017

Purpose Computer tomography angiography is used to assess peripheral arterial disease. Its preference over other imaging modalities is based upon its rapid acquisition and high spatial resolution, along with ease of access. TASC II have recently updated their vascular lesion classification to include infrapopliteal lesions, and our aim is to assess the reproducibility of TASC II on infrapopliteal disease when using computer tomography angiography. Methods A retrospective analysis of a series of consecutive computer tomography angiographies was performed by seven assessors (three consultant radiologists, two consultant vascular surgeons and two vascular specialty trainees). Each assessor was asked to classify the target vessel based on the TASC II classification. Statistical analysis was performed using Cohen’s weighted kappa. Results Seven assessors analysed 48 target vessels in 25 patients (20 men), with a mean age of 72.9 years. Twenty posterior tibial, 27 anterior tibial and one peroneal artery were analysed. Poor agreement was demonstrated between the two vascular consultants, with a kappa of 0.094. Weak agreement was demonstrated among the radiologists, with a kappa of 0.547. The total group of assessors had a kappa of 0.176. Conclusion This study showed poor agreement between assessors when applying the TASC II classification to infrapopliteal lesions on computer tomography angiography. TASC II should not be used to classify lesions, for clinical or research purposes, with this image modality.
A comparison of magnetic resonance venography findings and venous occlusion plethysmography variables in postthrombotic syndrome
Authors: Blomgren Lena , Engström Jan , Rosfors Stefan 
Published: January 2017

Objective The relation between venous morphology and venous function in postthrombotic syndrome is poorly understood. The aim of this study was to compare obstruction and collateralization as seen with magnetic resonance venography with variables of venous occlusion plethysmography in patients with postthrombotic syndrome. Methods Medical records, magnetic resonance venography and venous occlusion plethysmography data were analyzed in 28 patients (33 legs). Magnetic resonance venography images were scored for degree of obstruction and collateralization in segments of pelvic and abdominal veins and correlated to venous occlusion plethysmography data. Results Obstruction of the inferior vena cava correlated with an overall increase of collaterals ( p < 0.001). The summary scores of collaterals or obstructions did not correlate with venous occlusion plethysmography variables. Relative expelled volume at 4 s correlated inversely with obstruction of the inferior vena cava ( p = 0.045) and vertebral collateralization ( p = 0.033). Conclusions Modest correlations were found between magnetic resonance venography scores and venous occlusion plethysmography variables. Prospective studies with refined scoring and magnetic resonance venography techniques may increase our knowledge further.
Systematic review and meta-analysis of endovascular treatment for acute mesenteric ischaemia
Authors: El Farargy Marawan , Abdel Hadi Ahmed , Abou Eisha Mohamed , Bashaeb Khalid , Antoniou George A 
Published: January 2017

Introduction Acute mesenteric ischaemia is associated with a significant morbidity and mortality. Endovascular techniques have emerged as a viable alternative treatment option to conventional surgery. Our objective was to conduct a systematic review of the literature and perform a meta-analysis of reported outcomes. Methods Our review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards and the protocol was registered in PROSPERO (CRD42016035667). We searched electronic information sources (MEDLINE, EMBASE, CINAHL, CENTRAL) and bibliographic lists of relevant articles to identify studies reporting outcomes of endovascular treatment for acute mesenteric ischaemia of embolic or thrombotic aetiology. We defined 30-day or in-hospital mortality and bowel resection as the primary outcome measures. We used the Newcastle–Ottawa scale to assess the methodological quality of observational studies. We calculated combined overall effect sizes using random effects models; results are reported as the odds ratio and 95% confidence interval. Results We identified 19 observational studies reporting on a total of 3362 patients undergoing endovascular treatment for acute mesenteric ischaemia. The pooled estimate of peri-interventional mortality was 0.245 (95% confidence interval 0.197–0.299), that of the requirement for bowel resection 0.326 (95% confidence interval 0.229–0.439), and the pooled estimate for acute kidney injury was 0.132 (95% confidence interval 0.082–0.204). Eight studies reported comparative outcomes of endovascular versus surgical treatment for acute mesenteric ischaemia (endovascular group, 3187 patients; surgical group, 4998 patients). Endovascular therapy was associated with a significantly lower risk of 30-day mortality (odds ratio 0.45, 95% confidence interval 0.30–0.67, P = 0.0001), bowel resection (odds ratio 0.45, 95% confidence interval 0.34–0.59, P < 0.00001) and acute renal failure (odds ratio 0.58, 95% confidence interval 0.49–0.68, P < 0.00001). No differences were identified in septic complications or the development of short bowel syndrome. Conclusion Endovascular treatment for acute mesenteric ischaemia is associated with a considerable mortality and requirement of bowel resection. However, endovascular therapy confers improved outcomes compared to conventional surgery, as indicated be reduced mortality, risk of bowel resection and acute renal failure. An endovascular-first approach should be considered in patients presenting with acute mesenteric ischaemia.
Provisional Coding Practices: Are They Really a Waste of Time?
Authors: Krypuy Matthew , McCormack Lena 
Published: January 2017

In order to facilitate effective clinical coding and hence the precise financial reimbursement of acute services, in 2005 Western District Health Service (WDHS) (located in regional Victoria, Australia) undertook a provisional coding trial for inpatient medical episodes to determine the magnitude and accuracy of clinical documentation. Utilising clinical coding software installed on a laptop computer, provisional coding was undertaken for all current overnight inpatient episodes under each physician one day prior to attending their daily ward round. The provisionally coded episodes were re-coded upon the completion of the discharge summary and the final Diagnostic Related Group (DRG) allocation and weight were compared to the provisional DRG assignment. A total of 54 out of 220 inpatient medical episodes were provisionally coded. This represented approximately a 25% cross section of the population selected for observation. Approximately 67.6% of the provisionally allocated DRGs were accurate in contrast to 32.4% which were subject to change once the discharge summary was completed. The DRG changes were primarily due to: disease progression of a patient during their care episode which could not be identified by clinical coding staff due to discharge prior to the following scheduled ward round; the discharge destination of particular patients; and the accuracy of clinical documentation on the discharge summary. The information gathered from the provisional coding trial supported the hypothesis that clinical documentation standards were sufficient and adequate to support precise clinical coding and DRG assignment at WDHS. The trial further highlighted the importance of a complete and accurate discharge summary available during the coding process of acute inpatient episodes.
Selective Serotonin-Reuptake Inhibitors in Premenstrual Dysphoric Disorder
Authors: Barcelona Irma G , Mauro Laurie S 
Published: January 2017

Objective: To briefly review the symptoms of premenstrual syndrome (PMS), late luteal-phase dysphoric disorder (LLPDD), and premenstrual dysphoric disorder (PMDD); summarize the physiologic relationship between serotonin and these disorders; and review the available clinical information on the role of selective serotonin-reuptake inhibitors (SSRIs) in the treatment of LLPDD/PMDD. Data Sources: A MEDLINE search for English-language journal articles published between 1966 and August 2000 was performed, with the following keywords: serotonin reuptake inhibitors, fluoxetine, sertraline, or paroxetine matched with premenstrual syndrome, late luteal-phase dysphoric disorder, or premenstrual dysphoric disorder. Data Selection and Extraction: All English-language clinical studies of SSRIs for LLPDD/PMDD were included. Study design, population, methods, clinical outcomes, and adverse effects were evaluated. Data Analysis: Continuous therapy with SSRIs, particularly fluoxetine and sertraline, is beneficial in the pharmacotherapy of LLPDD/PMDD. Response rates vary, but are generally near 65% for global clinical outcomes. Both behavioral and physical symptoms are improved. Studies as long as 18 months have demonstrated continued benefit with SSRI therapy. Recent literature suggests that intermittent therapy with these agents, only during the luteal phase, may provide benefits similar to those achieved with continuous therapy in selected patients. Conclusions: The SSRIs, particularly fluoxetine and sertraline, are useful in the pharmacotherapy of LLPDD/PMDD.
Acute Valproic Acid Poisoning in Young Children
Authors: Lifshitz Matityahu , Gavrilov Vladimir 
Published: January 2017

Objective: To assess the signs and symptoms of acute valproic acid (VPA) overdose in young children. Methods: The medical records of previously healthy children admitted to the pediatric department for accidental acute VPA poisoning during the years 1995–1999 were evaluated retrospectively. Information was retrieved on serum VPA concentrations, signs and symptoms on admission and during hospitalization, electrocardiography findings, and laboratory tests. Results: All 16 children included in the study were in the age range of two to six years. In 13 cases, the drug had been intended for use by a family member and was ingested accidentally by the child. Three children were receiving VPA to treat a seizure disorder and had an adverse reaction due to unintentional overdose. For four children, a diagnosis of VPA poisoning was not made on admission because of inadequate history and was revealed only on toxicology screening. Drowsiness occurred in all the children, hypotonia in 11, ataxia in eight, miosis in six, and mild hypernatremia in five. Only two children had mildly elevated hepatic enzymes. The peak VPA serum concentrations in the study group ranged from 128 to 142 μg/mL (mean ± SD 135 ± 4.25; therapeutic range 50–100). Conclusions: Drowsiness was the most common symptom in young children with mild to moderate VPA poisoning. Other symptoms included hypotonia, ataxia, and miosis. A third of the patients had hypernatremia, most probably due to VPA formulated as sodium valproate. Unlike in cases of chronic toxicity, hepatic damage was not a characteristic finding.
Risk of Adverse Drug Events Related to Ibuprofen Use in a Community Sample
Authors: Nykamp Diane , Barnett Candace W. , Hooper Celynda 
Published: January 2017

Objective: To determine whether consumers are using nonprescription ibuprofen more predominantly to treat acute or chronic conditions, incidence of adverse effects, and whether a healthcare professional is providing patient information. Design: A questionnaire was developed and placed in 15 randomly selected community pharmacies in a major metropolitan area. Adult consumers who were purchasing an ibuprofen over-the-counter product or who had previously used an ibuprofen product were asked to complete a written questionnaire (n=190). The information collected included age, gender, prescription, and other over-the-counter drugs presently used, quantity, duration, present illnesses or conditions, both intended and past use of ibuprofen, and incidence of adverse reactions. Results: Most subjects who self-treated with ibuprofen were female (70.8 percent) with a mean age of 37 years. Consumers generally used ibuprofen for stress/tension headache (38.9 percent), menstrual cramps (34.2 percent), generalized pain (31.8 percent), or muscle strain/sprain (30.0 percent). Most (55.9 percent) took 400 mg when needed, and 42.2 percent used ibuprofen for a period of 24 hours. Counseling concerning ibuprofen use was provided by a physician (42.9 percent) or pharmacist (39.7 percent) in most cases. The label was read the majority of the time (75 percent), and everyone who read the label understood the printed information. Conclusions: The findings indicate that this community sample of consumers was using nonprescription ibuprofen appropriately for acute or as needed conditions over a short period of time. They experienced few adverse reactions to ibuprofen. Both pharmacists and physicians were providing patient information about ibuprofen. Counseling is needed regarding prescription and nonprescription drugs with a potential to interact with ibuprofen.