bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Exertional Compartment Syndrome
Authors: Hislop Matthew , Tierney Paul , Murray Pairic , O'Brien Moira , Mahony Nick 
Published: July 2017

Background The existence of a “fifth” compartment in the leg capable of developing distinct chronic exertional compartment syndrome remains a subject of controversy. Hypothesis Specific pressure recordings and dissection will confirm or disprove the existence of a fifth compartment. Study Design Empirical anatomic study. Methods Radiopaque dye was injected directly into the tibialis posterior muscle of 25 embalmed cadaveric legs while intracompartmental pressure was monitored. Radiographs demonstrated dye distribution, and dissection-documented fascial and epimysial layers. Results Evidence was found that the fibular origin of the flexor digitorum longus muscle, when present, could create subcompartments within the deep posterior compartment. The nature of this attachment varied from being absent, to small (<8 cm), to extensive (>8 cm). The attachment partially covered the tibialis posterior muscle in the majority of the 14 legs that developed high pressures, and it was limited or absent in the 11 legs that did not. Radiographs demonstrated that the dye was confined to the tibialis posterior muscle in four legs. Conclusions No consistent fifth compartment exists in the leg; however, subcompartments within the deep posterior compartment created by the fibular origin of the flexor digitorum longus muscle may develop pressures congruent with chronic exertional compartment syndrome. Clinical Relevance Potential deep posterior subcompartments demand accurate pressure investigation. A modified technique to decompress the entire deep posterior compartment, including the tibialis posterior muscle, is necessary for successful treatment of chronic exertional compartment syndrome.
Injury Rates in Rugby League Football: Impact of Change in Playing Season
Authors: Gissane Conor , Jennings De , Kerr Kathleen , White John 
Published: July 2017

Background In 1996, the professional rugby league moved its playing season from the autumn and winter months to the spring and summer. Purpose To determine whether the change in playing season altered the risk of player injury. Study Design Prospectively collected data comparing two cohorts. Methods Injuries incurred by all players in one club during match play were recorded over 9 seasons: 4 winter (138 games) and 5 summer (144 games). Each injury was classified according to site, type, player position, activity at the time of injury, and number of games missed as a result of injury. Results The total exposure time during this study was 4876 player-hours (winter, 2386, summer, 2490). The relative risk of injury doubled after the move from winter to summer. Winter rugby accounted for 72 injuries, and summer rugby, for 150 injuries. Conclusions Risk of injury to players in a professional rugby league club greatly increased as a result of changing the playing calendar, possibly as a result of environmental factors. However, other factors, such as increased conditioning levels, which have been a direct consequence of players moving to full-time professionalism, may have increased injury potential.
Children's Persistence with Methylphenidate Therapy: A Population-Based Study
Authors: Miller Anton R , Lalonde Christopher E , McGrail Kimberlyn M 
Published: July 2017

Objective: To examine persistence with methylphenidate (MPH) therapy among children and youth in the general population. Method: We conducted a retrospective analysis of longitudinally organized, individual-specific anonymous data from linked prescription and health databases covering the population of British Columbia for 1990 through 1996. No prescriptions being filled for 4 months indicated cessation of one bout of therapy. Results: Among 16 945 identified MPH patients aged 19 years or under, overall duration of therapy was 584 days, and the average number of prescriptions received was 6.6. One-third of patients received 2 or fewer prescriptions, while 18% followed a chronic, continuous course. Among patients receiving more than 2 prescriptions, 50% of discrete therapy bouts lasted 4 months or less, and one-third of cases had multiple bouts of therapy (range 2 to 6 bouts). Younger age (that is, children aged 0 to 8 years, vs those aged 10 to 19 years), male sex, and receipt of initial prescription from a psychiatrist were associated with greater persistence. Conclusions: Enormous variability in persistence with MPH therapy and often-occurring low rates of persistence raises questions about the diligence with which MPH patients are selected, prepared, and followed in the general population. Special attention to the needs of older children and to the needs of girls is required, and discontinuities during children's therapy courses require explication.
One-Year Prevalence of Psychiatric Disorder in Ontarians 15 to 64 Years of Age
Authors: Offord David R , Boyle Michael H , Campbell Dugal , Goering Paula , Lin Elizabeth , Wong Maria , Racine Yvonne A 
Published: July 2017

Objective: To present the one-year prevalence of 14 psychiatric disorders in a community sample of Ontarians aged 15 to 64 years. Method: Data on psychiatric disorders were collected on 9953 respondents using the University of Michigan revision of the Composite International Diagnostic Interview (UM-CIDI). DSM-III-R criteria were used to define the psychiatric disorders. Results: Almost 1 in 5 Ontarians (18.6%) had one or more of the disorders measured in the survey. Among 15- to 24-year-olds, 1 in 4 was affected. The distribution of individual disorders varied by sex and age. Conclusion: Because of the immense burden of suffering associated with psychiatric disorders, clinical and research efforts in this area should receive high priority within the health budget.
Factors Affecting Medical Students' Selection of Canadian Psychiatric Residency Programs: Part II—Some Contemporary Issues
Authors: Leverette John , Massabki Albert , Peterson Heather 
Published: July 2017

Objective: The presence of a national cohort of trainees entering psychiatric residency allowed an assessment of contemporary factors influencing their particular program choices. Factors of specific interest included the effect on program choice of relationships with significant others and government attitudes to fiscal restraint, mental health care reform, and licensure. Method: A self-administered questionnaire was sent to 110 trainees identified in the 16 Canadian university departments of psychiatry who began training in July 1994. Results: While a committed relationship was a primary determinant of program choice, government policies attempting to influence patterns of care had little effect. Conclusion: A strong commitment to undergraduate teaching will improve the attractiveness of psychiatry as a career. This must include exposure of students to teachers who mentor practice patterns attuned to provincial mental health reforms, since government initiatives alone, developed to promote desired transitions in psychiatric care, will not influence training program choice.
Micro-Dependency: The Cuban Factor in Southern Africa
Authors: Mazrui Ali A. 
Published: July 2017

We accept the proposition that the worst kind of dependency lies in North-South interaction. But emphasizing this dimension should not go to the extent of ignoring other dimensions. It is simply not true that all forms of international dependency concern interactions between the Northern Hemisphere and the South, or between industrialism and sources of raw materials. There are important forms of dependency among industrialized nations themselves. Increasingly, there are also forms of dependency between one country in the Third World and another; or between one region of the Third World and another. Dependency is a form of political castration. For the purposes of this essay, dependency between one country in the Northern Hemisphere and another or between one industrialized state and another, is categorized as macro-dependency. This involves variations in power within the upper stratum of the world system. Macro-dependency is thus upper-horizontal, involving variations in affluence among the affluent, or degree of might among the mighty. Micro-dependency for our purposes here concerns variations of technical development among the under-developed, or relative influence among the weak, or degrees of power among those that are basically exploited. The dependency of some West African countries upon Nigeria, or of some of the Gulf States upon Iran or Saudi Arabia, are cases of micro-dependency. We shall return to this level more fully later, but let us first begin with the phenomenon of macro-dependency.
The Future of the American Party System
Authors: Gilmour C. Edwin 
Published: July 2017

A central theme of contemporary literature on American political parties—a theme with a broad consensus that is uncommon in the discipline—is that the party system of the United States is in transition due to significant changes within the past two decades that distinguish the operation of today's party system from what it was before 1960. However, consensus is lacking as to the implications of these changes for the future status of the American party system. This paper has four broad objectives: 1. to review briefly the phenomenon of party re-alignment in American history as a useful perspective on the present party era; 2. to identify and discuss significant alterations in the party system since 1960 ; 3. to note various scenarios in the literature concerning the future of the parly system in ‘the United States and 4. to hazard a personal assessment of the scenarios as to their plausibility and probability.
The Role of Dornase Alfa in the Treatment of Cystic Fibrosis
Authors: Cramer Gena W , Bosso John A , Maldonado Wanda T , Guévremont Chantal 
Published: July 2017

Objective To review the current utility and proper role of dornase alfa (recombinant human DNase or rhDNase), which has been approved for use in cystic fibrosis. Several aspects related to these issues are addressed including the drug's mechanism of action, administration and dosing, and clinical safety and efficacy. We also critically examine the agent's role in the treatment of cystic fibrosis and consider the controversies involved with its use. data source A MEDLINE search was conducted to identify pertinent literature, including review articles and clinical trials. Study Selection Studies examining the efficacy and safety of dornase alfa in patients with cystic fibrosis. Data Extraction Results from published, prospective, randomized trials are presented and critiqued. Data Synthesis Production of viscous respiratory secretions is a hallmark phenomenon of cystic fibrosis, leading to a variety of symptoms. Dornase alfa targets this symptom and decreases the viscosity of these secretions. Clinical trials have indicated a small but statistically significant improvement in forced expiratory volume in 1 second and forced vital capacity. Enhancement in a patient's dyspnea and quality of life has varied between the trials, with few of the studies noting no statistically significant improvement. Adverse reactions are minimal and did not result in any patient withdrawals from the trials. A positive impact on infection rates, length of hospitalization, and need for intravenous antibiotic therapy was noted in one trial. However, reports of similar results have not yet been published, and thus the clinical significance or impact of this phenomenon is not fully understood. Moreover, results of more long-term use and in patients whose conditions are less stable have yet to undergo the scrutiny of peer/editorial review. Administration of the drug, which must be maintained continuously, is relatively expensive. Conclusions Dornase alfa appears to produce small but sustained improvements in lung function in patients with cystic fibrosis. It may also slow the progression of pulmonary disease. Infection rates appear to be reduced, which may well have important long-term consequences. However, evidence to date has not clarified the most appropriate use of dornase alfa in the treatment of cystic fibrosis. Whether quality of life is affected in a meaningful and measurable way is yet to be clarified. A trial of the drug in patients with cystic fibrosis who have obvious lung disease is reasonable, but continued treatment should be based on clear clinical response. Therefore, questions about the drug's exact role in the overall management of cystic fibrosis remain to be answered. Although benefits received may not prove to be cost-effective, long-term effects on disease progression may well justify use of this agent.
Steady State Average Evoked Potentials as a Measure of Tracking Difficulty
Authors: Wilson Glenn F. 
Published: July 2017

The utility of steady state average evoked potentials (AEPs) to measure the difficulty of a tracking task will be reported. Medium (14 Hz) and high (50–56 Hz) frequency sine wave modulated light was used to evoke steady state AEPs while subjects performed a tracking task. Three levels of difficulty, based upon each subject's ability, were used in the single axis visual tracking task. The phase lag between stimulus input and the AEP waveform was found to be significantly related to task difficulty. Increasing difficulty levels were associated with greater amounts of phase lag of the AEPs during the high frequency stimulation. Neither the phase lag nor the amplitude of the medium frequency AEPs were significantly affected by the level of tracking difficulty. Each subject was found to have one particular frequency of stimulation in the high range which produced an enhanced AEP amplitude. This suggests that researchers using high frequency stimulation with sine wave modulated light should test each subject to find the frequency which produces the maximal amplitude.
Maintenance and Testing Errors in Nuclear Power Plants: A Preliminary Assessment
Authors: Adams S. Keith , Sabri Zeinab A. , Husseiny Abdo A. 
Published: July 2017

Safety and reliability in the operation of nuclear power plants have been topics for intense analysis and debate in recent years. Once crucial factor which has received little attention until very recently, is human reliability in the operation, maintenance and testing of nuclear plants. Maintenance and testing errors are of particular importance in that, despite the fact that they are relatively few in number compared with hardware related events, their occurrence programs the system for future operator errors bv introducing erroneous data in operator-hardware system communication or by eliminating a portion of that communication. Erroneous data or a lack of anticipated feedback following control actions by the operator can tend to cause further inappropriate responses and to escalate the frequency of operator errors. Such effects are most undesirable during emergencies. A number of improvements based upon improved human factors engineering will be necessary to eliminate maintenance errors of the type encountered in this study. These include: standardization of design for given types of subsystems, standardization of maintenance operations, work simplification involving both physical and psychological aspects of maintenance work, the use of training simulators to increase the amount of practice in performing maintenance operations, automanual control to show predicted outcome of results, assignment of individual responsibility and accountability to specific hardware subsystems, measures of job performance against some criterion, programmed instruction, improved divisions of responsibility among maintenance, operating and technical personnel, and improved management practices.
Preferred Height and Angle Settings of Crt and Keyboard for a Display Station Input Task
Authors: Miller Irwin , Suther Thomas W. 
Published: July 2017

This study investigated the display station physical adjustments preferred by a sample of visual display terminal (VDT) operators preselected to span the 5th, 50th, and 95th percentiles in physical stature with respect to United States or Japanese anthropometric surveys. Thirty-seven operators were taken individually through a step-by-step sequence to determine their preferred adjustments of seat height, keyboard height and slope angle, and CRT height and tilt angle. Each operator then performed a brief transcription task. Measurements corresponding to the final preferred height and angle adjustments do not agree with some currently evolving German ergonomic display station requirements. In addition, intermeasure correlations strongly suggest that “flat” (low slope angle) keyboards are inappropriate for operators who select low seat heights and are short in stature.
Immunohistochemical Analysis of the Stem Cell Marker LGR5 in Pediatric Liver Disease
Authors: Khan Zahida , Orr Anne , Michalopoulos George K , Ranganathan Sarangarajan 
Published: July 2017

Aims In regenerating liver, hepatic progenitor cells (HPCs) are recruited in response to injury; however, few highly specific human HPC markers exist for the hepatocyte lineage. Leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5), a Wnt-associated stem cell marker, has been extensively studied in intestinal stem cells, but little is known about its expression in human liver. We hypothesized that LGR5+ HPCs are induced in the regenerative response to pediatric liver injury. Methods and results Immunohistochemistry was used to characterize LGR5 expression in pediatric liver explants (n = 36). We found cytoplasmic LGR5 expression in all cases; although, much less was observed in acute hepatic necrosis compared to chronic liver diseases. In the latter cases, >50% of hepatocytes were LGR5+, signifying a robust regenerative response mainly in the periphery of regenerative nodules. Only weak LGR5 staining was noted in bile ducts, suggesting hepatocyte-specific expression at the interface. Conclusions Although we observed some degree of regenerative response in all cases, LGR5 was highly expressed in chronic liver disease, possibly due to alternate regeneration and reprogramming pathways. LGR5 is predominant in peri-septal hepatocytes rather than epithelial cell adhesion molecule (EpCAM) positive ductular reactions in chronic pediatric liver diseases and may represent a transitional HPC phenotype for the hepatocyte lineage. These studies are the first to support a unique role for LGR5 in human hepatocyte regeneration and as a potential predictive biomarker for recovery of liver function in children. Future work will also investigate the molecular mechanisms behind LGR5 expression.
Negligent performance of bilateral carpal tunnel
Authors: Stephensons  
Published: July 2017

‘General damages: £20,000; December 2004; Total Award: £70,000 Negligent performance of bilateral carpal tunnel compression inadequate release of carpal tunnel leading to re-exploration, temporary loss of use of fingers and thumb of left (non-dominant)hand, permanent numbness of two fingers and thumb, increased sensitivity of scar and reduced grip strength.
Telemedicine in the future
Authors: Heinzelmann Paul J , Lugn Nancy E , Kvedar Joseph C 
Published: July 2017

summary Telemedicine can provide a compelling alternative to conventional acute, chronic and preventive care, and can improve clinical outcomes. In the industrialized world, it is likely that telemedicine will continue to move healthcare delivery from the hospital or clinic into the home. In the developing world or in regions with limited infrastructure, telemedicine will mainly be used in applications that link providers based at health centres, referral hospitals and tertiary centres. The future of telemedicine will depend on: (1) human factors, (2) economics and (3) technology. Behaviours related to technology affect change at the individual, organizational and societal level. Personnel shortages and decreasing third-party reimbursement are significant drivers of technology-enabled health care in the industrialized world, particularly in the areas of home care and self-care. We can safely assume that developments in mobile communications, sensor devices and nanotechnology will alter the way that health care is delivered in the future. The growth and integration of information and communication technologies into health-care delivery holds great potential for patients, providers and payers in health systems of the future. Perhaps the most difficult question to answer, however, is ‘When will telemedicine become part of the standard of care?’
Telemedicine for eye care
Authors: Tang Rosa Ana , Morales Marlene , Ricur Giselle , Schiffman Jade S 
Published: July 2017

summary Tele-ophthalmology has been employed mainly for patients in under-served rural areas in need of specialty care, but other applications such as telementoring have also been used. In certain populations, cost containment is a significant issue and telemedicine is a solution. Tele-ophthalmology can be performed in realtime, by store-and-forward mode, or by hybrid techniques. After appropriate modification, a range of peripherals may be used for tele-ophthalmology, including the direct ophthalmoscope, indirect ophthalmoscope, slit lamp or retinal camera. Tele-ophthalmology applications include: detecting, screening and diagnosing diabetic retinopathy; anterior segment imaging; glaucoma screening; low vision consultation; telementoring. Tele-ophthalmology shows great promise for improving patient care and increasing access to specialty care not available in under-served areas. In developing countries tele-ophthalmology may be a cost-effective method by which richer countries can assist them.
Bases for assessments made by telephone advice nurses
Authors: Wahlberg Anna Carin , Cedersund Elisabet , Wredling Regina 
Published: July 2017

summary Telephone advice nursing includes triage, advice, referral, information and coordination. The aim of the study was to explore what telephone nurses base their assessments on. We conducted 14 interviews with seven telephone nurses at a health-care call centre in Sweden. Two authentic calls per nurse were used in stimulated recall interviews, where the nurses commented on the basis for their assessments. A qualitative manifest content analysis was employed. Three major categories emerged in the analysis: care-seeker, e.g. ‘symptomatic sounds’; nurse, e.g. ‘nurse's own experience’; and organization, e.g. ‘health-care accessibility’. The findings show that the telephone advice nurses’ bases for assessments appear to be very broad. They include both verbally and non-verbally communicated information, and care-seeker-, nurse- and certain organization-related factors influence the assessments. We found that an individualistic view of the care-seeker seems to dominate the assessments in non-urgent calls to a health-care call centre.