bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensitivity and specificity of bedside ultrasonography in the diagnosis of fractures of the fifth metacarpal
Authors: Aksay Ersin , Yesilaras Murat , Kılıc Turgay Yılmaz , Tur Feriyde Calıskan , Sever Mustafa , Kaya Ahmet 
Published: October 2013

ObjectivesUltrasonography is becoming increasingly common in the diagnosis of fracture in emergency medicine. The aim of our study was to investigate the diagnostic accuracy of sonographic examinations for diagnosing fifth metacarpal fractures.MethodsA prospective study was performed of consecutive patients aged >14 years admitted to the emergency department with hand trauma and tenderness over the fifth metacarpal. Anteroposterior and oblique plain x-rays were taken on all patients. Emergency physicians performed bedside sonographic examination. The x-rays were reported by an orthopaedic surgeon who was blinded to the sonographic examination findings. The orthopaedic surgeon’s report was considered the gold standard unless a CT scan was performed. In the single case where this occurred, the CT scan report was considered the gold standard.ResultsEighty one patients were included in the study, 39 of whom had fractures. Sonographic examination identified the fractures in 38 patients. One occult fracture undetected by plain radiography, later shown on CT scan, was identified by sonographic examination. There were three cases with false positive ultrasound findings. The sensitivity of the diagnosis of fifth metacarpal fractures by ultrasonography was 97.4% (95% CI 84.9% to 99.9%), specificity was 92.9% (95% CI 79.4% to 98.1%), positive likelihood ratio (LR) was 14 (95% CI 4.58 to 41), negative LR was 0.03 (95% CI 0.00 to 0.19), negative predictive value was 97.5% (95% CI 85.3% to 99.9%) and positive predictive value was 92.6% (95% CI 79% to 98.1%).ConclusionsSonographic examination can be used as an effective diagnostic tool in patients with fifth metacarpal trauma.
Employment predicts decreased mortality among HIV-seropositive illicit drug users in a setting of universal HIV care
Authors: Richardson Lindsey A , Milloy M-J S , Kerr Thomas H , Parashar Surita , Montaner Julio S G , Wood Evan 
Published: October 2013

ObjectiveGiven the link between employment and mortality in the general population, we sought to assess this relationship among HIV-positive people who use illicit drugs in Vancouver, Canada.MethodsData were derived from a prospective cohort study of HIV seropositive people who use illicit drugs (n=666) during the period of May 1996–June 2010 linked to comprehensive clinical data in Vancouver, Canada, a setting where HIV care is delivered without charge. We estimated the relationship between employment and mortality using proportional hazards survival analysis, adjusting for relevant behavioural, clinical, social and socioeconomic factors.ResultsIn a multivariate survival model, a time-updated measure of full time, temporary or self-employment compared with no employment was significantly associated with a lower risk of death (adjusted HR=0.44, 95% CI 0.22 to 0.91). Results were robust to adjustment for relevant confounders, including age, injection and non-injection drug use, plasma viral load and baseline CD4 T-cell count.ConclusionsThese findings suggest that employment may be an important dimension of mortality risk of HIV-seropositive illicit drug users. The potentially health-promoting impacts of labour market involvement warrant further exploration given the widespread barriers to employment and persistently elevated levels of preventable mortality among this highly marginalised population.
Percutaneous sclerotherapy with ethanolamine oleate for lymphatic malformations of the head and neck
Authors: Alexander Matthew David , McTaggart Ryan A , Choudhri Omar A , Marcellus Mary L , Do Huy M 
Published: October 2013

IntroductionLymphatic malformations are low flow congenital lesions that frequently occur in the head and neck, and often require treatment. Multiple therapeutic modalities exist, including percutaneous sclerotherapy, which has been performed successfully with numerous sclerosants. Few data exist on use of ethanolamine oleate to treat lymphatic malformations. This study reports single center results using this agent to treat lymphatic malformations of the head and neck.Materials and methodsProspectively maintained procedural records were retrospectively reviewed to identify all patients with lymphatic malformations who underwent percutaneous sclerotherapy. The Mulliken and Glowacki classification was used to diagnose lymphatic malformations. Medical records and images were reviewed to record demographic information, lesion characteristics, treatment sessions, and clinical and imaging response. Lesions and outcomes were evaluated with both qualitative and quantitative volumetric analysis. Response was assessed after each session and after all sessions in those patients undergoing more than one intervention, and χ2analysis was performed to evaluate the effects of lesion and demographic characteristics on outcomes.Results12 interventions were performed for lesions in 10 patients. No procedural complications occurred following any procedures. Four (40.0%) patients had an excellent result after treatment, which was accomplished in one session for each of these lesions. Four (40.0%) had good results. One (10.0%) had a fair result after three sessions. One (10.0%) patient with an indeterminate syndrome with multiple congenital anomalies had a poor response following treatment. The family decided to withdraw care, and the airway was compromised. Average lesion volume reduction was 28% for all lesions and 42% when excluding the lesion for which future treatments were declined. Purely macrocystic lesions were more likely to have an excellent response to treatment than lesions with both macrocystic and microcystic components.ConclusionsPercutaneous sclerotherapy using ethanolamine oleate to treat lymphatic malformations of the head and neck appears safe and efficacious. This agent should be considered when treating these complex lesions, particularly those that are exclusively macrocystic. Further investigation of such treatments should evaluate this agent alongside the many others currently utilized.
Holocene coastal environments and processes in subantarctic/temperate cold Tierra del Fuego, Argentina-Chile
Authors: Bujalesky G. G. , González Bonorino G. , Abascal Liliana 
Published: October 2013

Abstract
Holocene coastal environments in the Tierra del Fuego archipelago, southernmost South America, evolved in a temperate cold climate characterized by strong and persistent mid-latitude westerly winds, and under stable to falling relative sea-level. Southern and western coasts are rocky, microtidal and generally devoid of Holocene accretionary coastal landforms. They are young, having originated from flooding by the early Holocene. Northern and eastern coasts are lined by receding cliffs that supply abundant sediment to macro/mesotidal embayments lodging extensive accretionary coastal landforms. Spit growth on the Atlantic shore played a major part in modifying the development of other landforms by barring the shoreline from wave attack. Sediment was mainly supplied from Pleistocene glacial deposits exposed at eroding headlands and, more locally, obtained by cannibalization and from elevated Pleistocene beaches. In places, westerly winds combined with Atlantic swell to foster spit growth under high-energy wave power on both bay and ocean flanks – a unique occurrence. In addition, the westerlies caused widespread deflation on supratidal marshes and delivered fine-grained sediment inland and to the sea. Recent acceleration of glacio-eustatic rise is gradually changing the coastal zone to a condition of relative sea-level rise. The generally high and steep coastlines will not be greatly affected. A few gently-dipping lowlands might be flooded and biodiversity will be negatively affected.
Asymmetries in English Vowel Perception Mirror Compression Effects
Authors: Katz Jonah 
Published: October 2013

Abstract
A series of vowel-identification experiments using gated consonant stimuli shows that English listeners are capable of recovering the vocalic context in which a consonant appears from information contained in the consonant alone. This is true for most consonants tested, including liquids, nasals, and stops in onset and coda position. Positional asymmetries in vowel sensitivity go in opposite directions for liquids (coda sensitivity &amp;gt; onset) and stops (onset &amp;gt; coda). Nasals pattern with liquids in terms of vowel sensitivity from consonant steady states alone, but pat- tern more closely with stops when portions outside the steady state are taken into account. It is argued that these asymmetries are related to patterns of cluster-driven vowel compression (also called ‘compensatory shortening') in speech production.
Listener Expectations and Gender Bias in Nonsibilant Fricative Perception
Authors: Babel Molly , McGuire Grant 
Published: October 2013

Abstract
The nonsibilant English fricatives /f/ and /θ / are known to be acoustically nonrobust. Using /f/ and /θ/ stimuli produced in CV, VCV, and VC syllables in /i α u/ contexts spoken by 10 talkers (5 male), we first replicate previous research suggesting that the most robust cues to this contrast are in the formant transitions in adjacent vowels. We also demonstrate vowel and syllable contextual differences that point to the contrast being most robust in /u/ contexts. In a series of perception experiments we go on to demonstrate effects of bias on perception of /f/ and /θ/ that derive from the uninformative nature of the frication noise, making them vulnerable to misperception in general, and especially in low-saliency contexts where the formant transition information is less robust. In experiment 1, listeners' classification of /f/ and /θ/ demonstrated a general bias to respond /f/ for fricatives produced by females and /θ/ for those produced by males. We hypothesize that the perceived concentrations of spectral energy in the fricative are shifted based on the concentration of energy in the vowel, which depend on a talker's gender. In experiment 2, vowel and frication noise portions were cross-spliced to probe this effect, resulting in the same gender-based bias. In a final experiment the vocalic information was removed and only the frication noise was presented to listeners for classification. In this task there was a general bias for /f/, regardless of the talker gender. Overall we demonstrate topdown gender effects in perception that originate in the strong indexical properties of adjacent vowels rather than being present in the frication noise itself.
Pharmacodynamic effects of standard dose prasugrel versus high dose clopidogrel in non-diabetic obese patients with coronary artery disease
Authors: Darlington Andrew , Tello-Montoliu Antonio , Rollini Fabiana , Ueno Masafumi , Ferreiro José Luis , Patel Ronakkumar , Desai Bhaloo , Guzman Luis A. , Bass Theodore A. , Angiolillo Dominick 
Published: October 2013

SummaryIncreased body weight is independently associated with impaired clopidogrel pharmacodynamic (PD) response. Prasugrel has more potent PD effects compared with clopidogrel, although its PD effects in obese patients are unknown. The aim of this prospective, randomised, study was to compare the PD effects of standard-dose prasugrel [60 mg loading dose (LD)/10 mg daily maintenance dose (MD)] with highdose clopidogrel (900 mg LD/150 mg daily MD) in non-diabetic obese [body mass index (BMI) ≥30 kg/m2] patients, with coronary artery disease (CAD) on aspirin therapy. PD assessments (baseline, 2 hours post-LD and 6 ± 2 days after MD) were conducted using four platelet function assays, and the platelet reactivity index (PRI) assessed by VASP was used for sample size estimation. A total of 42 patients with a BMI of 36.42 ± 5.6 kg/m2 completed the study. There were no differences in baseline PD measures between groups. At 2 hours post-LD, prasugrel was associated with lower PRI compared with clopidogrel (24.3 ± 5.5 vs 58.7 ± 5.7, p≤0.001), with consistent findings for all assays. At one-week, PRI values on prasugrel MD were lower than clopidogrel MD without reaching statistical significance (34.7 ± 5.8 vs 42.9 ± 5.8, p=0.32), with consistent findings for all assays. Accordingly, rates of high on-treatment platelet reactivity were markedly reduced after prasugrel LD, but not after MD. In conclusion, in non-diabetic obese patients with CAD, standard prasugrel dosing achieved more potent PD effects than high-dose clopidogrel in the acute phase of treatment, but this was not sustained during maintenance phase treatment. Whether an intensified prasugrel regimen is required in obese patients warrants investigation.
Mortality in vitamin K antagonist-related intracerebral bleeding treated with plasma or 4-factor prothrombin complex concentrate
Authors: Meijer Karina , Larrazabal Ramiro , Arnberg Fabian , Luijckx Gert J. , Roberts Robin S. , Schulman Sam , Majeed Ammar 
Published: October 2013

SummaryProthrombin complex concentrates (PCC) can rapidly normalise prolonged prothrombin time, induced by vitamin K antagonists (VKA). We conducted a multicentre retrospective study to investigate whether reversal of VKA coagulopathy with 4-factor PCC improves the survival of patients with VKA-related intracerebral haemorrhage as compared to plasma. We included 135 consecutive patients with VKA-related intracerebral haemorrhage treated either with plasma (mainly in Canada) or 4-factor PCC (The Netherlands and Sweden) for the reversal of VKA. Data on characteristics of the patients and the haemorrhage were collected. The volume of intracerebral haematoma was calculated from the first computed tomography (CT) scan. The unadjusted and adjusted odds ratio (OR) for 30-day all-cause mortality in both treatment groups was compared using logistic regression. Patients who received plasma (n=35, median 4 units) more often had diabetes, antiplatelet therapy, and intraventricular haemorrhage on the initial CT scans than patients who received PCC (n=100, median 22.5 IU/kg [interquartile range 20–26 IU], median of total dose 1,700 IU). The volume of intracerebral haematoma was larger in the plasma-treated group compared to the PCC-treated group (haematoma, mean 64.5 vs 36.0 cm3; p=0.021). The unadjusted OR for all-cause 30-day mortality in the PCC group was 0.40 (95% confidence interval, 0.18–0.87; p=0.021) compared to the plasma group. After adjusting for the haematoma volume, bleeding localisation and age, the effect of PCC on mortality became non-significant. In conclusion, treatment with 4-factor PCC for VKA reversal in patients with intracerebral haemorrhage does not seem to reduce the 30-day all-cause mortality compared to plasma.
Legal, Political and Social Obstacles for Headscarved Women Working at State Institutions in Turkey
Authors: Bottoni Rossella 
Published: October 2013

Abstract
This article aims to offer some remarks as to legal, political and social obstacles for women wearing a headscarf and working at State institutions. The first part focuses upon the historical background and the ideological context of the creation of the ‘new Turkey’, in order to explain why a garment revealing the affiliation to the majority’s religion is so controversial. The second part deals with the legal basis for the prohibition for headscarved women to work at State institutions, the political opposition to the use of the headscarf in State institutions, and the polarisation in the social understandings of the headscarf. The third part is a critique of the arguments for this limitation and takes three principles into special account: equality between men and women, secularism and State neutrality. Finally, some conclusive remarks are made concerning the prospects for resolution.
Two Generations of Debate on Freedom of Religion in Turkey
Authors: Vural Hasan Sayim 
Published: October 2013

Abstract
Within the debate on freedom of religion in Turkey, we can identify two distinct generations, both of which are alive with an oscillating degree of vibrancy. The first generation of debate has evolved around the question on the proper place of Islam in the secular nation-state; while the second one has encompassed the plural concerns of protecting the rights and freedoms, pertaining to religion or belief, of a diverse multitude, under the rule of law. The first generation of debate resulted in a dual deadlock: Freedom to religion versus freedom from religion. The second generation is informed by a pluralisation of parties and concerns. The first generation has produced well-established results in jurisprudence, where the effect of the second generation is far from being significant. Yet, as this paper will explain in conclusion, we have good reasons to expect the second generation to prevail over the first one.
Serum and MRI Biomarkers in Mobile Device Texting
Authors: Gold Judith E. , Mohamed Feroze B. , Ali Sayed , Barbe Mary F. 
Published: October 2013

Objective: We aimed to determine if serum biochemical and MRI biomarkers differed between high volume (≥ 230 texts sent/day; n = 5) and low volume (≤ 25 texts sent/day; n = 5) texters. A secondary aim was to ascertain what correlations between the biochemical and imaging biomarkers could tell us about the pathophysiology of early onset tendinopathies. Background: Text messaging has become widespread, particularly among college-aged young adults. There is concern that high rates of texting may result in musculoskeletal disorders, including tendinopathies. Pathophysiology of tendinopathies is largely unknown. Method: Ten females with a mean age of 20 were recruited. We examined serum for 20 biomarkers of inflammation, tissue degeneration, and repair. We used conventional MRI and MRI mean intratendinous signal intensity (MISI) to assess thumb tendons. Correlations between MISI and serum biomarkers were also examined. Results: Three high volume texters had MRI tendinopathy findings as did one low volume texter. Increased serum TNF-R1 was found in high volume texters compared to low volume texters, as were nonsignificant increases in MISI in two thumb tendons. Serum TNF-R1 and TNF-α correlated with MISI in these tendons, as did IL1-R1. Conclusion: These results suggest that early onset tendinopathy with concurrent inflammation may be occurring in prolific texters. Further studies with larger sample sizes are needed for confirmation. Application: High volume texting may be a risk factor for thumb tendinopathy in later years. Multidisciplinary research using biochemical and imaging biomarkers may be used to gain insight into pathophysiological processes in musculoskeletal disorders.
Power and Resistance in the Shaping of Argentine Domestic Policy
Authors: Firchow Pamina 
Published: October 2013

In contemporary Argentina, as in much of Latin America, politics is often found in the streets. In recent years it has bypassed traditional political party politics to bring day-to-day needs to the forefront through road blockades and cacerolazos (pot banging). These methods have been particularly successful in Argentina, not only in changing policy but also in bringing down administrations and politicians. They emerged from the 2001 Argentinazo’s repertoire of assemblies, demonstrations, riots, looting, and sit-ins as the primary tactics for actors participating in protests in Argentina today. The continuity of resistance in Argentina is a concrete example of Foucault’s notions of power and resistance in practice. En la Argentina contemporánea, como en gran parte de la América Latina, la política muchas veces se encuentra en la calle. En años recientes se ha desviado de la política partidaria tradicional para dar énfasis más bien a las necesidades cotidianas del pueblo por medio de bloqueos a los caminos y cacerolazos. Estos métodos han sido particularmente exitosos en Argentina no solo para cambiar políticas públicas sino también para quitar a políticos y administraciones. Emergieron del repertorio de asambleas, manifestaciones, disturbios, saqueos, y sentadas del Argentinazo de 2001 como las tácticas principales usadas por los actores que participan hoy día en las protestas argentinas. La continuidad de la resistencia en Argentina es un ejemplo concreto de las nociones foucaultianas de la práctica de poder y resistencia.
Impact of Perineural Invasion in the Pathologically N0 Neck in Oral Cavity Squamous Cell Carcinoma
Authors: Chinn Steven B. , Spector Matthew E. , Bellile Emily L. , McHugh Jonathan B. , Gernon Thomas J. , Bradford Carol R. , Wolf Gregory T. , Eisbruch Avraham , Chepeha Douglas B. 
Published: October 2013

ObjectivePatients with oral cavity squamous cell carcinoma (OCSCC) undergo adjuvant radiation for pathologically high‐risk features including positive nodal disease and extracapsular spread (ECS). In the absence of these high‐risk features, our objective was to determine if perineural invasion (PNI) is an independent risk factor and if adjuvant radiation (XRT) improves disease control rates.Study DesignHistorical cohort analysis.SettingTertiary university hospital.MethodsEighty‐eight OCSCC patients (46 males, 42 females; mean age = 56.7 years; median follow‐up = 4.6 years) treated surgically with pathologically N0 (pN0) necks were studied. Overall, 23% (20/88) were pN0/PNI+ and of those with PNI, 70% (14/20) underwent XRT. Survival analysis using Kaplan‐Meier followed by multivariable Cox models was performed.ResultsMultivariate analysis verified PNI to be associated with worse disease‐free interval (DFI) (P =. 012) and local‐regional control (LRC) (P =. 005) and perivascular invasion (PVI) associated with worse DFI (P =. 05). Among pN0/PNI+ patients, those who received XRT demonstrated significantly improved DFI (mean = 6.5 years vs 1.7 years; P =. 014) and LRC (mean 6.7 years vs 1.9 years; P =. 047). There was no improvement in overall survival (P =. 68) or disease‐specific survival (P =. 8) in those receiving XRT.ConclusionsPNI is an independent adverse risk factor in the absence of nodal metastasis and extracapsular spread. We observed a statistically significantly longer DFI and LRC when patients were treated with adjuvant radiation.
Perception of Better Nasal Patency Correlates with Increased Mucosal Cooling after Surgery for Nasal Obstruction
Authors: Sullivan Corbin D. , Garcia Guilherme J. M. , Frank‐Ito Dennis O. , Kimbell Julia S. , Rhee John S. 
Published: October 2013

ObjectivesTo (1) quantify mucosal cooling (ie, heat loss) spatially in the nasal passages of nasal airway obstruction (NAO) patients before and after surgery using computational fluid dynamics (CFD) and (2) correlate mucosal cooling with patient‐reported symptoms, as measured by the Nasal Obstruction Symptom Evaluation (NOSE) and a visual analog scale (VAS) for sensation of nasal airflow.Study DesignProspective.SettingAcademic tertiary medical center.Subjects and MethodsComputed tomography (CT) scans and NOSE and VAS surveys were obtained from 10 patients before and after surgery to relieve NAO. Three‐dimensional models of each patient's nasal anatomy were used to run steady‐state CFD simulations of airflow and heat transfer during inspiration. Heat loss across the nasal vestibule and the entire nasal cavity, as well as the surface area of mucosa exposed to heat fluxes >50 W/m2, were compared pre‐ and postoperatively.ResultsAfter surgery, heat loss increased significantly on the preoperative most obstructed side (P <. 0002). A larger surface area of nasal mucosa was exposed to heat fluxes >50 W/m2 after surgery. The best correlation between patient‐reported and CFD measures of nasal patency was obtained for NOSE against surface area in which heat fluxes were >50 W/m2 (Pearson r = −0.76).ConclusionA significant postoperative increase in mucosal cooling correlates well with patients’ perception of better nasal patency after NAO surgery. Computational fluid dynamics–derived heat fluxes may prove to be a valuable predictor of success in NAO surgery.