bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical experience with Affinity Pixie™ oxygenation system in paediatric and infant patients
Authors: Issitt R , Robertson A , Cross N , Crook R , Molyneux V , Shaw M , Walton N , Tsang V 
Published: January 2014

Introduction: Great Ormond Street Children’s Hospital undertakes over 500 open heart cardiothoracic procedures requiring cardiopulmonary bypass per year. Data from our centre show that many of our neonatal/paediatric patients require higher cardiac indexes than previously thought. We evaluated the new Pixie™ oxygenation system, rated from 0.1 L/min to 2 L/min, to determine if it could be used for these patients. Methods: Between 2010 and 2012, 250 Pixie™ oxygenators were used on consecutive patients requiring correction of congenital cardiac defects. Data were collected on FiO2 requirements, oxygenator pressure drop and gaseous microemboli handling. Retrospective analysis was also undertaken on the procedures and demographics of all patients during 2011-2012 to determine the percentage of patients on whom the Pixie™ could be used. Results: Analysis of the procedures undertaken at Great Ormond Street Hospital (GOSH) showed that 89% were in patients under 20 kg, requiring a flow rate of <2 L/min (at a base cardiac index of 2.8 L/min/m2). The maximum FiO2 required at 2.5 L/min was 85%. Gaseous microemboli were reduced by 82.5±9.9% and bubble volume was decreased by 94.3±8.4% from the ‘venous’ pre-oxygenator to the ‘arterial’ post-oxygenator. Discussion: The Pixie™ oxygenator proved effective at flows up to 2.5 L/min, with air-handling capabilities comparable with other oxygenators. This represents a single oxygenator that could potentially be used to cover 89% of our surgical procedures. However, we believe that, for the smallest patients (i.e. < 2kg), a smaller priming oxygenator should be used in order to limit unnecessary haemodilution in this vulnerable group.
Experiences of sexuality and intimacy in terminal illness: A phenomenological study
Authors: Taylor Bridget 
Published: January 2014

Background: There is a paucity of research considering sexuality and intimacy in palliative care. It is therefore unclear whether palliative care professionals have a role in addressing these issues with patients and their partners. Aim: To understand people’s experiences of sexuality and intimacy when living with a terminal illness. Design: A Heideggerian hermeneutic (interpretive) phenomenological study was undertaken. Data were collected using one-to-one conversational interviews. An iterative approach to analysing the narratives was used to reveal shared meanings. Setting/participants: A total of 27 patients and 14 partners of patients with either cancer or motor neuron disease were recruited from outpatient, community and hospice inpatient units. All participants were aware that the illness was life-limiting. Findings: When someone is living with a life-limiting illness, their coupled relationship is also dying. In their being-towards-death-of-the-couple, patients and partners of patients with motor neuron disease and terminal cancer experienced connecting and disconnecting within their coupled relationship. Becoming-apart-as-a-couple was experienced as loss of spontaneity, as lack of reciprocity and as rejection. This was influenced by a range of factors including medical treatments, disfigurement and the disabling effects of equipment. Some participants experienced re-connecting through becoming-closer-as-a-couple, although this was not always sustained. Conclusions: This study sheds new light on people’s experiences of sexuality and intimacy when living with a terminal illness. The ethos of holistic care requires palliative care professionals to provide opportunities for patients and their partners to discuss any concerns they might have about their coupled relationship and to understand the meanings symptoms have for them.
Brain functional connectivity and morphology changes in medication-overuse headache: Clue for dependence-related processes?
Authors: Chanraud S , Di Scala G , Dilharreguy B , Schoenen J , Allard M , Radat F 
Published: January 2014

Background Several imaging studies have identified localized anatomical and functional brain changes in medication-overuse headache (MOH). Objective The objective of this article is to evaluate whole-brain functional connectivity at rest together with voxel-based morphometry in MOH patients, in comparison with episodic migraine (EM) patients and healthy controls (HCs). Methods Anatomical MRI and resting-state functional MRI scans were obtained in MOH patients ( n = 17 and 9, respectively), EM patients ( n = 18 and 15, respectively) and HCs ( n = 17 and 17). SPM8 was used to analyze voxel-based morphometry and seed (left precuneus) to voxel connectivity data in the whole brain. Results Functional connectivity at rest was altered in MOH patients. Connectivity was decreased between precuneus and regions of the default-mode network (frontal and parietal cortices), but increased between precuneus and hippocampal/temporal areas. These functional modifications were not accompanied by significant gross morphological changes. Furthermore, connectivity between precuneus and frontal areas in MOH was negatively correlated with migraine duration and positively correlated with self-evaluation of medication dependence. Gray matter volumes of frontal regions, precuneus and hippocampus were also negatively related to migraine duration. Functional connectivity within the default-mode network appeared to predict anxiety scores of MOH patients while gray matter volumes in this network predicted their depression scores. Conclusions Our data suggest that MOH is associated with functional alterations within intrinsic brain networks rather than with macrostructural changes. They also support the view that dependence-related processes might play a prominent role in its development and maintenance.
Effects of plasma-emulating light-emitting diode (LED) versus conventional LED on cytotoxic effects and polymerization capacity of orthodontic composites
Authors: Çörekçi B , Irgın C , Halıcıoğlu K , Dursun S , Yavuz MZ 
Published: January 2014

Objectives: The aim of this study was to evaluate, the cytotoxicity of orthodontic composites in vitro as a function of degree of conversion (DC) and the light curing units (LCU) employed on mouse fibroblast (L929). Materials and Methods: Cured samples of the composites Light bond ( Reliance Orthodontic Products, Itasca, Illinois, USA), Ortho bracket paste (Bisco, Schaumburg, Illinois, USA), Opal bond MV (OPAL, South Jordan, Utah, USA), and Transbond XT (3M, Monrovia, California, USA) were prepared. Polymerization was performed with two LCUs: VALO Ortho (Ultradent, South Jordan, Utah, USA) is a third-generation LCU and Elipar S10 (3M, USA) is a second-generation LCU. Four samples were immersed in cell culture medium to obtain composite extracts. After incubation of L929 cell cultures with the extracts obtained, cytotoxicity was determined using the methyl tetrazolium test. Fourier transform infrared spectroscopy (FTIR) was used to evaluate DC for five samples. A multivariate analysis of variance (ANOVA), two-way ANOVA, and Tukey’s honestly significant difference test were utilized for statistical analyses. Results: Cytotoxicity and DC of all tested composites ( p < 0.001) and the interaction between composites and LCUs ( p < 0.01) were significantly different. LCUs had no significant influence on the cytotoxicity and DC of composite materials ( p > 0.05). The correlations between cell viability and DC were positive for three composites but statistically insignificant. Conclusion: Composites and LCUs must be matched with one another to result in satisfactory maximal biocompatibility and DC. Opal Bond plasma light-emitting diode combination was a better choice for cell viability. Three composites showed a positive correlation between cytotoxicity and DC. Therefore high-intensity LCUs can be said to efficiently affect polymerization, and so, higher DC rates may achieve higher cell viability rates.
Trade Openness, Real Exchange Rate, Gross Domestic Investment and Growth in Indonesia
Authors: Yusoff Mohammed B. , Febrina Ilza 
Published: January 2014

This study examines the relationships among economic growth, domestic investment, real exchange rate and trade openness in Indonesia using the Johansen cointegration test and Granger causality test. The results suggest that there exists a long-run relationship among the variables. All the estimated coefficients of the long-run equation have the correct positive signs and significant at least at the 5 per cent level. Specifically, in the long run, a 1 per cent increase in trade openness leads to about 26.5 per cent increase in Indonesian real GDP, a 1 per cent increase in domestic investment will spur real GDP by 1.8 per cent, and a 1 per cent depreciation of the rupiah raises real GDP by about 6.4 per cent. The results from the Granger causality test suggest that all the variables affect real GDP in the short run. Both trade openness and gross domestic investment cause growth unidirectionally in the short run, but feedback occurs between growth and the real exchange rate. The evidences suggest that trade openness, gross domestic investment and the exchange rate are important determinants of economic growth and therefore policy makers should seriously take these variables into account in their policy construct in order to achieve sustained economic growth in Indonesia. Specifically, Indonesia should liberalise foreign trade, improve the domestic investment climate and maintain exchange rate stability. JEL Classification: F31, F41, F43
The Impact of the Australian Carbon Tax on Industries and Households
Authors: Meng Sam , Siriwardana Mahinda , McNeill Judith 
Published: January 2014

With the new Australian Government and various interest groups objecting to the Australian carbon tax, public opinion about pricing carbon is divided. Some of the disagreement may be due to misunderstandings about the effects of the policy. In an effort to clarify some of the issues, this article reports the simulated effects of a carbon tax of A$23 per tonne of carbon dioxide on different economic agents, with and without a compensation policy. We employ a computable general equilibrium (CGE) model with an environmentally extended social accounting matrix (SAM). At the sectoral level, brown coal electricity, black coal electricity and the brown coal mining sectors are big losers. The effect on various employment occupations is mildly negative, ranging from −0.6 per cent to −1.7 per cent, with production and transport workers worst affected. According to household utility projections, low-income households suffer more from a carbon tax and benefit more from the proposed compensation policy. However, the commonly used equivalent variation (EV) tends to reverse this conclusion. JEL Classification: H23, H31, H32, Q52, Q54
Creditworthiness of a Borrower and the Selection Process in Micro-finance: A Case Study from the Urban Slums of India
Authors: Paul Sohini 
Published: January 2014

This article examines whether urban micro-finance institutions (MFIs) consider proxy/hidden collateral in the absence of physical as well as social collateral in judging the creditworthiness of a borrower. MFIs operating in urban slums often adopt an individual lending mechanism since borrowers are not willing to bear joint liability due to the acute problem of migration. Therefore, urban MFIs that offer individual loans are extra-cautious about minimising default risk. This article studies whether MFIs consider ownership of a room in a slum as a hidden selection criterion in a loan programme. Room ownership indicates stability in a particular location, and also indicates the income-generation capability of an aspirant borrower. We use a primary survey database collected from a non-governmental organisation, Navnirman Samaj Vikas Kendra, which provides micro-credit in four slums of north Mumbai in India. We find that the probability of getting selected in a micro-credit programme is significantly higher if a loan applicant owns a room than if the applicant lives in a rented room. MFIs appear to be more concerned about shielding themselves from default than fulfilling the broad goal of maximising social welfare by reaching the poorest of the poor. We present our study with the caveat that the results may not be generalisable, since they are based on a case study. JEL Classification: D78, G20, G21
Reflecting on our practice: an evaluation of Balint groups for medical students in psychiatry
Authors: Parker Stephen D , Leggett Andrew 
Published: January 2014

Objective: This paper qualitatively evaluates a one-year trial of Balint clinical reflection groups for medical students in psychiatry at a large Australian tertiary referral hospital. The trial considered whether clinical reflection groups following the Balint process would be perceived as useful and relevant to the learning needs of the student participants. Method: A grounded theory approach was undertaken. This included survey data, thematic analysis of written feedback, and facilitator reflection on the process. Facilitators adapted the group process in response to participants’ needs. These modifications included: increased education regarding the Balint process; the introduction of co-presenters; and the inclusion of a didactic summary following each session. Results: The evaluation suggested that fidelity of the Balint group experience was achieved and that student attitudes were neutral to mildly positive regarding the educational experience. Conclusions: Balint groups are potentially useful to medical students in the Australian context. We suggest that Balint groups may be more useful when applied in less alienating learning environments, such as during general practice rotations. Emphasis is placed on the need to maintain a dynamic approach by adapting the group and the educational processes as the work unfolds.
The Long-Term Clinical Outcomes Following Autogenous Bone Grafting for Large-Volume Defects of the Knee
Authors: Johnson Lanny Leo , Delano Mark , Spector Myron , Pittsley Andrew , Gottschalk Alexander 
Published: January 2014

Objective: We report the long-term clinical outcomes of patients who underwent autogenous bone grafting of large-volume osteochondral defects of the knee due to osteochondritis dessicans (OCD) and osteonecrosis (ON). This is the companion report to one previous published on the biological response. We hypothesized that these grafts would integrate with host bone and the articular surface would form fibrocartilage providing an enduring clinical benefit. Design: Three groups (patients/knees) were studied: OCD without a fragment ( n = 12/13), OCD with a partial fragment ( n = 14/16), and ON ( n = 25/26). Twenty-five of 52 patients were available for clinical follow-up between 12 and 21 years. Electronic medical records provided comparison clinical information. In addition, there were plain film radiographs, MRIs, plus repeat arthroscopy and biopsy on 14 patients. Results: Autogenous bone grafts integrated with the host bone. MRI showed soft tissue covering all the grafts at long-term follow-up. Biopsy showed initial surface fibrocartilage that subsequently converted to fibrocartilage and hyaline cartilage at 20 years. OCD patients had better clinical outcomes than ON patients. No OCD patients were asymptomatic at anytime following surgery. Half of the ON patients came to total knee replacement within 10 years. Conclusions: Autogenous bone grafting provides an alternative biological matrix to fill large-volume defects in the knee as a singular solution integrating with host bone and providing an enduring articular cartilage surface. The procedure is best suited for those with OCD. The treatment for large-volume articular defects by this method remains salvage in nature and palliative in outcome.
Are There Differences in Ice Hockey Injuries Between Sexes?
Authors: MacCormick Lauren , Best Thomas M. , Flanigan David C. 
Published: January 2014

Background: Men’s ice hockey allows for body checking, and women’s ice hockey prohibits it. Studies have reported injury data on both sexes, but no systematic reviews have compared the injury patterns between male and female ice hockey players. Hypothesis: Men’s and women’s ice hockey would have different types of injuries, and this difference would extend across the different age groups and levels of play. Study Design: Systematic review; Level of evidence, 4. Methods: Three databases, 3 scientific journals, and selected bibliographies were searched to identify articles relevant to this study. Articles were further screened by the use of predetermined inclusion and exclusion criteria. Twenty-two studies met these criteria and were subsequently reviewed. Results: Men sustained higher rates of injuries than women at all age levels, and both sexes sustained at least twice as many injuries in games than practices. Both sexes sustained most of their injuries from player contact. Men and women in college sustained most injuries to the head and face, and women suffered from higher percentages of concussion. At all ages and levels of play, men had higher rates of upper extremity injuries (shoulder), while women were found to sustain more injuries to the lower extremity (thigh, knee). Conclusion: Although findings showed men sustaining higher rates of injuries than women, the predominant mechanism of player contact was the same. The most common locations and types of injuries in female ice hockey players are comparable to other sports played by women, and similar interventions could offer protection against injury. Clinical Relevance: Further studies that report injury data for women playing ice hockey at all levels will assist in understanding what prevention strategies should be implemented.
Functional Performance Testing After Anterior Cruciate Ligament Reconstruction
Authors: Abrams Geoffrey D. , Harris Joshua D. , Gupta Anil K. , McCormick Frank M. , Bush-Joseph Charles A. , Verma Nikhil N. , Cole Brian J. , Bach Bernard R. 
Published: January 2014

Background: When to allow an athlete to return to unrestricted sporting activity after anterior cruciate ligament (ACL) reconstruction remains controversial. Purpose: To report the results of functional performance testing reported in the literature for individuals at differing time points following ACL reconstruction and to examine differences between graft types. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of Medline, Scopus, and Cochrane Central Register of Controlled Trials was performed using PRISMA guidelines. Inclusion criteria were English-language studies that examined any functional rehabilitation test from 6 months to 2 years following ACL reconstruction. All patient-, limb-, and knee-specific demographics were extracted from included investigations. All functional rehabilitation tests were analyzed and compared when applicable. Results: The search term returned a total of 890 potential studies, with 88 meeting inclusion and exclusion criteria. A total of 4927 patients were included, of which 66% were male. The mean patient age was 26.5 ± 3.4 years. The predominant graft choices for reconstruction were bone–patellar tendon–bone (BPTB) autograft (59.8%) and hamstring autograft (37.9%). The most commonly reported functional tests were the hop tests. The results of these functional tests, as reported in the Limb Symmetry Index (LSI), improved with increasing time, with nearly all results greater than 90% at 1 year following primary ACL reconstruction. At 6 months postoperatively, a number of isokinetic strength measurements failed to reach 80% LSI, most commonly isokinetic knee extension testing in both BPTB and hamstring autograft groups. The knee flexion strength deficit was significantly less in the BPTB autograft group as compared with those having hamstring autograft at 1 year postoperatively, while no significant differences were found in isokinetic extension strength between the 2 groups. Conclusion: Hop testing was the most commonly reported functional test following ACL reconstruction. Increases in performance on functional tests were predictably seen as time increased following surgery. Those with hamstring autografts may experience increased strength deficits with knee flexion versus those having BPTB autograft. These data provide information that may assist providers in determining timing of return to unrestricted sporting activity.
Surface Replacement Arthroplasty of the Humeral Head in Young, Active Patients
Authors: Iagulli Nicholas D. , Field Larry D. , Hobgood E. Rhett , Hurt James A. , Charles Ryan , O’Brien Michael J. , Savoie Felix H. 
Published: January 2014

Background: The treatment of glenohumeral arthritis in young, active patients remains controversial. Standard total shoulder arthroplasty in this patient group has not obtained the same satisfaction rate as in older patients. One surgical option that has emerged is humeral resurfacing. Hypothesis: Humeral head surface replacement arthroplasty (SRA) would provide satisfactory clinical outcomes in active patients, allowing them to maintain their normal lifestyle without activity restrictions. Study Design: Case series; Level of evidence, 4. Methods: From 2004 to 2007, all consecutive surface replacement arthroplasties of the humerus performed at the authors’ institution were identified and retrospectively reviewed, and 118 patients who underwent SRA during this time were identified. This study included patients younger than 60 years who wished to maintain an active lifestyle; 52 of the 118 patients met the inclusion criteria. University of California at Los Angeles (UCLA) shoulder scores and subjective shoulder value (SSV) scores were used to measure clinical outcomes at an average follow-up of 6 years (range, 4-8 years). Of the 52 patients meeting the inclusion criteria, 48 were contacted and examined for the study, with 4 patients lost to follow-up. Results: The mean postoperative UCLA score was 28.03, with 1 patient requiring revision because of pain and glenoid wear. The mean SSV was 92% (range, 0%-100%), with 3 patients restricting their activity because of the shoulder. Forty-seven of the 48 contacted patients stated that, given the option, they would have the same surgery again. One patient required revision surgery because of pain. Conclusion: Surface replacement arthroplasty provided reasonable results in patients younger than 60 years with high activity demands with a low rate of revision at midterm follow-up.