bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Lesotho Constitution and Doctrine of Separation of Powers: Reflections on the Judicial Attitude
Authors: Nwafor Anthony O. 
Published: July 2013

Abstract
Since the popularization of the doctrine of separation of powers in the 18th century by Baron De Montesquieu, emerging democratic nations have continued to strive towards evolving patterns of governance that suit their internal needs with regards to the political, social and cultural peculiarities of each nation. Lesotho is no exception to this evolutionary trend, as the country transitions from a traditional monarchical to parliamentary system of government, founded on popular democracy. The 1993 Constitution of Lesotho embodies provisions that ensure the distribution of governmental powers among the three arms of government, but with due reverence to the monarch whose powers cut across each branch of government. The judiciary plays a very important role in preserving the tenets of the constitution. The courts in Lesotho have been very assertive, sometimes excessively so, by intruding into the functions of the other arms of government. This paper captures the true importance of the doctrine of separation of powers, examines the Lesotho constitutional arrangement in preserving this doctrine and calls for caution on the part of the courts as guardians of the constitutional order.
Odetta zekiergeni a new species of Pyramidellidae (Mollusca: Gastropoda) from the eastern Mediterranean Sea
Authors: ÖZTÜRK BILAL 
Published: July 2013

During the past decades intensive investigations on the zoobenthic fauna of Izmir Bay have been carried out (Çınar et al., 2012). This area has suffered from intense pollution due to the influx of untreated wastes of different origin. Until the year 2000, the inner part of Izmir Bay, where the Alsancak harbour is located, has been considered as one of the most polluted areas in the Mediterranean Sea. Recent studies performed in the area (Çınar et al., 2006; Ergen et al., 2006) showed that a number of species of alien or native origin have gradually re-colonized the area after the establishment of a wastewater treatment station within “The Grand Canal Project” on February 2000. Since then Çınar et al. (2012) have reported 417 species from the area including 13 alien taxa in a study of the zoobenthic organisms inhabiting the soft substrate in Izmir Bay.
Gray matter abnormalities as brain structural vulnerability factors for bipolar disorder: A review of neuroimaging studies of individuals at high genetic risk for bipolar disorder
Authors: Nery Fabiano G , Monkul E Serap , Lafer Beny 
Published: July 2013

Objective: Cortical and subcortical gray matter abnormalities have been reported in individuals at high genetic risk for bipolar disorder, but the findings are inconsistent. The aim of this study was to review the available literature to identify common findings that could represent brain structural vulnerability factors for bipolar disorder and to discuss challenges for the advancement of the field. Method: A systematic search was conducted using the PubMed database to identify all original articles investigating cortical or subcortical gray matter abnormalities in first-degree relatives of bipolar disorder patients. Results: Very few findings were replicated, with the exception of larger insular cortex volumes in adult first-degree relatives and larger right inferior frontal gyrus in offspring of probands with bipolar disorder, both when compared with healthy controls. Isolated findings included decreased gray matter density in the left thalamus, decreased gray matter volumes in the left hippocampus and parahippocampal gyrus, and thicker right hippocampus in unaffected first-degree relatives. Genetic liability for bipolar disorder was associated with gray matter volumes in regions of the anterior cingulate cortex, ventral striatum, medial frontal gyrus, right precentral gyrus, right insular cortex, and medial orbital gyrus. Some studies found no evidence for gray matter abnormalities in first-degree relatives of bipolar disorder patients. Conclusions: Possible reasons for the discrepancies of findings across studies include small samples sizes, small effect size of susceptibility genes, the phenotypic heterogeneity of bipolar disorder, and the possible confounding effect of other Axis I psychopathologies among the relatives of patients. Future multisite, prospective, large studies with more homogeneous samples would be a key strategy to advance the field. The ultimate benefit would be an understanding of how to use brain imaging tools to identify individuals at increased risk for bipolar disorder and develop preventive strategies for that population.
Selective cerebral perfusion with aortic cannulation and short-term hypothermic circulatory arrest in aortic arch reconstruction
Authors: Turkoz R , Saritas B , Ozker E , Vuran C , Yoruker U , Balci S , Altun D , Turkoz A 
Published: July 2013

Background: The deep hypothermic circulatory arrest (DHCA) technique has been used in aortic arch and isthmus hypoplasia for many years. However, with the demonstration of the deleterious effects of prolonged DHCA, selective cerebral perfusion (SCP) has started to be used in aortic arch repair. For SCP, perfusion via the innominate artery route is generally preferred (either direct innominate artery cannulation or re-routing of the cannula in the aorta is used). Herein, we describe our technique and the result of arch reconstruction in combination with selective cerebral and myocardial perfusion (SCMP) and short-term total circulatory arrest (TCA) (5-10 min) through ascending aortic cannulation. Methods: Thirty-seven cases with aortic arch and isthmus hypoplasia accompanying cardiac defects were operated on with SCMP and short TCA in Baskent University Istanbul Research and Training Hospital between January 2007 and Sep 2012. There were 17 cases with ventricular septal defect (VSD)-coarctation with aortic arch hypoplasia (CoAAH), 4 cases of transposition of the great arteries-VSD-CoAAH, 4 cases of Taussing Bing Anomaly-CoAAH, 2 cases complete atrioventricular canal defect-CoAAH, 3 cases single ventricle-CoAAH, 3 cases of type A interruption-VSD, 2 subvalvular aortic stenosis-CoAAH and 2 cases of isolated CoAAH. The aorta was cannulated in the middle of the ascending aorta in all cases. The cross-clamp was applied to the aortic arch distal to either the innominate artery or the left carotid artery. In addition, a side-biting clamp was applied to the descending aorta. The aorta between these two clamps was reconstructed with gluteraldehyde-treated autogeneous pericardium, using SCMP. The proximal arch and distal ascending aorta reconstructions were carried out under short TCA. Results: The mean age of the patients was 2.5±2 months. The mean cardiopulmonary bypass and cross-clamp times were 144±58 and 43±27 minutes, respectively. The mean SCMP and descending aorta ischemia times were 22.6±4.8 and 27±6.3 minutes, respectively. Mean TCA time was 7.6±2.1 minutes (min: 4, max 10 min). The mean in-hospital stay time was 8.6±1.9 days. None of the cases operated with this technique had neurological defects. The mortality rate was 2.7% (1 patient). Conclusion: SCMP with aortic cannulation and short TCA (under 10 minutes) in aortic reconstruction is safe and practical in this high-risk patient group.
Assessment of team training in management of adverse acute events occurring during cardiopulmonary bypass procedure: a pilot study based on an animal simulation model (Fouilloux, Team training in cardiac surgery)
Authors: Fouilloux V , Gsell T , Lebel S , Kreitmann B , Berdah S 
Published: July 2013

Background: Successful cardiac surgery is highly dependent upon effective and efficient teamwork. Practical training and development will further enhance the team ability to react to a series of low-frequency occurring adverse events during cardiopulmonary bypass (CPB). One of our specialized educational programs focuses on training the whole team. This training is based on an original animal simulation model. The objective of this pilot study was to assess our method of training and learning in an attempt to optimize and improve team management and functioning. Methods: Four members of the same cardiac surgery team joined our program. They performed a common procedure, with a cardiopulmonary bypass (CPB) circuit set up to produce several adverse incidents. Events management was analyzed and debriefed in technical and non-technical perspectives. Results: Management of the adverse events was significantly improved. Discussion and debriefing time was fundamental in identifying the most appropriate management for each event. Rescue procedures were assimilated and team training was found to be effective, with the time reduced by up to 50% for 3 events and by up to 70% for air embolism. Conclusion: Our pilot program is an innovative, low-cost tool for the improvement of the management of adverse events occurring during CPB. It includes the different components of surgical education and training. Such an educational tool might be relevant for training. To confirm those encouraging results, it should be assessed in a larger surgical team panel. Further investigations are required for assessing efficiency in real conditions.
Effect of whole-body vibration exercise on mobility, balance ability and general health status in frail elderly patients: a pilot randomized controlled trial
Authors: Zhang Li , Weng Changshui , Liu Miao , Wang Qiuhua , Liu Liming , He Yao 
Published: July 2013

Objective: To study the effects of whole-body vibration exercises on the mobility function, balance and general health status, and its feasibility as an intervention in frail elderly patients. Design: Pilot randomized controlled trial. Subjects: Forty-four frail older persons (85.27 ± 3.63 years) meeting the Fried Frailty Criteria. Interventions: All eligible subjects were randomly assigned to the experimental group, who received a whole-body vibration exercise alone (vibration amplitude: 1–3 mm; frequency: 6–26 Hz; 4–5 bouts × 60 seconds; 3–5 times weekly), or a control group, who received usual care and exercises for eight weeks. Main measures: The Timed Up and Go Test, 30-second chair stand test, lower extremities muscle strength, balance function, balance confidence and General Health Status were assessed at the beginning of the study, after four weeks and eight weeks of the intervention. Results: Whole-body vibration exercise reduced the time of the Timed Up and Go Test (40.47 ± 15.94 s to 21.34 ± 4.42 s), improved the bilateral knees extensor strength (6.96 ± 1.70 kg to 11.26 ± 2.08 kg), the posture stability (surface area ellipse: 404.58 ± 177.05 to 255.95 ± 107.28) and General Health Status (Short-form Health Survey score: 24.51 ± 10.69 and 49.63 ± 9.85 to 45.03 ± 11.15 and 65.23 ± 9.39, respectively). The repeated-measures ANOVA showed that there were significant differences in the Timed Up and Go Test, 30-second chair stand test, bilateral knees extensor strength, activities-specific balance confidence score and general health status between the two groups ( P < 0.05). No side-effects were observed during the training. Conclusions: Whole-body vibration exercise is a safe and effective method that can improve the mobility, knee extensor strength, balance and the general health status in the frail elderly.
An occupation-based strategy training approach to managing age-related executive changes: a pilot randomized controlled trial
Authors: Dawson Deirdre , Richardson Julie , Troyer Angie , Binns Malcolm , Clark Amanda , Polatajko Helene , Winocur Gordon , Hunt Anne , Bar Yael 
Published: July 2013

Objective: To determine the feasibility of recruitment and retention of healthy older adults and the effectiveness of an intervention designed to manage age-related executive changes. Design: A pilot randomized controlled trial. Setting: Research centre and participants’ homes. Participants: Nineteen healthy, community dwelling older adults with complaints of cognitive difficulties and everyday problems, but no evidence of mild cognitive impairment, dementia or depression on objective testing. Interventions: Seventeen hours of group and individual training. Participants in the experimental arm received education about self-management, successful aging and an occupation-based meta-cognitive strategy-training program. Participants in the control arm received education about brain health and participated in cognitively stimulating exercises. Main measures: Changes on untrained, everyday life goals were identified using the Canadian Occupational Performance Measure. Generalization of benefits was measured using the Stanford Chronic Disease Questionnaire, general self-efficacy and changes in executive function (Delis-Kaplan Executive Function System Tower Test, Word Fluency and Trail-Making Test). Results: 20% (19/96) of healthy older adults approached were eligible, consented and were enrolled in the study, 90% (17/19) were retained to three-month follow-up. Participants in the experimental arm reported significantly more improvement on untrained goals (11/22 compared with 9/46, χ2=4.92, p<0.05), maintenance of physical activity ( p<0.05) and better preparation for doctors’ visits ( p<0.05) relative to the control group. There were no significant between group differences on objective measures of executive function. Conclusions: These data support the feasibility of a larger trial where a sample of 72 (36 participants in each arm) would be required to confirm or refute these findings.
Acute prevertebral calcific tendinitis: a source of non-surgical acute cervical pain
Authors: Silva Claudio F , Soffia Pablo S , Pruzzo Edda 
Published: July 2013

Background Prevertebral calcific tendinitis results from calcium hydroxyapatite crystal deposits in the longus colli muscles, which induce symptoms similar to some surgically-treated conditions, such as retropharyngeal abscesses. Imaging techniques are critical for accurate diagnosis. Purpose To describe the computed tomography (CT) findings associated with prevertebral calcific tendinitis. Material and Methods Retrospective analysis performed in an 18-month period, searching for patients with neck CT and reports with diagnosis of “calcific longus collis tendinitis” or “prevertebral calcific tendinitis”. CT images and clinical data available in the medical records were analyzed. Results One hundred and thirty-four examinations were performed in the period studied. Nine patients who fulfilled inclusion criteria were identified and their CT imaging characteristics are presented. Six presented with calcific deposits in the right longus colli muscle. CT matched the clinical pain lateralization in all cases. Eight patients had no significant enhancement post injection of contrast media. Conclusion Prevertebral calcific tendinitis is a cause of acute cervical pain that clinically mimics a retropharyngeal abscess, however on neck CT has a characteristic appearance. Correct identification of this pathologic condition will help avoiding unnecessary invasive procedures.
The contribution of diffusion tensor imaging and magnetic resonance spectroscopy for the differentiation of breast lesions at 3T
Authors: Tsougos Ioannis , Svolos Patricia , Kousi Evanthia , Athanassiou Evangelos , Theodorou Kiriaki , Arvanitis Dimitrios , Fezoulidis Ioannis , Vassiou Katerina 
Published: July 2013

Background Conventional breast magnetic resonance imaging (MRI), including dynamic contrast-enhanced MR mammography (DCE-MRM), may lead to ambiguous diagnosis and unnecessary biopsies. Purpose To investigate the contribution of proton MR spectroscopy (1H-MRS) combined with diffusion tensor imaging (DTI) metrics in the discrimination between benign and malignant breast lesions. Material and Methods Fifty-one women with known breast abnormalities from conventional imaging were examined on a 3T MR scanner. DTI was performed during breast MRI, and fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in the breast lesions and the contralateral normal breast. FA and ADC were compared between malignant lesions, benign lesions, and normal tissue. 1H-MRS was performed after gadolinium administration and choline peak was qualitatively evaluated. Results In our study 1H-MRS showed a sensitivity of 93.5%, specificity 80%, and accuracy 88.2%. FA was significantly higher in breast carcinomas compared to benign lesions. However, no significant difference was observed in ADC between benign and malignant lesions. The combination of Cho presence and FA achieved higher levels of accuracy and specificity in discriminating malignant from benign lesions over Cho presence or FA alone. Conclusion In conclusion, applying DTI and 1H-MRS together, adds incremental diagnostic value in the characterization of breast lesions and may sufficiently improve the low specificity of conventional breast MRI.
Correlation between anatomic landmarks and fMRI in detection of the sensorimotor cortex in patients with structural lesions
Authors: Hingwala Divyata , Thomas Bejoy , Radhakrishnan Ashalatha , Nair N Suresh , Kesavadas C 
Published: July 2013

Background Structural lesions in/near the sensorimotor cortex may cause distortion/obscuration of the anatomic landmarks. Purpose To compare the localization of the sensorimotor cortex using anatomical landmarks and fMRI in the clinical setting in patients with structural lesions in/near the central sulcus. Material and Methods We analyzed the anatomic and fMRI data of 68 consecutive patients (42 tumors, 15 gliotic lesions, 11 focal cortical dysplasias [FCD]) who underwent MRI to assess the relationship of these lesions to the sensorimotor cortex. Anatomical data was analyzed on conventional two- and three-dimensional sequences. BOLD fMRI was performed with block design hand/leg or lip movement paradigm and general linear model was used for detecting the activated cortex. fMRI was considered as a valid method for identifying the sensorimotor cortex based on previously reported literature. Results The sensorimotor cortex could not be identified with anatomical landmarks in 9/68 (13.2%) patients. fMRI detected activation in areas different from that predicted by anatomical landmarks in 11/68 (16.2%) cases. This occurred in 5/42 (11.9%) tumors, 6/15 (40%) gliotic lesions, and 0/11 (0%) FCDs. The kappa value for concordance between fMRI and anatomic landmarks was 0.883 overall, 1.0 for tumors, 0.721 for gliotic lesions, and in none of the patients with focal cortical dysplasias. Conclusion In patients with lesions that obscure normal cerebral landmarks, fMRI supplies the information that is not available from the anatomic images. In patients with landmarks that can be recognized, the location of the rolandic cortex may be misjudged in some cases if functional imaging is not used. Anatomic landmarks may not correlate with the area of functional activation in gliotic lesions and tumors. Determining the risk of a postoperative neurologic defect from surgery is likely to be more reliable with functional imaging than with conventional anatomic imaging.
Trends in Meniscus Repair and Meniscectomy in the United States, 2005-2011
Authors: Abrams Geoffrey D. , Frank Rachel M. , Gupta Anil K. , Harris Joshua D. , McCormick Frank M. , Cole Brian J. 
Published: July 2013

Background: Meniscus deficiency may lead to degenerative arthritis in the knee. There is a significant emphasis on meniscus preservation, particularly in the young patient, to reduce the risk of arthritis. Purpose: To report on the incidence of meniscus repair and meniscectomy, with and without concomitant anterior cruciate ligament (ACL) reconstruction, in the United States (US) over the past 7 years. Study Design: Descriptive epidemiology study. Methods: Patients who underwent arthroscopic meniscectomy ( Current Procedural Terminology [ CPT] codes 29880 and 29881), meniscus repair ( CPT codes 29882 and 29883), and ACL reconstruction ( CPT code 29888) for the years 2005 through 2011 were identified using the PearlDiver Patient Record Database. Age group and sex were collected for each patient. Patient groups included meniscectomy alone, meniscus repair alone, meniscus repair followed by meniscectomy, ACL reconstruction with concomitant meniscus repair, and ACL reconstruction with concomitant meniscus repair followed by meniscectomy. Linear regression and Student t tests were utilized for comparisons, with an α value of .05 set as significant. Results: The database represented approximately 9% of the US population under 65 years of age. There was no significant change in the number of patients in the covered population during the study time frame ( P = .138). From 2005 to 2011, there were a total of 387,833 meniscectomies, 23,640 meniscus repairs, and 84,927 ACL reconstructions. There was a significant increase in the total number of isolated meniscus repairs performed ( P = .001) and a doubling of the incidence of repairs from 2005 to 2011. There was no significant increase in the total number of meniscectomies performed ( P = .712), while the incidence of meniscectomies increased only 14% from 2005 to 2011. There was no significant change in the number of meniscus repairs performed at the same time as ACL reconstruction during the study time frame. The total number and incidence of meniscectomies after repair with and without ACL reconstruction significantly decreased. Conclusion: There has been an increased number of isolated meniscus repairs being performed in the US over the past 7 years without a concomitant increase in meniscectomies over the same time frame. These data suggest that meniscus repairs are preferentially being performed over meniscectomies.
The Stress Response to Surgery and Postoperative Delirium
Authors: Cerejeira Joaquim , Batista Pedro , Nogueira Vasco , Vaz-Serra Adriano , Mukaetova-Ladinska Elizabeta B. 
Published: July 2013

Introduction: The aim of this study is to determine whether postoperative delirium is associated with dysregulation of hypothalamic–pituitary–adrenal and growth hormone/insulin-like growth factor 1 (GH/IGF-1) responses following acute systemic inflammation. Methods: Plasma levels of cortisol, IGF-1, C-reactive protein, interleukin (IL)-6, IL-8, and IL-10 were measured before and after surgery in 101 patients ≥60 years without dementia undergoing elective hip arthroplasty. Participants were assessed with confusion assessment method and Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR) postoperatively and 37 patients fulfilled the DSM-IV-TR criteria for delirium. Results: Preoperative plasma cortisol levels were similar in delirium and nondelirium groups (405.37 ± 189.04 vs 461.83 ± 219.39; P = .22). Participants with delirium had higher postoperative cortisol levels (821.67 ± 367.17 vs 599.58 ± 214.94; P = .002) with enhanced postoperative elevation in relation to baseline (1.9- vs 1.5-fold; P = .004). The plasma levels of IGF1 did not differ in delirium and nondelirium groups before (18.12 ± 7.58 vs 16.8 ± 7.86; P = .477) and following surgery (13.39 ± 5.94 vs 11.12 ± 6.2; P = .639), but the levels increased in relation to baseline more frequently in patients who developed delirium (24.3% vs 7.8%; P = .034). The magnitude of postoperative cortisol elevation correlated with ΔIL-6 ( P = .485; P = .002), ΔIL-8 ( P = .429; P = .008), and ΔIL-10 ( P = .544; P < .001) only in patients with delirium. Conclusions: Hypothalamic–pituitary–adrenal axis hyperresponsiveness and a less frequent suppression of the GH/IGF-1 axis in response to acute stress are possibly involved in delirium pathophysiology.