bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative low-dose ketamine has no preemptive analgesic effect in opioid-naïve patients undergoing colon surgery when nitrous oxide is used - a randomized study
Authors: Nistal-Nuño Beatriz , Freire-Vila Enrique , Castro-Seoane Francisco , Camba-Rodriguez Manuel 
Published: September 2014

Background: The analgesic properties of ketamine are associated with its non-competitive antagonism of the N-methyl-D-aspartate receptor; these receptors exhibit an excitatory function on pain transmission and this binding seems to inhibit or reverse the central sensitization of pain. In the literature, the value of this anesthetic for preemptive analgesia in the control of postoperative pain is uncertain. The objective of this study was to ascertain whether preoperative low-dose ketamine reduces postoperative pain and morphine consumption in adults undergoing colon surgery.Methods: In a double-blind, randomized trial, 48 patients were studied. Patients in the ketamine group received 0.5 mg/kg intravenous ketamine before surgical incision, while the control group received normal saline. The postoperative analgesia was achieved with a continuous infusion of morphine at 0.015 mg∙kgˉ¹∙hˉ¹ with the possibility of 0.02 mg/kg bolus every 10 min. Pain was assessed using the Visual Analog Scale (VAS), morphine consumption, and hemodynamic parameters at 0, 1, 2, 4, 8, 12, 16, and 24 hours postoperatively. We quantified times to rescue analgesic (Paracetamol), adverse effects and patient satisfaction.Results: No significant differences were observed in VAS scores between groups (P>0.05), except at 4 hours postoperatively (P=0.040). There were no differences in cumulative consumption of morphine at any time point (P>0.05). We found no significant differences in incremental postoperative doses of morphine consumption in bolus, except at 12 h (P =0.013) and 24 h (P =0.002). The time to first required rescue analgesia was 70 ± 15.491 min in the ketamine group and 44 ± 19.494 min in the control (P>0.05). There were no differences in hemodynamic parameters or patient satisfaction (P>0.05).Conclusions: Preoperative low-dose-ketamine did not show a preemptive analgesic effect or efficacy as an adjuvant for decreasing opioid requirements for postoperative pain in patients receiving intravenous analgesia with morphine after colon surgery.
Interdiction Games on Markovian PERT Networks
Authors: Gutin Eli , Kuhn Daniel , Wiesemann Wolfram 
Published: September 2014

In a stochastic interdiction game a proliferator aims to minimize the expected duration of a nuclear weapons development project, and an interdictor endeavors to maximize the project duration by delaying some of the project tasks. We formulate static and dynamic versions of the interdictor’s decision problem where the interdiction plan is either precommitted or adapts to new information revealed over time, respectively. The static model gives rise to a stochastic program, whereas the dynamic model is formalized as a multiple optimal stopping problem in continuous time and with decision-dependent information. Under a memoryless probabilistic model for the task durations, we prove that the static model reduces to a mixed-integer linear program, whereas the dynamic model reduces to a finite Markov decision process in discrete time that can be solved via efficient value iteration. We then generalize the dynamic model to account for uncertainty in the outcomes of the interdiction actions. We also discuss a crashing game where the proliferator can use limited resources to expedite tasks so as to counterbalance the interdictor’s efforts. The resulting problem can be formulated as a robust Markov decision process. This paper was accepted by Dimitris Bertsimas, optimization.
Memory ability after subarachnoid haemorrhage: Relatives' and patients' statements in relation to test results
Authors: Berggren Elisabeth , Sidenvall Birgitta , Larsson Dennis 
Published: September 2014

Aim The aim of this study was to describe memory after a subarachnoid haemorrhage (SAH) from the perspective of relatives and patients in two cohorts and also to evaluate the application of relatives' statements as a tool in nursing care and rehabilitation, in order to support the patient. Background Cognitive sequelae due to SAH are a large disability and may influence the adjustment to daily life. Supporting patients and relatives requires knowledge concerning the patients' memory both from the perspective of patients and relatives. Method Eleven relatives and 11 patients (Cohort 1), 11 years after the onset of a SAH and 15 relatives and 15 patients (Cohort 2) 6 years after the onset of a SAH, participated in the study. Interview questions and memory tests were used to collect data. Findings Problems with memory, including meta-memory problems regarding relatives' statements, were common. Relatives and patients stated patients' memory in a similar manner. However, patients' statements concerning their memory corresponded in higher degree with memory test results, in comparison with relatives' statements. Conclusions Relatives' and patients' statements are useful as tools in nursing care and rehabilitation. However, from results showing meta-memory problems and that patients' statements concerning their memory corresponded better with memory test results (in comparison with relatives' statements), it is vital to offer patients memory tests in order to prevent complications in mutual family relationships.
Adjuvant therapy decisions based on magnetic resonance imaging of extramural venous invasion and other prognostic factors in colorectal cancer
Authors: Chand M , Swift RI , Chau I , Heald RJ , Tekkis PP , Brown G 
Published: September 2014

Introduction There remains a lack of high quality randomised trial evidence for the use of adjuvant chemotherapy in stage II rectal cancer, particularly in the presence of high risk features such as extramural venous invasion (EMVI). The aim of this study was to explore this issue through a survey of colorectal surgeons and gastrointestinal oncologists. Methods An electronic survey was sent to a group of colorectal surgeons who were members of the Association of Coloproctology of Great Britain and Ireland. The survey was also sent to a group of gastrointestinal oncologists through the Pelican Cancer Foundation. Reminder emails were sent at 4 and 12 weeks. Results A total of 142 surgeons (54% response rate) and 99 oncologists (68% response rate) responded to the survey. The majority in both groups of clinicians thought EMVI was an important consideration in adjuvant treatment decision making and commented routinely on this in their multidisciplinary team meeting. Although both would consider treating patients on the basis of EMVI detected by magnetic resonance imaging, oncologists were more selective. Both surgeons and oncologists were prepared to offer patients with EMVI adjuvant chemotherapy but there was lack of consensus on the benefit. Conclusions This survey reinforces the evolution in thinking with regard to adjuvant therapy in stage II disease. Factors such as EMVI should be given due consideration and the prognostic information we offer patients must be more accurate. Historical data may not accurately reflect today’s practice and it may be time to consider an appropriately designed trial to address this contentious issue.
Parathyroid adenoma in third pharyngeal pouch cyst as a rare case of primary hyperparathyroidism
Authors: Salido S , Gómez-Ramírez J , Bravo JM , Martín-Pérez E , Fernández-Díaz G , Nova JL Múñoz de , Auza J , Larrañaga E 
Published: September 2014

The primitive thymus and inferior parathyroid derive from the third branchial cleft. During embryonic development, these structures descend, reaching their final localisation. Third branchial cleft anomalies present usually as a fistula, abscess or cyst. However, there are no reports on parathyroid adenomas in the literature other than as a morphological possibility. We describe the case of a 47-year-old man, who had been diagnosed with arterial hypertension and who presented with a cervical mass at the edge of the lower third of the sternocleidomastoid muscle. On ultrasonography, the mass had a cystic walled appearance. Laboratory analysis only revealed an intact parathyroid hormone level of 140.5pg/ml. Sestamibi imaging showed a probable parathyroid adenoma in the anterior mediastinum. During surgery, a tract running from beyond the superior thyroid pedicle to the superior mediastinum was dissected and removed. In the inferior end of the tract, a brown mass was visible. Pathological examination revealed a thymus cyst surrounding a parathyroid adenoma. The primal alteration was the lack of division between the thymus and inferior parathyroid gland, and the prompt prevention of their development. In the case of our patient, a parathyroid adenoma had grown by chance.
The acute management of haemorrhoids
Authors: Hardy A , Cohen CRG 
Published: September 2014

Introduction Although the acute thrombosis and strangulation of haemorrhoids is a common condition, there is no consensus as to its most effective treatment. Methods A PubMed search was undertaken for papers describing the aetiology and treatment of the acute complications of haemorrhoids. Results The anatomy and treatments for strangulated internal haemorrhoids and thrombosed perianal varices are discussed. Studies of the effectiveness and complications of conservative and operative treatments are reviewed. Conclusions Ambiguities exist in the terminology used to describe the two separate pathologies that make up the acute complications of haemorrhoids. These complications have traditionally been treated conservatively. There is evidence that early operative intervention for strangulated internal haemorrhoids is safe and effective. A suggested algorithm for treatment is given, based on the published literature.
The morbidity of negative appendicectomy
Authors: Lee M , Paavana T , Mazari F , Wilson TR 
Published: September 2014

Introduction The increased use of diagnostic laparoscopy for management of right iliac fossa pain may have lowered the threshold for removing normal appendices, particularly as there is a perception that this practice carries little additional morbidity. The aim of this retrospective audit was to determine the negative appendicectomy rate after laparoscopic appendicectomy (LA) in our busy district hospital, and to compare the relative incidence and severity of complications after removal of an inflamed or non-inflamed appendix. Methods Adult patients who underwent LA in 2011–2012 were identified from theatre registers. Histology results were reviewed to differentiate between inflamed and normal appendices. Postoperative complications and events following discharge were identified via electronic patient records. Complication severity was stratified using the Clavien–Dindo classification. Results Over 2 years, 467 LAs were performed, of which 143 (30.6%) were for normal appendices. Significantly more negative appendicectomies were performed in women (43%) than in men (17%) (p<0.0001). Complications were seen in 62 patients (13.3%). There was no significant difference between the complication rates for those who had an inflamed (16.6%) or non-inflamed (11.9%) appendix (p=0.141). Similarly, there was no difference in the severity of complications between these groups. Reoperation or invasive intervention was required after four negative appendicectomies (2.8%). Conclusions LA carries a similar morbidity regardless of whether the appendix is inflamed. Negative appendicectomy should not be undertaken routinely during laparoscopy for right iliac fossa pain.
Patient reported outcome measures in male incontinence surgery
Authors: Tran MGB , Yip J , Uveili K , Biers SM , Thiruchelvam N 
Published: September 2014

Introduction Patient reported outcome measures (PROMs) were used to evaluate outcomes of the artificial urinary sphincter (AUS) and the AdVance™ (American Medical Systems, Minnetonka, MN, US) male sling system (AVMS) for the symptomatic management of male stress urinary incontinence. Methods All male patients with stress urinary incontinence referred to our specialist clinic over a two-year period completed the ICIQ-UI SF (International Consultation on Incontinence Questionnaire on Urinary Incontinence Short Form) and the ICIQ-MLUTS LF (International Consultation on Incontinence Questionnaire on Male Lower Urinary Tract Symptoms Long Form) at consultation as well as at subsequent follow-up appointments. The Wilcoxon signed-rank test for non-parametric paired data was used for pre and postoperative comparisons. The chi-squared test was used for categorical variables. Results Thirty-seven patients (forty surgical cases) completed a preoperative and at least one follow-up questionnaire. There was a statistically significant improvement in PROMs postoperatively, regardless of mode of surgery (p<0.01). Analysis of the ICIQ-MLUTS LF showed that patients with higher preoperative scores (>25) had greater improvement with an AUS than with the AVMS (p<0.01). Conclusions This prospective study shows that completion and collection of PROMs as part of routine clinical practice is achievable and useful in the assessment of male stress incontinence surgery. PROMs are important instruments to assess effectiveness of healthcare intervention and they are useful adjuncts in surgical studies.
Outcomes of a metal-on-metal total hip replacement system
Authors: Matharu GS , Theivendran K , Pynsent PB , Jeys L , Pearson AM , Dunlop DJ 
Published: September 2014

IntroductionHigh short-term failure rates have been reported for a variety of metal-on-metal (MoM) total hip replacements (THRs) owing to adverse reactions to metal debris (ARMD). This has led to the withdrawal of certain poorly performing THRs. This study analysed the outcomes of a MoM THR system.MethodsBetween 2004 and 2010, 578 uncemented MoM THRs (511 patients, mean age: 60.0 years) were implanted at one specialist centre. The THR system used consisted of the Corail®stem, Pinnacle®cup, Ultamet®liner and Articul/eze®femoral head (all DePuy, Leeds, UK). All patients were recalled for clinical review with imaging performed as necessary.ResultsThe mean follow-up duration was 5.0 years (range: 1.0–9.1 years). Overall, 39 hips (6.7%) in 38 patients (all 36mm femoral head size) underwent revision at a mean time of 3.5 years (range: 0.01–8.3 years) from the index THR with 30 revisions (77%) performed in women. The cumulative eight-year survival rate for all THRs was 88.9% (95% confidence interval [CI]: 78.5–93.4%), with no difference (p=0.053) between male (95.2%, 95% CI: 84.2–98.7%) and female patients (85.3%, 95% CI: 70.2–92.1%) at eight years. Seventeen revisions (44%) were performed for ARMD. There was no significant difference in absolute postoperative Oxford hip scores between men and women (p=0.608). The mean acetabular inclination in unrevised THRs was 44.0°. Forty-seven non-revised THRs (8.7%) had blood metal ion concentrations above recommended thresholds (seven had periprosthetic effusions).ConclusionsAlthough this MoM THR system has not failed as dramatically as other similar designs, we recommend against continued use and advise regular clinical surveillance to identify ARMD early.
Delayed diagnosis in metastatic lesions of the foot
Authors: Evans S , Ramasamy A , Jeys L , Grimer R 
Published: September 2014

Introduction Pedal acrometastases are a rare complication of disseminated malignancy. To date, there is little in the literature documenting their clinical course. Methods Our large orthopaedic oncology database was used to review the clinical course of symptomatic pedal acrometastases. Results A total of 15 cases of pedal acrometastases were identified from 2,595 patients with metastases. The median age at presentation was 64.5 years (range: 14–83 years) and the median length of foot symptoms (predominantly pain and swelling) prior to diagnosis of metastasis was 16 weeks (range: 6–104 weeks). The median survival following diagnosis was 4.6 months (range: 2.3–104.5 months). Conclusions This study suggests that 0.58% of all osseous metastases involve the foot, and that symptoms of foot pain and swelling are often misdiagnosed, leading to delays in treatment. A high index of suspicion is required to diagnose pedal acrometastases early, thereby allowing early treatment so that the patient’s quality of life can be maintained prior to death.
Media and culture: Movement across the decades
Authors: Rowe David 
Published: September 2014

Abstract
Over the last decade there have been well-documented, far-reaching changes to the media environment as digitalization – among other forces and processes – has substantially altered media production, consumption and use. A notable consequence of this shift has been the intensified co-dependency of the media and (especially ‘live’) sport, and the continuing expansion of the ‘media sports cultural complex’. The developing phenomenon of social media now figures prominently across the cultural sphere (including the ‘zone’ of media and sport), but it is necessary to question some ostensibly over-optimistic or premature claims about its lasting significance as a vehicle for human liberation. Thus, in considering a broad research agenda in this domain for the next decade, the centrality of political economy, media history, and anti-technological determinism are emphasized as necessary components of any workable analytical engagement with questions of power, media and cultural politics.
Countersymbols and the Constitution of Resistance in American Fundamentalism, 1919–1922
Authors: Edwards Jonathan J. 
Published: September 2014

Abstract
Christian fundamentalism is a doctrinal system and an argumentative frame, but it also functions as a “countermovement” whose members advocate resistance from a purported place of ecclesial and political marginalization. This article explores the roots of early fundamentalist resistance rhetoric as it manifested through a series of “countersymbols”—oppositional condensation symbols that invoke the corruption of an idealized community by its other to rhetorically justify resistance as necessary response.
Extending the dominion of effective control – Its applicability to mood choice in Spanish and Portuguese
Authors: Vesterinen Rainer 
Published: September 2014

AbstractWithin the model of Cognitive Grammar, the concept of dominion is fundamental to the analysis of the conceptualizer's attitude toward an event or a proposition. However, the concept has, first and foremost, been understood in epistemic terms, whereas there has been less concern with the conceptualizer's efforts to influence and manipulate the course of events in the world. This being so, the present paper shows that the conceptualizer's dominion of effective control is relevant in a number of linguistic contexts. The analysis provides evidence for this particular feature in factive contexts, deontic contexts, contexts of volition and causation, and in adverbial clauses of purpose, manner and condition. The analysis further shows that the conceptualizer's dominion of effective control is capable of providing a conceptually grounded explanation for the occurrence of the Spanish and the Portuguese subjunctive mood in these grammatical contexts.
Estimation of Equilibrium Moisture Content of Pistachio Powder through the ANN and GA Approaches
Authors: Tavakolipour Hamid , Mokhtarian Mohsen 
Published: September 2014

AbstractIn this study, two intelligent tools of genetic algorithm (GA) and artificial neural network (ANN) were employed to use experimental data to predict equilibrium moisture content (EMC) of Persian pistachio powder. Initially the moisture sorption isotherms of pistachio powder were determined by gravimetric method at different temperatures (15, 25, 35 and 40°C) and constant relative humidity’s (0.11, 0.23, 0.36, 0.49, 0.62, 0.75 and 0.88awvalues) and then traditional mathematical models including BET, Iglesias and Chirife, GAB, Caurie and Freundlich were used to check the fitness of experimental data. Later the experimental data were compared with similar data obtained from GA and ANN models. The overall results showed that the Caurie model had high performance to predict EMC and revealed that GA model had greater accuracy to predict EMC of pistachio powder with very highR2values (equal to 0.9996).
A Generalization of the Wadati-Konno-Ichikawa Soliton Hierarchy and its Liouville Integrability
Authors: Ma Wen-Xiu , Xia Tiecheng , Zhu Zuonong 
Published: September 2014

Abstract
A new matrix spectral problem associated with sl(2,), which generalizes the Wadati-Konno-Ichikawa spectral problem, is introduced, and the corresponding hierarchy of soliton equations is generated from the associated zero curvature equations. A bi-Hamiltonian structure of the resulting generalized soliton hierarchy is furnished by using the trace identity, and thus, every system in the generalized hierarchy is Liouville integrable.
Cellular and molecular basis of decision‐making
Authors: Yapici Nilay , Zimmer Manuel , Domingos Ana I 
Published: September 2014

AbstractPeople think they are in control of their own decisions: what to eat or drink, whom to marry or pick a fight with, where to live, what to buy. Behavioural economists and neurophysiologists have long studied decision‐making behaviours. However, these behaviours have only recently been studied through the light of molecular genetics. Here, we review recent research in mice, Drosophila melanogaster and Caenorhabditis elegans, that analyses the molecular and cellular mechanisms underlying decision‐making. These studies interrogate decision‐making about food, sexual behaviour, aggression or foraging strategies, and add molecular and cell biology understanding onto the consilience of brain and decision.
Color-Coded Digital Subtraction Angiography in the Management of a Rare Case of Middle Cerebral Artery Pure Arterial Malformation
Authors: Feliciano Caleb E. , Pamias-Portalatin Eva , Mendoza-Torres Jorge , Effio Euclides , Moran Yadira , Rodriguez-Mercado Rafael 
Published: September 2014

The advent of flow dynamics and the recent availability of perfusion analysis software have provided new diagnostic tools and management possibilities for cerebrovascular patients. To this end, we provide an example of the use of color-coded angiography and its application in a rare case of a patient with a pure middle cerebral artery (MCA) malformation. A 42-year-old male chronic smoker was evaluated in the emergency room due to sudden onset of severe headache, nausea, vomiting and left-sided weakness. Head computed tomography revealed a right basal ganglia hemorrhage. Cerebral digital subtraction angiography (DSA) showed a right middle cerebral artery malformation consisting of convoluted and ectatic collateral vessels supplying the distal middle cerebral artery territory-M1 proximally occluded. An associated medial lenticulostriate artery aneurysm was found. Brain single-photon emission computed tomography with and without acetazolamide failed to show problems in vascular reserve that would indicate the need for flow augmentation. Twelve months after discharge, the patient recovered from the left-sided weakness and did not present any similar events. A follow-up DSA and perfusion study using color-coded perfusion analysis showed perforator aneurysm resolution and adequate, albeit delayed perfusion in the involved vascular territory. We propose a combined congenital and acquired mechanism involving M1 occlusion with secondary dysplastic changes in collateral supply to the distal MCA territory. Angiographic and cerebral perfusion work-up was used to exclude the need for flow augmentation. Nevertheless, the natural course of this lesion remains unclear and long-term follow-up is warranted.