bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Decorated Stone from the Synagogue at Migdal
Authors: Aviam Mordechai 
Published: June 2013

Abstract
In the center of the first century CE synagogue which was discovered at ancient Magdala (Migdal), a large decorated stone block was found. It is covered with decorative-symbolic elements on four sides and on the upper face as well, standing on four short legs. As the façade is carrying the Temple’s Menorah, this article will suggest that all other elements are not decorative but rather symbolic and symbolizing the Temple in Jerusalem. Another conclusion is that the block was used as a base for the Torah reading table in the synagogue. These symbols show that there was a very strong connection between Galileans and Jerusalem with the Temple in its center, and that there is an important reflection and relations between Jewish symbolism and Jewish heavenly mysticism as it appears in ancient Jewish sources, both Biblical and non-Biblical.
Three Models of Development: Community Ophthalmology NGOs and the Appropriate Technology Movement
Authors: Williams Logan D. A. 
Published: June 2013

Abstract
This paper describes a new shift in the appropriate technology movement in less economically developed countries as seen in a multi-sited ethnography of non-governmental organizations (NGOs) in the scientific field of ophthalmology. This research reveals how Aravind Eye Care System in southern India and Tilganga Institute of Ophthalmology in Nepal are addressing “undone science” for avoidable blindness. They are creating the requisite local hospital and personnel infrastructure while conducting “civil society research.” They are also providing high quality modern care to low-income patients of the global south while charging reduced or no fees. This paper argues that they represent a third model in the appropriate technology movement—contextually appropriate local production of high technology. This third model focuses on socially responsible innovation for purposes of social improvement; it is rooted in nonprofit, social enterprise organizations to include the following four aspects: (1) scientific innovation or the “appropriation” of new science; (2) organizational innovation, including changes in operations management for self-sufficiency through multiple revenue streams; (3) technological innovation or the creation of new products and artifacts; and (4) an underlying ideological orientation that is based on local philosophy (and challenges hegemonic understandings of postcolonial dependency or neoliberalism).
The Market at the Bottom of the Pyramid: Understanding the Culture of Poverty
Authors: Ahmed Fauzia Erfan 
Published: June 2013

Abstract
As never before, the private sector can make a difference at the bottom of the pyramid (BOP). But little is known about who the poor really are, the environment in which they live, and how to create value for them. This also means that little is known about how to establish a business at the BOP that meets both development and profit goals. This article presents a segmentation approach embedded in a larger theory of the culture of poverty to help businesses focus on serving the BOP. I focus on examples from my research on the Grameen Bank in Bangladesh and Patrimonio Hoy in Mexico to show examples of applications of segmentation theory to businesses at the BOP.
Spatial Gradients in Aerosol-Induced Atmospheric Heating and Surface Dimming over the Oceanic Regions around India: Anthropogenic or Natural?
Authors: Nair Vijayakumar S. , Babu S. Suresh , Moorthy K. Krishna , Prijith S. S. 
Published: June 2013

Abstract
Making use of the extensive shipboard and aircraft measurements of aerosol properties over the oceanic regions surrounding the Indian peninsula, under the Integrated Campaign for Aerosols, gases and Radiation Budget (ICARB) field experiment during the premonsoon season (March–May), supplemented with long-term satellite data and chemical transport model simulations, investigations are made of the east–west and north–south gradients in aerosol properties and estimated radiative forcing, over the oceans around India. An eastward gradient has been noticed in most of the aerosol parameters that persisted both within the marine atmospheric boundary layer and above up to an altitude of ~6 km; the gradients being steeper at higher altitudes. It was also noticed that the north–south gradient has contrasting patterns over the Bay of Bengal and the Arabian Sea on the either side of the Indian peninsula. The aerosol-induced atmospheric heating rate increased from a low value of ≤0.1 K day−1 in the southwestern Arabian Sea to as high as ~0.5 K day−1 over the northeastern Bay of Bengal. The simulations of species-resolved spatial gradients have revealed that the observed gradients are the result of the strong modulations by anthropogenic species over the natural gradients, thereby emphasizing the role of human activities in imparting regional forcing. These large spatial gradients in aerosol forcing induced by mostly anthropogenic aerosols over the oceanic regions around the Indian peninsula can potentially affect the regional circulation patterns.
The Strain Index and ACGIH TLV for HAL
Authors: Kapellusch Jay M. , Garg Arun , Hegmann Kurt T. , Thiese Matthew S. , Malloy Elizabeth J. 
Published: June 2013

Objective: The objective of this study was to investigate the association between job physical exposure (JPE) and incidence of flexor tendon entrapment of the digits (FTED). Background: FTED, commonly known as trigger digit, is associated with age, gender, and certain health disorders. Although JPE has been suggested as a risk factor for FTED, there are no prospective cohort studies. Method: A cohort of 516 workers was enrolled from 10 diverse manufacturing facilities and followed monthly for 6 years. Worker demographics, medical history, and symptoms of FTED were assessed. JPE was individually measured using the Strain Index (SI) and American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL). Changes in JPE (assessed quarterly) and symptoms (assessed monthly) were recorded during follow-up. FTED was defined as demonstrated triggering on examination. Results: Point prevalence of FTED at baseline was 3.6%. During follow-up there were 23 incident FTED cases (left and/or right hands). The incident rate for first occurrence of FTED from enrollment was 1.38 per 100 person-years. Risk factors were JPE, age, gender, diabetes mellitus, carpometacarpal osteoarthrosis, and rheumatoid arthritis. In multivariate models, the SI showed strong association with risk of FTED when treated as a continuous variable and marginal association when dichotomized (SI > 6.1). TLV for HAL showed a statistical trend of increasing risk of FTED using the ACGIH limits, but no association as a continuous variable. Conclusions: Both JPE and personal risk factors are associated with FTED development. The SI and TLV for HAL are useful tools for estimating JPE.
Accountability as a policy technology: accounting for education performance in Europe
Authors: Ozga Jenny 
Published: June 2013

This article discusses the investigation of accountability in different national contexts in the rapidly developing and increasingly important policy field of education in Europe. It draws on recent and current research to argue for a focus on what changing practices of accountability in education tell us about changes in governing education (and by extension, other public policy areas) within and across shifting policy spaces. The article further argues that accountability in education is increasingly defined as technical accountability through international and national comparative measures of performance, so that political accountability has been displaced, and performativity contributes to growing problems of diminished trust across and within education systems. Points for practitioners This article seeks to place the development of comparative measures of performance – in education and in other public sector provision – in a critical frame that draws attention to the reduction in political accountability that accompanies the explosion of performance measurement. The article underlines the extent to which competitive measurement of performance both drives out other, more complex forms of assessment of performance and creates relations of mistrust between education professionals and governments. Professionals working in the education sector are encouraged to scrutinize the operation of technologies like PISA and to be informed about their political effects and assumptions
From civil servants to liberal professionals: an empirical analysis of the reform of Portuguese notaries
Authors: Tavares António F , Rodrigues Miguel A 
Published: June 2013

The use of market mechanisms has been progressively introduced as an alternative solution to public service delivery since the 1980s. This work addresses an uncommon public service function – civil law notaries – and seeks to analyse the factors that led to the formation of diverse market structures as a result of the choice of the privatization path over civil service status by public notaries. The Portuguese government gave public notaries the choice of becoming private, and regulated a numerus clausus of notaries by district. Since the reform was completed, a diversity of market structures have prevailed throughout the 278 notarial districts. Our key hypothesis is that markets with multiple agents formed in jurisdictions having a larger and more profitable number of notary and legal acts that provided financial survival and profit. In contrast, monopolies formed as a result of a perceived absence of market opportunities and demand. During the period 2010–11 we collected data from official statistics of the notary system supplemented by data on the economic and demographic features of each jurisdiction. Multinomial logistic regression is used to test the key hypothesis regarding market arrangements in the 278 notarial districts of continental Portugal. Points for practitioners The trend in the deregulation of the notary profession is likely to continue to sweep European Union countries. Lessons can be drawn from the Portuguese experience, where the change from civil service status is not yet mandatory for all notaries, but financial constraints and fiscal pressures indicate privatization as the inevitable path.
Analysing the role of ministerial cabinets in Italy: legacy and temporality in the study of administrative reforms
Authors: Di Mascio Fabrizio , Natalini Alessandro 
Published: June 2013

The article explores the transformations which have occurred in ministerial cabinets as entrenched advisory structures in the Italian executive since the early 1990s when the party system collapsed and a permanent cycle of public management reforms was introduced. It examines how ministerial advisers have acquired a greater role in executive coordination filling the void of governing capacity left by the failed institutionalization of the new party system. In doing so, the empirical analysis identifies the constellation of actors that reproduced ministerial cabinets as a legacy of the past in the present set-up of the Italian system, eventually hindering the innovation of governance structures according to international standards. Points for practitioners This article seeks to contribute to the literature on the development of ministerial staff as a key manifestation of increasing public service politicization. With its more nuanced type of legacy explanation, focused on the identification of causal mechanisms that link institutional arrangements and actor choices in reform processes, the article can also contribute to general debates on the role of time in public management. It also recommends an integrated focus on the different policies of civil service reform in order to map interrelations of administrative changes.
Validation of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool: a multicentre study
Authors:   LoTS care LUNS study team, Forster Anne , Murray Jenni , Young John , Shannon Rosie , Mellish Kirste , Horton Mike , Tennant Alan , Breen Rachel , Alvarado Natasha , Bhakta Bipin , Bogle Sue , Hewison Jenny , House Allan 
Published: June 2013

Objective: To evaluate the acceptability, test–retest reliability and validity of the Longer-term Unmet Needs after Stroke monitoring tool. Design: A questionnaire pack was posted to stroke survivors living at home three or six months after stroke. A second pack was sent two weeks after receipt of the completed first pack. Setting: Stroke survivors living at home across England. Subjects: Stroke survivors were recruited from 40 hospitals across England, in two phases. The first with an optimal cohort of patients, the second to capture a broader post-stroke population, including those with communication and/or cognitive difficulties. Patients were excluded if they required palliative care or if permanent discharge to a nursing or residential home was planned. Main measures: The questionnaire pack included the Longer-term Unmet Needs after Stroke tool, General Health Questionnaire-12, Frenchay Activities Index, and Short Form-12. Results: Interim analysis of phase 1 data ( n = 350) indicated that the tool was sufficiently robust to progress to phase 2 ( n = 500). Results are reported on the combined study population. Of 850 patients recruited, 199 (23%) had communication and/or cognitive difficulties. The median age was 73 years (range 28–98). Questionnaire pack return rate was 69%. For the new tool, there was 3.5% missing data and test–retest reliability was moderate to good (percentage item agreement 78–99%, kappa statistic 0.45–0.67). Identification of an unmet need was consistently associated with poorer outcomes on concurrent measures. Conclusions: The Longer-term Unmet Needs after Stroke tool is acceptable, reliable, can be self-completed, and used to identify longer-term unmet needs after stroke.
Video game play (Dance Dance Revolution) as a potential exercise therapy in Huntington’s disease: a controlled clinical trial
Authors: Kloos Anne D , Fritz Nora E , Kostyk Sandra K , Young Gregory S , Kegelmeyer Deb A 
Published: June 2013

Objective: To investigate the feasibility, acceptability, and safety of a supervised video game exercise program administered via Dance Dance Revolution in individuals with Huntington’s disease. Design: A cross-over, controlled, single-blinded, six-week trial. Setting: Home-based. Participants: Eighteen ambulatory individuals with Huntington’s disease (seven male, mean age 50.7 SD 14.7). Interventions: Participants played the Dance Dance Revolution game with supervision and the handheld game without supervision for 45 minutes, two days per week for six weeks. Outcome measures: Game play performance and adherence, participant perceptions of the game, safety (vital signs, adverse health changes), spatiotemporal gait measures, Four-Square Step Test, Tinetti Mobility Test, Activities-Specific Balance Confidence Scale, and World Health Organization Quality of Life – Bref, before and after each intervention. Results: Most participants improved on game play, enjoyed playing the game, and wanted to continue playing after study completion. After playing Dance Dance Revolution, participants showed significant reductions in double support percentage (adjusted mean difference (95% confidence intervals): –2.54% (–4.75, –0.34) for forward walking and −4.18 (–6.89, –0.48) for backward walking) and those with less severe motor symptoms had reductions in heel-to-heel base of support during forward walking. The remaining measures were not significantly impacted by the intervention. Conclusion: Dance Dance Revolution appears to be a feasible, motivating, and safe exercise intervention for individuals with Huntington’s disease.
Operative and Nonoperative Treatment of Cervical Disc Herniation in National Football League Athletes
Authors: Meredith Dennis S. , Jones Kristofer J. , Barnes Ronnie , Rodeo Scott A. , Cammisa Frank P. , Warren Russell F. 
Published: June 2013

Background: Limited evidence exists to guide clinical decision making regarding cervical disc herniations in professional athletes playing for the National Football League (NFL) in the United States. Purpose: To describe the presentation and treatment outcomes of cervical disc herniations in NFL athletes with a focus on safety and return to sport. Study Design: Case series; Level of evidence, 4. Methods: The records of a single NFL team and its consulting physicians were reviewed from 2000 to 2011. Only athletes with magnetic resonance imaging (MRI)–proven disc herniation concordant with the reported symptoms were included. Results: A total of 16 athletes met inclusion criteria. Linemen, linebackers, and defensive backs were the most represented positions (13/16 athletes; 81%). The most common presentation was radiculopathy after a single traumatic event (9/16 athletes; 56%). Three players had transient paresis. Three players underwent one-level anterior cervical discectomy and fusion. These 3 players had failed nonoperative therapy and had evidence of spinal cord compression with signal change on MRI, but only 1 returned to sport. Three players received epidural steroid injections, which provided transient symptomatic relief. Five players were treated nonoperatively and did not return to sport. Two of these 5 athletes had cord compression with signal change and retired rather than undergo surgery. The other 3 were cleared but were released by the team. Eight players were treated nonoperatively and returned to sport. Three of these 8 athletes had evidence of disc material abutting the cord without cord signal change but had a normal examination finding and returned to sport after resolution of their symptoms and repeat MRI that demonstrated no cord compression. Five of the 8 players had evidence of root compression and were treated symptomatically. There were no subsequent traumatic spinal cord injuries at a minimum of 1-year follow-up. Conclusion: Data regarding the treatment of this unique population are limited but suggest that NFL athletes can safely return to sport after the treatment of cervical disc herniations. In the treatment algorithm for this study, cord compression with signal change in the cord on MRI was a consistent operative indication. Discs abutting the cord can be treated nonoperatively but do not allow for return to sport until symptoms have improved and repeat imaging demonstrates no cord compression. Isolated nerve root compression has a more favorable prognosis. It can be treated symptomatically and return to sport allowed when symptoms permit.
Relationship Between Humeral Torsion and Injury in Professional Baseball Pitchers
Authors: Polster Joshua M. , Bullen Jennifer , Obuchowski Nancy A. , Bryan Jason A. , Soloff Lonnie , Schickendantz Mark S. 
Published: June 2013

Background: High levels of humeral torsion allow baseball pitchers to achieve maximum external rotation in the late cocking phase of pitching with lower twisting and shear forces on the long head of the biceps tendon and rotator cuff tendons. Hypothesis: Humeral torsion is inversely related to the incidence and severity of shoulder injuries and other upper extremity injuries in professional baseball pitchers. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 25 professional pitchers from a single Major League Baseball organization were prospectively recruited into this study. Computed tomography (CT) was performed on dominant and nondominant humeri, and image data were processed with a 3-dimensional volume-rendering postprocessing program. The software program was then modified to model a simplified throwing motion and to measure potential internal impingement distances in a small subset of players. Players were followed for 2 years after CT, and the number of days missed from pitching activities was recorded as a measure of injury severity and incidence. Results: The mean dominant humeral torsion was 38.5° ± 8.9°; the mean nondominant humeral torsion was 27.6° ± 8.0°. The difference between dominant and nondominant torsions was significant ( P < .0001). Among the 11 pitchers (44%) injured during follow-up, 5 players had shoulder injuries, 7 had elbow injuries, and 2 had finger injuries. Dominant humeral torsion was a statistically significant predictor of severe injuries (≥30 days; P = .048) but not of milder injuries. Among injured players, higher numbers of days missed because of injury were strongly correlated with lower degrees of dominant humeral torsion ( r = −0.78; P = .005) and smaller differences between dominant and nondominant humeral torsions ( r = −0.59; P = .055). There was no significant association between the incidence of shoulder injury and minimum glenoid-tuberosity distance in the dominant or nondominant shoulder or degree of dominant glenoid version. Conclusion: A strong relationship was found between lower degrees of dominant humeral torsion and more severe upper extremity injuries as well as a trend relating lower side-to-side differences in torsion with more severe dominant upper extremity injuries. In addition, there was a higher incidence of severe injuries in players with lower degrees of dominant torsion. If future studies confirm these results, humeral torsion measurements could play a role in risk assessment in pitchers.
Apoptosis Occurs Throughout the Diseased Rotator Cuff
Authors: Lee Hyo-Jin , Kim Yang-Soo , Ok Ji-Hoon , Song Ha-Jung 
Published: June 2013

Background: Even though apoptosis is known to be closely associated with rotator cuff tears, the differences in apoptosis according to the location within the torn supraspinatus tendon are still unknown. Purpose: To elucidate where apoptosis begins within the supraspinatus tendon. Study Design: Controlled laboratory study. Methods: Tendon tissues were collected from 14 patients undergoing arthroscopic rotator cuff repair surgery and 7 patients undergoing surgery for proximal humeral fracture who served as controls. In the patients with rotator cuff tears, the samples were harvested at 3 sites: the most lateral torn margin, 1 cm medial from the torn margin, and at the posterior torn corner. Caspase 3/7, 8, and 9 and cytochrome c activities were measured to determine the intracellular apoptosis pathway. Apoptotic cells were determined by in situ TUNEL (terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling) staining, and immunohistochemistry was performed. Results: The apoptotic activities of tendons from the experimental subjects were significantly higher than those of the controls. There were, however, no significant differences between the 3 sample sites. Immunohistochemistry also revealed strong expression of increased caspase 3/7, 8, and 9 and cytochrome c but no significant difference between them. Conclusion: This study shows that the intracellular apoptotic pathway is not only through the cell membrane receptor but also via intracellular mitochondria cascade. Clinical Relevance: Because apoptosis occurs regardless of the location within the rotator cuff, debridement of the torn margin to obtain a healthy tendon may not be needed. Further study should focus on not only the technique of tying the torn tendon back to the bone but also biological augmentation to reverse or prevent further apoptosis within rotator cuff tendon.