To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This prospective study aimed to evaluate the relationship between serum ischaemia-modified albumin levels and Bell's palsy severity.
The study included 30 patients diagnosed with Bell's palsy and 30 healthy individuals. The patients were separated into three disease severity groups (grades 2, 3 and 4) according to House–Brackmann classification. Blood samples were collected from all participants and the results compared between groups.
Significant differences in serum ischaemia-modified albumin were found between the study and control groups (p < 0.001); values were significantly higher in the study group than in the control group.
The significantly higher levels of serum ischaemia-modified albumin in the study group suggest that Bell's palsy pathogenesis is associated with oxidative stress.
Hospital evacuations of patients with special needs are extremely challenging, and it is difficult to train hospital workers for this rare event.
Researchers developed an in-situ simulation study investigating the effect of standardized checklists on the evacuation of a patient under general anesthesia from the operating room (OR) and hypothesized that checklists would improve the completion rate of critical actions and decrease evacuation time.
A vertical evacuation of the high-fidelity manikin (SimMan3G; Laerdal Inc.; Norway) was performed and participants were asked to lead the team and evacuate the manikin to the ground floor after a mock fire alarm. Participants were randomized to two groups: one was given an evacuation checklist (checklist group [CG]) and the other was not (non-checklist group [NCG]). A total of 19 scenarios were run with 28 participants.
Mean scenario time, preparation phase of evacuation, and time to transport the manikin down the stairs did not differ significantly between groups (P = .369, .462, and .935, respectively). The CG group showed significantly better performance of critical actions, including securing the airway, taking additional drug supplies, and taking additional equipment supplies (P = .047, .001, and .001, respectively). In the post-evacuation surveys, 27 out of 28 participants agreed that checklists would improve the evacuation process in a real event.
Standardized checklists increase the completion rate of pre-defined critical actions in evacuations out of the OR, which likely improves patient safety. Checklist use did not have a significant effect on total evacuation time.
To evaluate the relationship between spiritual well-being (SpWB) and quality of life (QoL) in cancer (CA) survivors.
The current study was conducted in the oncology center at a university hospital in Central Anatolia/Turkey. In this study, a descriptive cross-sectional survey design was used. The data collected included: a questionnaire form, the current study was conducted in the oncology center at a university hospital in Central Anatolia/Turkey. In this study, a descriptive cross-sectional survey design was used. SpWB was assessed by the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, version 4 (FACIT-Sp12, v. 4), including Meaning, Peace, and Faith subscales. The QoL was evaluated using the Functional Assessment of Cancer Therapy-General scale (FACT-G, v. 4). The results were analyzed using descriptive statistics, Pearson correlations, independent sample t-test, Kruskal-Wallis, and Mann-Whitney U test.
One hundred fifty patients participated in this study: 61.30% female, 78% 45 years of age or older, 94.70% married, 46% had finished, and 69% had gastrointestinal tract CA. The mean age was 53.48 (SD = 9.43). The majority of participants (96.7%) endorsed “a force pushing them a will to live” while 59.3% supported “the power of relationships with others.” There was a positive, strong correlation between overall QoL and SpWB (r = 0.619, p < 0.01). The Meaning dimensions of SpWB with Functional Well-Being (FWB) and overall QoL (r = 0.512; 0.595, p < 0.000 respectively), Peace with Emotional Well-Being (EWB) and FWB (r = 0.598; 0.540, p < 0.000 respectively) dimensions of FACT-G and overall QoL (r = 0.609, p < 0.001) were strong correlated. Faith and QoL were not significantly correlated.
Significance of results
This study demonstrates that SpWB positively contributed to the QoL of CA survivors. SpWB is not necessarily limited to any specific types of beliefs or practices. For some people, faith in self, others and/or God constitutes, in large part, the meaning, purpose, and fulfillment they find in life.
Anomalous single coronary artery from pulmonary artery is a very rare congenital heart anomaly. Anomalous single coronary artery from pulmonary artery has high mortality rates and poor surgical outcome despite advanced surgical techniques. We report a 4-month-old infant presented by congestive heart failure findings and diagnosed with anomalous single trunk coronary arteries arising from right pulmonary artery.
Values are important in understanding the managerial behaviour. Values are the unique criteria that enable people to become conscious of social relations and duties. We contribute to this understanding through determining the values which affect an organisation’s business approach by providing evidence from a comparative study of various airports through a questionnaire method. The study was carried out with 163 participants and factor analysis was used to reduce the complexity of a data set so that it becomes easier to use the data in applied settings. Ranking analysis was used to get the values hierarchy of managers. This hierarchy-addicted culture helps to understand corporate sustainability and loyalty. Managing values increases quality and retains sustainability. Further suggestions are made regarding values that should be taken into consideration for achieving corporate strategies, whether operating regionally or globally. This study contributes towards improving awareness on the effects of values in business management in both theory and practice, along with their limitations. The analysis shows that there is a conformity between organisational and individual values.
The aim of our study was to assess left ventricle and right ventricle systolic and diastolic functions in obese adolescents with metabolic syndrome using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotis intima-media thickness, and asymmetric dimethyl arginine levels.
A total of 198 obese adolescents were enrolled in the study. The obese patients were divided into metabolic syndrome group and non-metabolic syndrome group. All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulsed, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness.
Obese adolescents were characterised by enlarged left end-diastolic, end-systolic and left atrial diameters, thicker left and right ventricular walls compared with non-obese adolescents. The metabolic syndrome group had normal left ventricle systolic function, impaired diastolic function, and altered global systolic and diastolic myocardial performance. In the metabolic syndrome obese group patients, left ventricle mass was found positively correlated with body mass index, waist and hip circumferences, diastolic blood pressure, age, and waist-to-hip circumference ratio. The carotid intima-media thickness was found positively correlated with waist and hip circumferences and total cholesterol levels. Asymmetric dimethyl arginine levels were found positively correlated with systolic blood pressure, waist-to-hip circumference ratio, and diastolic blood pressure.
The results of this study demonstrate that metabolic syndrome in adolescence is associated with significant changes in myocardial geometry and function. In addition, it has been associated with a high level of asymmetric dimethyl arginine concentration and thicker carotid intima-media thickness reflecting endothelial dysfunction.
This study extends previous research on organizational resilience by focusing on its relational resilience dimension and integrating with its operational resilience dimension. Our main goal is to understand relational resilience construct and complement it with operational resilience construct to have a complete and balanced picture of organizational resilience. We analyze complementary contributions of relational and operational resilience on organizational resilience in survival and sustainability dimensions. A multiple-case study has been conducted on two manufacturing and two service organizations. This study has conceptualized relational resilience beyond its survival dimension and extended it in sustainability dimension. This understanding enables congruence with the recent conceptualization of organizational and operational resilience in survival and sustainability aspects.
This paper explores the key features of the emerging welfare mix for Syrian refugees in Turkey and identifies the modes of interaction between humanitarian assistance programmes, domestic policy responses and the Turkish welfare system. The welfare mix for Syrian refugees is a joint product of humanitarian assistance programmes implemented by international and domestic non-governmental organisations (NGOs) and domestic social policy programmes. Three policy domains are considered: social assistance schemes, employment and health care services. The paper suggests that granting of temporary protection status to Syrian migrants in Turkey and the agreement between Turkey and the EU shaped the welfare mix by empowering the public sector mandate vis-à-vis the humanitarian actors. As a result, the role of the public sector increases at the expense of NGOs, especially in social assistance and health care, while NGOs are increasingly specialised in protection work (especially in mental health support), where the Turkish welfare system has been weak. Employment has been essentially disregarded, in both humanitarian and social policy programmes, which casts doubt on the prospect of successful economic integration. Finally, this paper argues that the convergence of the rights of immigrants and citizens may well occur in mature components of less comprehensive welfare systems.
The top 100 physicians of otorhinolaryngology and head and neck surgery worldwide were investigated using the Google Scholar h-index.
Although there are various bibliometrics ranking systems that present the academic quantity and quality of scientists’ published articles, the h-index is the most popular and widely accepted. In this study, Google Scholar was used to search all the keywords involving all the subspecialties of otorhinolaryngology and head and neck surgery, with the aim of identifying as many physicians as possible. Obtaining the Google Scholar h-index and citations is not possible for scientists who do not have Google Scholar accounts. Thus, only those with Google Scholar accounts were included.
The average h-index of all 100 physicians enrolled in the study was 37.83, with a range of 25–81.
The current study details the academic impact of otorhinolaryngology and head and neck surgery physicians worldwide based on the Google Scholar h-index.
To evaluate the effects of CyberKnife stereotactic radiotherapy for the treatment of vestibular schwannoma on hearing, as evaluated by audiological tests.
Patients with vestibular schwannoma were evaluated before and after CyberKnife radiosurgery. Evaluation included pure tone thresholds, speech discrimination scores, auditory brainstem responses and radiological signs.
The study comprised 26 patients diagnosed with vestibular schwannoma and subsequently treated with CyberKnife radiosurgery. The mean follow-up time was 16.4 months. The mean post-treatment hearing preservation rate was 69.23 per cent. There was no significant relationship between hearing loss after treatment and patient age, radiation dosage during treatment, or size of tumour. With regard to auditory brainstem responses, patients with hearing loss following treatment had a significantly higher inter-peak latency between waves I–III than patients with preserved hearing.
Stereotactic CyberKnife radiosurgery is an excellent alternative treatment modality for patients with vestibular schwannoma, and results in acceptable preservation of hearing. Residual hearing following CyberKnife therapy is not significantly affected by factors such as age, size of tumour or dosage of treatment.
To compare functional and oncological treatment outcomes among patients with supraglottic laryngeal cancers who underwent transoral robotic supraglottic laryngectomy and open supraglottic laryngectomy.
A retrospective chart review was conducted of 17 patients treated by transoral robotic supraglottic laryngectomy and 20 patients treated by open supraglottic laryngectomy.
No tracheostomy or prolonged intubation was needed in the transoral robotic surgery group. Furthermore, that group had a shorter oral feeding time, hospitalisation and recovery period. There was no difference between groups in terms of complications. There were no differences in overall survival time and disease-specific survival time between groups.
Transoral robotic supraglottic laryngectomy for supraglottic laryngeal cancer is an oncologically safe and functional procedure with better results when compared to conventional open surgery.
The negative effects of cryopreservation on sperm parameters are well documented but little information is known about molecular basis of the process. The aim of the present study was to investigate the possible effects of sperm cryopreservation on main apoptotic signs including DNA fragmentation and caspase-3 activation and to determine if these effects vary according to sperm parameters. Sperm samples of 72 patients were cryopreserved. The patients were sub-grouped as normozoospermic or non-normozoospermic patients according to their semen parameters. DNA fragmentation rates and caspase-3 activation levels were analyzed before and after cryopreservation in both groups. Mean DNA fragmentation rate was increased significantly from 23.98% in neat semen samples to 27.34% after cryopreservation (P = 0.03). DNA fragmentation rates were slightly higher in non-normozoospermic patients compared with the normozoospermic patients in both the neat semen and after cryopreservation (23.25 and 24.71% vs. 26.32 and 28.36%, respectively) although the difference obtained were not statistically significant. An increasing trend for caspase-3 activations (0.093 vs. 0.116) was observed after cryopreservation but the differences were not statistically significant. Caspase-3 activation was found to be slightly higher in non-normozoospermic patients both in the neat semen and after cryopreservation compared with the normozoospermic patients but the differences were not statistically significant. Caspase-3 expression was also shown using immunocytochemistry in both fresh ejaculated sperm and thawed sperm after cryopreservation but at different localizations. The cryopreservation process had detrimental effects on sperm quality but the quality of the sperm samples was not adversely effective for the apoptotic markers including DNA fragmentation and caspase-3 activation patterns. In fact, it was the cryopreservation process itself that adversely effected the above apoptotic markers and apoptosis. It was concluded therefore that sperm cell cryopreservation triggers apoptosis after thawing and this process adversely affects semen parameters.
To analyse the clinical outcomes of biodegradable synthetic polyurethane foam versus ribbon gauze and ear wick in the treatment of severe acute otitis externa.
Ninety-two adults with severe acute otitis externa were randomly assigned to groups receiving ear wick (n = 28), ribbon gauze (n = 34) or biodegradable synthetic polyurethane foam (n = 30). Clinical efficacy, in terms of otalgia, oedema, erythema and tenderness of the external auditory canal, was assessed before packing was applied and at follow up on the 3rd and 7th days of presentation.
All packing materials were associated with improved otalgia and oedema on the 3rd day; however, there were significant differences between biodegradable synthetic polyurethane foam and the other packing materials, and there was no significant reduction in tenderness in the biodegradable synthetic polyurethane foam group on the 3rd day. In the ribbon gauze and ear wick groups, improvements in all clinical efficacy scores were statistically significant for all pairwise comparisons.
The three packing materials were all quite effective in treating severe acute otitis externa, but ear wick and ribbon gauze were superior to biodegradable synthetic polyurethane foam for relieving signs and symptoms, especially on the 3rd day.
Premature ventricular contractions are accepted as benign in structurally normal hearts. However, reversible cardiomyopathy can sometimes develop. Omega-3 polyunsaturated fatty acids have anti-arrhythmic properties in animals and humans.
We evaluated left ventricular function in children with premature ventricular contractions with normal cardiac anatomy and assessed the impact of omega-3 fatty acid supplementation on left ventricular function in a prospective trial.
A total of 25 patients with premature ventricular contraction, with more than 2% premature ventricular contractions on 24-hour Holter electrocardiography, and 30 healthy patients were included into study. All patients underwent electrocardiography, left ventricular M-mode echocardiography, and myocardial performance index testing. Patients with premature ventricular contraction were given omega-3 fatty acids at a dose of 1 g/day for 3 months, and control echocardiography and 24-hour Holter electrocardiography were performed. Neither placebo nor omega-3 fatty acids were given to the control group.
Compared with the values of the control group, the patients with premature ventricular contraction had significantly lower fractional shortening. The myocardial performance index decreased markedly in the patient groups. The mean heart rate and mean premature ventricular contraction percentage of Group 2 significantly decreased in comparison with their baseline values after the omega-3 supplementation.
In conclusion, premature ventricular contractions can lead to systolic cardiac dysfunction in children. Omega-3 supplementation may improve cardiac function in children with premature ventricular contractions. This is the first study conducted in children to investigate the possible role of omega-3 fatty acid supplementation on treatment of premature ventricular contractions.
This study aimed to investigate the relationship of epicardial fat thickness with severity of obstructive sleep apnoea, and clinical and polysomnographic parameters, and to determine independent predictors for epicardial fat thickness.
A total of 84 patients with a body mass index of less than 30 kg/m2 and suspected sleep-disordered breathing were included in the study. The correlations of epicardial fat thickness with polysomnographic and clinical data, and severity of obstructive sleep apnoea, were investigated.
Mean epicardial fat thickness was 3.75 ± 1.07 mm in the study group (n = 62) and 2.97 ± 0.62 mm in the control group (n = 22) (p < 0.001). There were significant positive correlations between epicardial fat thickness and: apnoea/hypopnoea index, oxygen desaturation index 3 and minimum oxygen saturation, as well as with age, body mass index, and neck and waist circumferences.
Non-obese obstructive sleep apnoea patients have thicker epicardial fat compared to controls. Oxygen desaturation index 3 has a strong correlation with epicardial fat thickness and is an independent predictor of it.
To evaluate the efficacy and safety of segmental superficial parotidectomy in the surgical treatment of benign parotid tumours.
Patients who underwent parotidectomy for benign primary parotid tumours limited to the superficial lobe were retrospectively reviewed. Tumour location, size, surgical procedure, follow-up period, complications and recurrence rates were noted.
The study included a total of 39 patients: 22 underwent segmental superficial parotidectomy (group 1) and 17 underwent superficial parotidectomy (group 2). The mean follow-up period was 41.79 months (range, 13–85 months). There were no recurrences in either group during the follow-up period. No significant differences were found between the two groups in terms of tumour size, complications or recurrence rates.
Segmental superficial parotidectomy is a safe and effective option in the surgical treatment of benign parotid tumours.
Using high-precision photometry from the Kepler mission, we investigate patterns of spot activity on the K1-type subgiant component of KIC 11560447, a short-period late-type eclipsing binary. We tested the validity of maximum entropy reconstructions of starspots by numerical simulations. Our procedure successfully captures up to three large spot clusters migrating in longitude. We suggest a way to measure a lower limit for stellar differential rotation, using slopes of spot patterns in the reconstructed time-longitude diagram. We find solar-like differential rotation and recurrent spot activity with a long-term trend towards a dominant axisymmetric spot distribution during the period of observations.
This article proposes a model of treaty-based veil piercing for civil liability claims by victims of human rights harm inflicted by businesses. The primary inspiration for this model comes from investment treaty provisions dealing with corporate investors. Our examination of investment law for this purpose exposes the double standard in the treatment of the corporate veil between these two remedy regimes, and offers a way to address this. The test we propose for lifting the veil in order to allow victims to claim against the parent company in a corporate group is one of ‘legal control’. It aims to capture cases where the parent did not necessarily take an active role in the subsidiary's business, but it is still treated as being in control of the subsidiary by virtue of its direct or indirect ownership or ability to appoint management.