bluuebunny/crossref_metadata_2025 huggingface dataset:
Online processing of the grammatical aspect marker by L2 Chinese learners
Authors: Liang Lijuan , Chondrogianni Vasiliki , Chen Baoguo
Published: February 2021

The perfective aspect marker in Chinese is partly functionally similar to inflectional suffixes in Indo-European languages but is non-inflectional and lexical in nature, lying thus at the semantics–syntax interface. This provides us with the opportunity to compare directly the syntactic and semantic constraints during second language (L2) sentence processing. The present study explored how L2 Chinese learners with Indo-European languages as their first languages (L1s) process the Chinese perfective marker. The Competition Model prioritizes syntactic processes entailed by cross-linguistic transfer from the participants’ L1s, but this prediction might be challenged by the concurrent functioning of semantic processes. In an event-related potentials (ERP) experiment, 22 European language-speaking L2 Chinese learners with low to intermediate proficiency level and 20 native Chinese speakers (i.e. the control group) participated. An aspectual agreement paradigm was used for materials. Results showed that in the aspect marker mismatch condition, L2 Chinese learners with a shorter learning experience were more likely to show a P600-like component, indicating a morpho-syntactic routine, supporting thus the predictions of cross-linguistic transfer based on the Competition Model. Those with a longer L2 learning experience were more likely to show an N400-like component similar to native Chinese speakers. This shift from P600 to N400 for more advanced learners suggests that L1–L2 syntactic similarity may exert much stronger influence than semantic constraints for learners with shorter L2 experience.
Megamarketing in The Post-Pandemic Era: Rebalancing Political and Social Power
Authors: Kotler Philip , Kartajaya Hermawan , Alaydrus Abdullah
Published: February 2021

Amid globalization and digitalization, market access is relatively more difficult due to various obstacles caused by political and social forces. Large enterprises with limited control over regulation-making with values not in sync with the society experience difficulty accessing markets. Megamarketing represents an effort by business enterprises to counter closed market access by way of managing two “mega” forces: political and social power. The practice of megamarketing has considerably evolved with the changing times -- considering the increasingly significant role of society, preventive interventions, and political forces. Business enterprises can apply megamarketing by (1) better understanding the political and social landscape, (2) integrating relevant organizational functions, and (3) addressing the issues that restrict market access.
The Swedish space of lifestyles and symbolic domination
Authors: Atkinson Will
Published: February 2021

This article constructs a model of the space of lifestyles in Sweden. It does so not simply to test whether its structure conforms to that discovered by Pierre Bourdieu and his colleagues in 1970s’ France, and confirmed by others across the globe, but to examine the extent to which it is wrapped up with symbolic domination. It draws on data from an unusually rich survey of consumption patterns and taste fielded in 2017–2018 (n=1,498) and deploys the technique of multiple correspondence analysis in combination with cluster analysis. Oppositions between exclusive and accessible culture and between ‘highbrow’ culture and materialistic/appearance-oriented practices are revealed and the correspondences with capital, age, gender and other factors explored. The cluster analysis suggests that the force of capital composition in differentiating lifestyles relative to age varies in proportion to capital volume. Crucially, analysis suggests it is the economically rich, rather than those rich in cultural capital, who are most confident in their tastes and lifestyles.
The problematic place of private payment for healthcare in Australia
Authors: Duckett Stephen
Published: February 2021

Private funding and private hospital provision play a key role in Australian healthcare. However, this role is inherently inequitable, creating a two-speed health system. Canada should avoid expanding private involvement in paying for healthcare.
Amantadine Associated Myoclonus: Case Report and Review of the Literature
Authors: Poon Linda H. , Lee Audrey J. , Vuong Mai , Zuzuarregui Jose Rafael
Published: February 2021

Purpose:

Amantadine is commonly used to treat Parkinson’s disease. A case of myoclonus and asterixis was associated with amantadine is reported.

Case Summary:

An 80-year-old man with Parkinson’s disease diagnosed in 2015 was started on amantadine for treatment of progressive tremor and orofacial dyskinesias induced by levodopa. He took amantadine 100mg orally daily for 7 days, then increased to 100mg twice a day thereafter. The patient complained of “worsening tremor” after 9 days and amantadine was decreased to 100mg daily. After 1 month on this dose, the patient reported that his “tremor” persisted and experienced visual hallucinations. His examination demonstrated diffuse myoclonus throughout his extremities and trunk, as well as asterixis when attempting to stand or holding his arms antigravity. Laboratory testing for renal and hepatic failure was unrevealing. Amantadine was reduced to 50mg daily for 4 days and then discontinued. Myoclonus resolved 3 days after discontinuation of amantadine.

Conclusion:

While amantadine-induced myoclonus is rare, health care providers should be vigilant in monitoring for signs and symptoms of myoclonus following amantadine initiation.
Early Child–Parent Relationship Quality and Cognitive Function in Older Rural Chinese Adults: The Mediating Role of Educational Attainment
Authors: Peng Changmin , Burr Jeffrey A. , Yang Dong , Lu Nan
Published: February 2021

Objectives: Framed within a life course perspective and cognitive reserve theory, this study examined the mediating role of educational attainment for the association between child–parent relationships during childhood and cognitive function among older adults in rural China. Methods: Data were obtained from three waves of the China Health and Retirement Longitudinal Study ( N = 9809). We employed latent growth curve modeling to test the association among early child–parent relationship quality, educational attainment, and cognitive function in later life. Results: Early child–mother relationship quality was associated with the level and change in cognitive function. Early child–father relationship quality was only related to baseline cognitive function. Educational attainment mediated the relationship between early child–parent relationship quality with mothers and fathers and cognitive function. Discussion: Parental relationship experience in childhood was one distal factor related to cognitive function among older adults. The findings supported the long-term impacts of childhood conditions for later life health consequences.
Ageism as a Modifying Influence on COVID-19 Health Beliefs and Intention to Social Distance
Authors: Graf Allyson S. , Knepple Carney Amy
Published: February 2021

Objectives: Commentaries have suggested that initial emphasis on the higher susceptibility and mortality rates of older adults to COVID-19 has instigated ageism within the public discourse and policy decisions. Using the health belief model, the current study examined ageism in interaction with other factors influencing intention to social distance. Methods: Threat of contracting COVID-19, benefits and barriers to social distancing, benevolent and hostile ageism, and intention to social distance were examined in 960 adults ( M = 37.81 years, SD = 11.65). Results: Benevolent and hostile ageism were significant moderators for both perceived threat and barriers on intent to social distance; hostile ageism also moderated benefits on intent to social distance. Discussion: The current study demonstrates how ageism influences behavior during a pandemic. With initial reports of COVID-19 presenting older adults as a homogenous group, ageism negatively interacted with intention to social distance and may place older adults at greater risk.
Prevalence of condomless anal intercourse and associated risk factors among men who have sex with men in Bamako, Mali
Authors: Knox Justin , Patnaik Padmaja , Hakim Avi J , Telly Nouhoum , Ballo Tako , Traore Bouyagui , Doumbia Seydou , Lahuerta Maria
Published: February 2021

Background

Men who have sex with men (MSM) are disparately impacted by HIV in sub-Saharan Africa and condomless anal intercourse (CAI) is a major driver of HIV transmission. The objective of the current study was to identify factors associated with CAI among MSM in Bamako, Mali, among whom HIV prevalence was 13.7%.

Methods

A bio-behavioral survey was conducted between October 2014 and February 2015 using respondent-driven sampling to recruit 552 adult MSM. Weighted statistical analyses were conducted to determine the prevalence of CAI with one’s most recent male partner and survey logistic procedures were used to identify associated factors.

Results

The prevalence of CAI with one’s most recent male partner was 40.7%. Associated factors included: inability to get a condom when needed (aOR = 5.8, 95%CI: 2.7–12.3) and believing CAI is acceptable under some circumstances (aOR = 8.4, 95%CI: 4.4–16.2).

Conclusions

Programs addressing HIV among MSM in Mali should aim to increase access to condoms and education about HIV prevention through consistent condom use during anal intercourse.
Elder care and paid work: gender differences in the relationship between unpaid elder care work and employment in Bulgaria
Authors: Meurs Mieke , Giddings Lisa
Published: February 2021

Care of elderly family members affects the welfare of the elderly and caregivers and has macroeconomic implications. In Eastern Europe, aging populations combined with under-developed care policy increase family care burdens, but the impact of care on labour force participation is understudied in this context. Using two waves of the Generations and Gender survey, we estimate the impact of care demand on paid employment in Bulgaria. We find that living with an elderly or disabled parent has a negative impact on employment for women and that this impact cannot be explained by reverse causality or unobserved individual characteristics. More developed care policy would benefit caregivers and would be likely to generate broader fiscal benefits.
Socio-economic Scenario of South Asia: An Overview of Impacts of COVID-19
Authors: Yadav Arti , Iqbal Badar Alam
Published: February 2021

The present study explores the socio-economic scenario of the South Asian region before and after the outbreak of the COVID-19 pandemic. It analyses the long run and short-run association between human development, unemployment and the economic growth of the region using the Pooled Mean Group (PMG) Autoregressive Distributed Lag (ARDL) model before the situation of the pandemic. It was found that human development has both short-run and long-run association, while the unemployment level has only a long run association with economic growth of the South Asian region. The study suggests that maintaining quality and growth sustainability during and after the pandemic situation will ultimately depend on the human development aspects of the region in terms of appropriate fiscal and monetary policy, vocational training, increased dependence on domestic production and consumption.
Cohort Size and Unemployment Rate: New Insights from Nigeria
Authors: Young Ademola Obafemi
Published: February 2021

The debate on the nature of the relationship between cohort size and unemployment rate has been widely studied and generated a substantial body of literature in labor economics discourse. However, an in-depth reading of this literature suggests that, besides the fact that findings are mixed and do not provide conclusive evidences, one hardly ever comes across studies exclusively on African countries. Likewise, generalized studies across countries employing pooled data seem to dominate the literature. In light of these, the current study examines the nature of the said relationship, over the period 1970–2019, in Nigeria in a multivariate and dynamic framework. Employing Bounds testing procedure, the article finds that both the short-run and long-run impacts of cohort size on overall unemployment rate are positive and statistically significant. This suggests that aggregate unemployment rate tends to be higher when many young people supply labor. In view of these findings, the article recommends that government should collaborate with private sector to develop and implement functional microcredit schemes. Such schemes should be flexibly structured to avert institutional bottlenecks and enhance accountability and transparency in their management.
Perceptions Regarding the Academic and Cognitive Performance of Individuals With Cleft Lip and/or Palate
Authors: Kara İlkem , Dumbak Aydan Baştuğ , Kayıkcı Maviş Emel Kulak
Published: February 2021

Introduction:

Factors such as teachers’ appropriate support and social interactions have an impact on the academic performance of children with cleft lip and/or palate (CL/P). This study was designed to investigate the perceptions of the teachers and the general public about the academic and cognitive performance of individuals with CL/P.

Methods:

This study was included 360 (male/female = 102/258) teachers and 640 (male/female = 259/381) participants that represent the general public. Anonymized web-based and paper-and-pencil self-administered questionnaire that included multiple-choice and yes/no questions were administered. Within-group differences and intergroup differences were analyzed in terms of academic and cognitive performance.

Results:

Most of the teachers and the general public indicated that the academic and cognitive performance of individuals with CL/P is the same as their unaffected peers. A significantly higher proportion of the teachers indicated that the academic performance of children with CL/P is the same as their unaffected peers than the general public.

Conclusion:

Considering that the general public’s attitudes and appropriate teacher support are crucial to prevent adverse impacts on the lives of individuals with CL/P, it is important to support teachers with the appropriate information and to encourage the public to recognize that everybody with a facial difference should be treated as an individual rather than a disability.
Looking at the Gig Picture: Defining Gig Work and Explaining Profile Differences in Gig Workers’ Job Demands and Resources
Authors: Watson Gwendolyn Paige , Kistler Lauren D. , Graham Baylor A. , Sinclair Robert R.
Published: February 2021

Gig workers are a growing portion of the workforce and of increased interest to researchers. Recent reports suggest one in four workers is involved in gig work to some extent. Additionally, gig work has been a trending topic in organizational psychology for the past few years; however, our systematic literature review revealed the need for more attention to address definitional ambiguity and consider the intricacies of gig work. Specifically, this article identified the following gaps in the extant literature: the need for a comprehensive definition of gig work, the creation of profiles to differentiate gig workers, and the application of organizational psychology theories to explain gig workers’ experiences. This conceptual article addresses these gaps by providing clarity with a definition for gig work that captures both the primary (e.g., shared by all gig workers) and secondary (e.g., shared by some gig workers) characteristics of gig work. Further, this article describes five gig worker profiles (i.e., Gig Service Providers, Gig Goods Providers, Gig Data Providers, Agency Gig Workers, and Traditional Gig Workers) based on combinations of secondary characteristics to identify different types of gig work. Using the definition provided in this article and applying the Job Demands-Resources (JD-R) model, propositions were developed to compare gig worker profiles based on the job demands and job resources they experience. Thus, this article serves as a foundation to advance the literature through a consistent definition of gig work that paves the way for future research to better understand gig workers through the JD-R model.
Shared Leadership, Unshared Burdens: How Shared Leadership Structure Schema Lowers Individual Enjoyment Without Increasing Performance
Authors: Evans Karoline , Sanner Bret , Chiu Chia-Yen (Chad)
Published: February 2021

Despite the growing popularity of shared leadership, there is little research on how beliefs about the benefits of shared leadership—a shared leadership structure schema (LSS)—affect individual outcomes. We address this by integrating adaptive leadership and conservation of resources theories. We apply adaptive leadership theory to hypothesize that a shared LSS leads individuals to support shared leadership by interacting more frequently and taking on interpersonal responsibility, especially when low peer engagement signals a leadership void that shared LSS members try to fill. However, adaptive leadership theory does not discuss how the tendencies motivated by shared LSS impacts members’ outcome. Therefore, we apply conservation of resources theory to hypothesize that taking on interpersonal responsibility makes frequent interactions more stressful, thereby harming individual enjoyment. Further, the demands of interpersonal responsibility reduce members’ ability to process the information acquired in interactions, which negates interaction frequency’s usual performance benefits. Together, these theories suggest that, especially when peer engagement is low, shared LSS has a negative indirect effect on enjoyment and an attenuating effect on performance through interaction frequency due to shared LSS members taking on interpersonal responsibility. We test our model using five waves of multisource data on student consulting teams. Our results extend understanding of shared LSS’s consequences to the individual level and highlight potential costs of supporting shared leadership.
Surgical correction of severe congenital ptosis using a modified frontalis muscle advancement technique: A single-arm trial
Authors: Zhang Lei , Ren Mingyu , Yan Yuqing , Zhai Wenjuan , Yang Lihong , Sun Chunhua , Pan Ye , Zhao Hong
Published: February 2021

Purpose:

To describe our experience with a modified frontal muscle advancement flap to treat patients with severe congenital ptosis.

Methods:

Analysis of the clinical charts of 154 patients who underwent a modified frontal muscle advancement flap. The FM was exposed by a crease incision. The FM flap was created by deep dissection between the orbicularis muscle and orbital septum from the skin crease incision to the supraorbital margin and subcutaneous dissection from the inferior margin of the eyebrow to 0.5 cm above the eyebrow. No vertical incision was made on the FM flap to ensure an intact flap wide enough to cover the entire upper tarsal plate. Contour, symmetry of height, marginal reflex distance (MRD1), and complications were assessed. Mean follow-up was 10 months.

Results:

The mean patient age was 7.6 ± 5.6 (range, 2–18) years. The mean MRD1 was 3.2 ± 1.3 mm after the operation. All bilateral cases achieved symmetry and optimal lid contour; 17 unilateral cases were under corrected, with a success rate of 89.0%. Complications such as entropion, exposure keratitis, FM paralysis, frontal hypoesthesia, severe haematoma, and entropion were not observed in our series.

Conclusion:

A modified frontal muscle advancement flap produced a high success rate with a clear field of vision, mild trauma, and few complications. This technique is relatively simple and should be considered for correcting severe congenital ptosis. Date of registration: 29-03-2020 Trial registration number: ChiCTR2000031364 Registration site: http://www.chictr.org/
Women who ‘talk the tools’ and ‘walk the work’: Using capital to do gender differently and re-gender the skilled trades
Authors: Wulff Elizabeth , Bridges Donna , Bamberry Larissa , Krivokapic-Skoko Branka
Published: February 2021

Social and cultural capital are valuable assets that assist individuals to succeed in work. This article reports on gender segregation in the skilled trades. We use Bourdieu’s theory of capital to illuminate how women are successfully recruited and retained in the skilled trades. Our findings indicate that women with pre-existing forms of capital are advantaged. Notably tradeswomen utilise masculine gender capital while maintaining aspects of feminine and female gender capital. In doing so, they re-gender the skilled trades and do gender differently. The study also found that female and feminine gender capital detracts from other forms of capital women bring with them or acquire in their trades work. Male gender capital privileges men and disadvantages women. We conclude that capital is an important point of intervention where women can be supported; however, the problems that gender capital creates for women can only be resolved by cultural change.
Conversion to an electronic missing medication request system at an academic medical center
Authors: Peters Michael J , Finch Chris K , Roberts Lauchland , Covington Angela , Krushinski Joseph
Published: February 2021

Missing medications can negatively contribute to the financial and operational workflows of pharmacy departments and add medication safety challenges. The missing medication request (MMR) system at the study institution converted to entirely electronic in June 2018 from a hybrid electronic system. This study evaluated 4-week periods pre- and post-conversion. The objective of this study was to evaluate the impact of conversion to an electronic MMR system on the quantity of requests received at an academic medical center. The average daily number of MMR’s decreased from the pre-conversion group to the post-conversion group (1.77 (±0.16) vs 1.48 (±0.17), p < 0.001). During post-conversion, the median triage time was 8 min [3 min–19 min], pharmacists triaged 62.4% of requests, and 29.6% of requests were declined. Conversion to an electronic MMR system represents one solution to decreasing missing medications. Future studies are needed to evaluate the financial, operational, and medication safety impact of conversion.
Layoffs, inequity and COVID-19: A longitudinal study of the journalism jobs crisis in Australia from 2012 to 2020
Authors: Dawson Nikolas , Molitorisz Sacha , Rizoiu Marian-Andrei , Fray Peter
Published: February 2021

In Australia and beyond, journalism is reportedly an industry in crisis, a crisis exacerbated by COVID-19. However, the evidence revealing the crisis is often anecdotal or limited in scope. In this unprecedented longitudinal research, we draw on data from the Australian journalism jobs market from January 2012 until March 2020. Using Data Science and Machine Learning techniques, we analyse two distinct data sets: job advertisements (ads) data comprising 3698 journalist job ads from a corpus of over 8 million Australian job ads; and official employment data from the Australian Bureau of Statistics. Having matched and analysed both sources, we address both the demand for and supply of journalists in Australia over this critical period. The data show that the crisis is real, but there are also surprises. Counter-intuitively, the number of journalism job ads in Australia rose from 2012 until 2016, before falling into decline. Less surprisingly, for the entire period studied the figures reveal extreme volatility, characterised by large and erratic fluctuations. The data also clearly show that COVID-19 has significantly worsened the crisis. We then tease out more granular findings, including: that there are now more women than men journalists in Australia, but that gender inequity is worsening, with women journalists getting younger and worse-paid just as men journalists are, on average, getting older and better-paid; that, despite the crisis besetting the industry, the demand for journalism skills has increased; and that, perhaps concerningly, the skills sought by journalism job ads increasingly include ‘social media’ and ‘generalist communications’ skills.
Going Local: Parliamentary Questions as a Means of Territorial Representation in the Italian Parliament
Authors: Russo Federico
Published: February 2021

Parliamentary questions are often employed by Members of Parliament to demonstrate their responsiveness to the needs of the constituency. This article takes advantage from this opportunity to study the determinants shaping the constituency focus of Italian deputies. Previous research has shown that the degree to which Members of Parliament devote attention to their geographical district depends on several factors related to electoral incentives, demands coming from citizens and taste-based preferences. By studying the behaviour of Italian deputies elected in three legislative terms with a system giving few incentives to perform constituency service, this article offers new evidence that non-electoral reasons are important to shape the role played by Members of Parliament.
Curricular Limitations and Recommendations for Training Health Care Providers to Respond to Intimate Partner Violence: An Integrative Literature Review
Authors: Ambikile Joel Seme , Leshabari Sebalda , Ohnishi Mayumi
Published: February 2021

Background:

Intimate partner violence (IPV) is a well-known public health problem occurring worldwide. With a multisectoral approach being emphasized in addressing IPV, the health sector has a key role to play due to many IPV victims who appear in health facilities without their needs being met. A well-designed and implemented IPV curriculum is necessary for effectively training health care professionals to provide quality IPV care and related services. This integrative review was conducted to establish evidence for existing curricular limitations and recommendations for training health care providers to respond to IPV.

Methods:

A systematic literature search was conducted for studies published from 2000 to 2020 in five databases (PubMed, Science Direct, Cochrane Library, Google, and Scholar). As a criterion, studies that reported curricular limitations in training health care providers/professionals to address IPV were included. A total of 198 studies were identified for screening, with 16 studies meeting the inclusion criteria and included in the review.

Findings:

Curricular limitations for IPV response training for health care providers were reported in the following areas (themes): time allocated for the training, amount of content in the existing curricula, institutional endorsement for the content, IPV response teachers/facilitators, teaching and learning strategies, and funding to support curricular implementation. Various recommendations to improving IPV response training were provided including guaranteeing the training in all courses, increasing academic capability to teach the content, allocation of funding to improve infrastructure for curriculum development and implementation, comprehensive approaches to teaching, and continuing education for health care providers.
Traumatic Arterio-Enteric Fistula—A Report of 2 Cases With Review of Literature
Authors: James Joses Dany , Agarwal Harshit , Kumar Vignesh , Kumar Atin , Hemachandran Naren , Gupta Amit
Published: February 2021

Background:

Traumatic arterio-enteric fistula is predominantly seen after penetrating trauma with only 21 reported cases documented in the past 25 years. They may present in an acute or delayed manner with upper or lower gastrointestinal bleed. A detailed clinical examination with requisite imaging can help in detecting such injuries.

Case Description:

Case 1: A 20-year-old gentleman, presented with penetrating stab injury to the gluteal region with bleeding per rectum. Imaging revealed evidence of injury to the inferior rectal artery which was found to be communicating with the extraperitoneal portion of the rectum. He was managed with a combination of endovascular and open surgery with a successful outcome. Case 2: A 29-year-old gentleman, presented in a delayed manner 2 weeks after a gunshot wound to the gluteal region, which was managed operatively in another hospital. He developed a massive lower gastrointestinal bleed 2 weeks after presentation. Imaging revealed evidence of a pseudoaneurysm of the inferior gluteal artery which had a fistulous communication with the gastrointestinal tract leading to bleeding. It was managed by endovascular techniques successfully.

Conclusion:

Arterio-enteric fistulas following trauma are rare phenomena and they need a high index of suspicion for diagnosis. Once diagnosed, they can be managed based on their location and patient physiology by interventional techniques, surgery, or a combination of the two.
Preoperative Levels of the Soluble Urokinase-Type Plasminogen Activator Receptor as Predictor for New Episodes of Atrial Fibrillation After Vascular Surgery
Authors: Lazarević Milan , Golubović Mladjan , Milić Dragan , Stanojević Dragana , Kostić Tomislav , Đorđević Miodrag , Marjanović Vesna , Perić Velimir
Published: February 2021

Introduction:

The soluble urokinase-type plasminogen activator receptor (suPAR) in uPAR soluble form is produced when the uPAR is cleaved from the cell membrane during the inflammatory process. Postoperative atrial fibrillation (AF) is the most common perioperative cardiac arrhythmia. It is speculated that elevated suPAR has a role in the development of AF. The aim of our study was to investigate the predictive role of preoperative suPAR in the occurrence of AF during the first 6 months after major vascular surgery.

Methods:

We included 119 male and 63 female patients with an average age of 67.19 ± 6.02 years, without permanent/persistent AF. Basic predictive model (BASIC) included traditional risk factors for AF: age, gender, body mass index-BMI, smoking status, presence of arterial hypertension, diabetes mellitus and dyslipidemia.

Results:

Over the 6-month period, 19 (10.4%) patients had one new episode of atrial fibrillation and 2 patients (1.1%) had 2 episodes of paroxysmal atrial fibrillation. Paroxysms of AF were significantly more frequent in patients who had a resection of an abdominal aneurysm than in patients with other types of major vascular surgery. BASIC had good discriminatory ability in the prediction of AF paroxysms during the first 6 months after surgery (AUC = 0.715, 95%CI 0.590-0.840). Adding suPAR to the basic model significantly improved the discriminative ability of the predictive model for AF episodes (ΔAUC = 0.238, p < 0.001). The predictive performance of the model BASIC+CRP+suPAR, measured using AUC, NRI and IDI statistics, was very similar to the model BASIC+suPAR.

Conclusion:

AF is a common complication in surgical patients with high mortality and morbidity. suPAR could improve the ability of traditional risk factors to predict its occurrence up to 6 months after major vascular surgery.
A Review on the Current Applications of Artificial Intelligence in the Operating Room
Authors: Birkhoff David C. , van Dalen Anne Sophie H.M. , Schijven Marlies P.
Published: February 2021

Background. Artificial intelligence (AI) is an era upcoming in medicine and, more recently, in the operating room (OR). Existing literature elaborates mainly on the future possibilities and expectations for AI in surgery. The aim of this study is to systematically provide an overview of the current actual AI applications used to support processes inside the OR. Methods. PubMed, Embase, Cochrane Library, and IEEE Xplore were searched using inclusion criteria for relevant articles up to August 25th, 2020. No study types were excluded beforehand. Articles describing current AI applications for surgical purposes inside the OR were reviewed. Results. Nine studies were included. An overview of the researched and described applications of AI in the OR is provided, including procedure duration prediction, gesture recognition, intraoperative cancer detection, intraoperative video analysis, workflow recognition, an endoscopic guidance system, knot-tying, and automatic registration and tracking of the bone in orthopedic surgery. These technologies are compared to their, often non-AI, baseline alternatives. Conclusions. Currently described applications of AI in the OR are limited to date. They may, however, have a promising future in improving surgical precision, reduce manpower, support intraoperative decision-making, and increase surgical safety. Nonetheless, the application and implementation of AI inside the OR still has several challenges to overcome. Clear regulatory, organizational, and clinical conditions are imperative for AI to redeem its promise. Future research on use of AI in the OR should therefore focus on clinical validation of AI applications, the legal and ethical considerations, and on evaluation of implementation trajectory.
Deep reinforcement learning for map-less goal-driven robot navigation
Authors: Dobrevski Matej , Skočaj Danijel
Published: February 2021

Mobile robots that operate in real-world environments need to be able to safely navigate their surroundings. Obstacle avoidance and path planning are crucial capabilities for achieving autonomy of such systems. However, for new or dynamic environments, navigation methods that rely on an explicit map of the environment can be impractical or even impossible to use. We present a new local navigation method for steering the robot to global goals without relying on an explicit map of the environment. The proposed navigation model is trained in a deep reinforcement learning framework based on Advantage Actor–Critic method and is able to directly translate robot observations to movement commands. We evaluate and compare the proposed navigation method with standard map-based approaches on several navigation scenarios in simulation and demonstrate that our method is able to navigate the robot also without the map or when the map gets corrupted, while the standard approaches fail. We also show that our method can be directly transferred to a real robot.
How much does fat mass change affect serum uric acid levels among apparently clinically healthy Korean men?
Authors: Ahn Joong Kyong , Hwang Jiwon , Lee Mi Yeon , Kang Mira , Hwang Junghye , Koh Eun-Mi , Cha Hoon-Suk
Published: February 2021

Objective:

The aim of this study was to examine the impact of fat mass alteration on serum uric acid (SUA) levels in apparently clinically healthy men.

Methods:

We evaluated 27,387 men who consecutively underwent health check ups between 2015 and 2017. We assessed the likelihood of achieving a SUA level of <0.41 mmol/L and compared the SUA levels according to fat mass changes.

Results:

Compared with those without fat mass change (the reference group), the odds ratios (95% confidence interval) of achieving a SUA level of <0.41 mmol/L for fat mass decreases of ⩾2.5, 1.5–2.5, and 0.5–1.5 kg were 1.63 (1.45–1.82), 1.19 (1.06–1.34), and 1.07 (0.97–1.18), respectively, while those for a fat mass increase of ⩾2.5, 1.5–2.5, and 0.5–1.5 kg were 0.71 (0.64–0.78), 0.87 (0.79–0.97), and 0.95 (0.86–1.04), respectively. The corresponding beta-coefficients of SUA levels (mmol/L) were –0.26 [–0.29–(–0.23)], –0.12 [–0.16–(–0.09)], and –0.09 [–0.12–(–0.06)] for fat mass decreases of ⩾2.5, 1.5–2.5, and 0.5–1.5 kg, respectively. Every 1-kg fat mass reduction was associated with 9% increased odds of achieving the target SUA level. The multivariate SUA level difference per 1-kg fat mass gain was 2.97 µmol/L. Similar levels of association persisted among the prespecified subgroups.

Conclusion:

We quantitatively demonstrated that fat mass reduction contributes to a clinically relevant decrease in SUA levels and a significant increase in the likelihood of achieving target SUA levels. Our findings may help to provide clear clinical guidance on fat mass alteration to reduce SUA levels in patients with hyperuricemia.
Relationship between long head of the biceps tendon histopathology and long-term functional results in smokers. A time to reevaluate the Bonar score?
Authors: Zabrzyński Jan , Gagat Maciej , Łapaj Łukasz , Paczesny Łukasz , Yataganbaba Alper , Szwedowski Dawid , Huri Gazi
Published: February 2021

Aim:

The purpose of this study was to investigate whether there is an association between smoking, the extent of the degeneration process in the biceps tendinopathy, including cells and extracellular matrix (ECM) alterations, and long-term surgical results.

Methods:

This study comprised 40 consecutive patients admitted for shoulder arthroscopy due to symptomatic biceps tendinopathy and classified into three groups based on smoking status: active smokers, former smokers, and non-smokers. According to the classical Bonar score criteria, the histopathologic evaluation of the harvested intra-articular portion of the tendon was done. The follow-up examination was based on the American Shoulder and Elbow Surgeons Score (ASES).

Results:

A cohort of 32 patients was enrolled in the final follow-up examination; mean 37.56 months. Histopathological evaluation according to the classical Bonar score revealed degeneration of the tendinous tissue in each group but there was no correlation between the extent of degeneration, smoking indexes and the ASES. After revision of Bonar scale within the vascularity criterion, we found a correlation between the extent of degeneration of tendinous tissue, smoking data, ASES score, and the severity of rotator cuff injury.

Conclusion:

In this paper, we indicate the ambiguous role of the neovascularization in the biceps tendinopathy, and it was used for modification of the classical Bonar score. Consequently, recalculated, modified Bonar score was correlated positively with smoking indexes and functional outcomes. Furthermore, the morphological alterations of rotator cuff tendons also correlated positively with the extent of biceps tendon degeneration, measured according to the modified scoring system.
Quality of life in multiple sclerosis: The differential impact of motor and cognitive fatigue
Authors: David Ruban Sabina , Christina Hilt Claudia , Petersen Thor
Published: February 2021

Background

Multiple sclerosis is a chronic disease leading to reduced quality of life.

Objectives

To investigate whether motor and cognitive fatigue impact differently on aspects of quality of life among patients with multiple sclerosis, independently from bodily disability.

Methods

79 patients with multiple sclerosis from Aalborg University Hospital, Denmark were included in an observational, cross-sectional study. Each subject completed two separate questionnaires regarding fatigue (Fatigue Scale for Motor and Cognitive Functions and Modified Fatigue Impact Scale) and one regarding quality of life (Short Form 36). Disability was measured with the Expanded Disability Status Scale (EDSS)-scores obtained from patient records.

Results

All fatigue scores were significantly correlated to all areas of quality of life (p < 0,05). This remained significant after adjustment for age, disease duration and EDSS-score. When looking at each type of fatigue separately, cognitive fatigue correlated mainly with mental health aspects of quality of life and motor fatigue with physical health areas of quality of life.

Conclusion

Increased motor and cognitive fatigue lead to a differential reduction in physical and mental quality of life, independently of bodily disability. This underlines the importance of proper assessment and treatment of fatigue among patients with multiple sclerosis.
Provider Attitudes and Practices on Treating Tobacco Dependence in New York City After 10 years of Comprehensive Tobacco Control Efforts
Authors: Kilgore Elizabeth A. , Waddell Elizabeth Needham , Tannert Niang Kathryn M. , Murphy Jennifer , Thihalolipavan Sayone , Chamany Shadi
Published: February 2021

To design strategies for provider education and implementation of clinical guidelines, this study investigated how physicians (1) approach tobacco cessation, including barriers to screening and treatment, (2) prioritize tobacco cessation, and (3) perceive the role of public health. Semi-structured focus groups were conducted with 30 New York City physicians across specialties. Physicians reported that they: (1) understand risks of smoking, as well as basic counseling and medications for smoking cessation; (2) do not always follow clinical guidelines for treatment of smoking cessation; (3) prioritize treatment of patients based upon a number of criteria; and (4) see the role of public health and the city health department as separate from the clinical environment, despite population-level interventions to reduce smoking. Physicians understand the importance of treating tobacco dependence, but identified barriers to treatment, some of which are health system-related. Further, patients who do not yet present with smoking-related illness may receive less intense interventions.
Return to Sport After Metacarpal and Phalangeal Fractures: A Systematic Review and Evidence Appraisal
Authors: Geoghegan Luke , Scarborough Alexander , Rodrigues Jeremy N. , Hayton Mike J. , Horwitz Maxim D.
Published: February 2021

Background:

Fractures of the metacarpals and phalanges account for more than half of all upper extremity fractures sustained by competitive athletes.

Purpose:

To determine which management strategy is best for expediting return to preinjury levels of competition in adult athletes with metacarpal and/or phalangeal fractures.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A methodology compliant with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used. A custom search strategy was designed and applied to MEDLINE and In-Process, Embase, EMCARE, and CINAHL.

Results:

Overall, 3135 records were identified, of which 8 met full inclusion criteria. All patients returned to preinjury levels of competition, at a mean of 30.6 days for phalangeal fractures and 21.9 days for metacarpal fractures. Meta-analysis demonstrated delayed return-to-sport time for operatively managed metacarpal fractures as compared with nonoperatively managed ones (28.5 vs 22.0 days). All studies were of fair or poor quality, and none were randomized.

Conclusion:

Optimal management strategies for athletes with metacarpal and phalangeal fractures remain equivocal. Injury, treatment, and sport-specific factors may confound results and preclude accurate estimation of optimal treatment strategies at present.
Glenoid Orientation and Profile in Atraumatic or Microtraumatic Posterior Shoulder Instability: Morphological Analysis Using Computed Tomography Arthrogram
Authors: Yoo Yon-Sik , Kim Jeehyoung , Im Wooyoung , Jeong Jeung Yeol
Published: February 2021

Background:

Posterior shoulder instability (PSI) is a relatively uncommon condition that occurs in about 10% of patients with shoulder instability. PSI is usually associated with dislocations due to acute trauma and multidirectional instability, but it can also occur with or without recognizable recurrent microtrauma. The infrequency of atraumatic or microtraumatic PSI and the lack of a full understanding of the pathoanatomy and the knowledge of management can lead to misdiagnosis or delayed diagnosis.

Purpose:

To evaluate the morphologic factors of the glenoid that are associated with atraumatic or microtraumatic PSI.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Enrolled in this study were patients who underwent arthroscopic posterior labral repair between January 2013 and March 2017 and were diagnosed with posterior glenohumeral instability by means of preoperative computed tomography arthrography (CTA) (n = 39; PSI group). These patients did not have any significant dislocation or subluxation episodes. The morphologic factors of the glenoid as revealed using CTA were compared with the CTA images from a sex-matched control group (n = 117) of patients without PSI who had been diagnosed with adhesive capsulitis in an outpatient clinic. The glenoid version and shape were evaluated between the 2 groups using the CTA findings, and the degree of centricity of the humeral head to the glenoid was assessed in the PSI group. Multivariate logistic regression analysis was performed to identify factors associated with PSI.

Results:

The results of the multivariate logistic regression analysis indicated no statistically significant difference between the PSI and control groups regarding glenoid version or a flat-shaped glenoid. However, statistically significant between-group differences were found regarding convex glenoid shape, with an odds ratio of 5.39 (95% CI, 1.31-23.35; P = .0207). The proportion of eccentricity was significantly higher in the PSI group (21/39; 54%) versus the control group (47/117; 40%) ( P = .031).

Conclusion:

The presence of convex glenoid shape was significantly associated with atraumatic or microtraumatic PSI. Humeral head eccentricity accounted for a high percentage of convex glenoid shape. However, there was no significant correlation between PSI and glenoid retroversion.
Practicing Procedural Skills Is More Effective Than Basic Psychomotor Training in Knee Arthroscopy: A Randomized Study
Authors: Jacobsen Mads Emil , Gustafsson Amandus , Jørgensen Per Gorm , Park Yoon Soo , Konge Lars
Published: February 2021

Background:

Simulator-assisted arthroscopy education traditionally consists of initial training of basic psychomotor skills before advancing to more complex procedural tasks.

Purpose:

To explore and compare the effects of basic psychomotor skills training versus procedural skills training on novice surgeons’ subsequent simulated knee arthroscopy performance.

Study Design:

Controlled laboratory study.

Methods:

Overall, 22 novice orthopaedic surgeons and 11 experienced arthroscopic surgeons participated in this study, conducted from September 2015 to January 2017. Novices received a standardized introductory lesson on knee arthroscopy before being randomized into a basic skills training group or a procedural skills training group. Each group performed 2 sessions on a computer-assisted knee arthroscopy simulator: The basic skills training group completed 1 session consisting of basic psychomotor skills modules and 1 session of procedural modules (diagnostic knee arthroscopy and meniscal resection), whereas the procedural skills training group completed 2 sessions of procedural modules. Performance of the novices was compared with that of the experienced surgeons to explore evidence of validity for the basic psychomotor training skills modules and the procedural modules. The effect of prior basic psychomotor skills training and procedural skills training was explored by comparing pre- and posttraining performances of the randomized groups using a mixed-effects regression model.

Results:

Validity evidence was found for the procedural modules, as test results were reliable and experienced surgeons significantly outperformed novices. We found no evidence of validity for the basic psychomotor skills modules, as test scores were unreliable and there was no difference in performance between the experienced surgeons and novices. We found no statistical effect of basic psychomotor skills training as compared with no training ( P = .49). We found a statistically significant effect of prior procedural skills training ( P < .001) and a significantly larger effect of procedural skills training as compared with basic psychomotor skills training ( P = .019).

Conclusion:

Procedural skills training was significantly more effective than basic psychomotor skills training regarding improved performance in diagnostic knee arthroscopy and meniscal resection on a knee arthroscopy simulator. Furthermore, the basic psychomotor skills modules lacked validity evidence.

Clinical Relevance:

On the basis of these results, we suggest that future competency-based curricula focus their training on full knee arthroscopy procedures. This could improve future education programs.