bluuebunny/crossref_metadata_2025 huggingface dataset:
Selecting technological alternatives for regulatory compliance towards emissions reduction from shipping: An integrated fuzzy multi-criteria decision-making approach under vague environment
Authors: Bui Khanh Q , Ölçer Aykut I , Kitada Momoko , Ballini Fabio
Published: June 2020

Due to the increasing pressure from stricter environmental regulations to reduce emissions in shipping, the maritime industry has been striving for finding more effective measures. Existing measures are often not enough to comply with new regulations. Among various alternative measures, it is not easy for decision-makers (shipowners and operators) to choose the most suitable alternative measure as it involves with multi-criteria decision-making where the prioritization of a number of alternatives vis-à-vis multiple criteria evaluation is undertaken. Further challenges on such analysis are the lack of information as well as its subjectivity and/or the inconsistency. This study proposes an integrative fuzzy multi-criteria decision-making method that combines fuzzy analytic hierarchy process (AHP) and fuzzy technique for order performance by similarity to ideal solution (TOPSIS) for the selection of technological alternatives for regulatory compliance under vague environment. Nine criteria within three sustainability aspects (social, economic and environmental aspects) were analysed and evaluated as regards four possible alternatives. The weights of these aspects and criteria were determined by the fuzzy AHP; meanwhile, alternatives were prioritized by the fuzzy TOPSIS. According to the outputs of the proposed decision-making framework, the study revealed that low-sulphur fuels are the best suitable alternative for regulatory compliance. The following alternatives are methanol, scrubbers and liquefied natural gas in order. Sensitivity analysis was conducted to tell us that the proposed framework is robust. This proposed method will be potentially applicable to other fields where decisions are required to make under vague information conditions.
Single Tertiary Care Center Outcomes After Lower Extremity Cadaveric Vein Bypass for Limb Salvage
Authors: Singh Kuldeep , Juneja Amandeep , Bajaj Tushar , Voto Christian , Schor Jonathan , Zia Saqib , Deitch Jonathan
Published: June 2020

Objective:

Cadaveric saphenous vein (CV) conduits are used in rare instances for limb salvage in patients without autogenous veins although long-term outcome data are scarce. This study was designed to evaluate the outcomes of CV bypass in patients with threatened limbs.

Methods:

We retrospectively reviewed the charts from 2010 to 2017 of 25 patients who underwent 30 CV allografts for critical limb ischemia and acute limb ischemia. Patient charts were reviewed for demographics, comorbidities, smoking status, indications for bypass, and outcomes. Primary outcomes included graft patency, major amputation rates, and mortality. Secondary outcomes measured included infection rates, 30-day major adverse cardiac events (MACE) and major adverse limb events (MALE). Statistical analysis was performed using time series and Kaplan-Meier survival curves.

Results:

A total of 30 limbs received CV lower extremity bypasses (20 males, 10 female), and the average age was 68 ± 4 years. Primary patency rates were 71%, 42%, and 28% at 3, 6, and 12 months, respectively. Assisted primary patency rates were 78%, 56%, and 37% at 3, 6, and 12 months, respectively. Secondary patency rates were 77%, 59%, and 28% at 3, 6, and 12 months, respectively. Minor amputations, defined as amputations below the transmetatarsal level occurred in 5 (20%) patients. Wound infection occurred in 8 (32%) patients which was managed with local wound care and no patients required an extraanatomic bypass for limb salvage. Thirty-day MALE occurred in 7 (23.3%) patients. We had no 30-day mortality or MACE. The average graft length was 64.2 ± 8 cm with an average graft diameter of 3.9 ± 2 mm. Amputation-free survival and overall survival at 12 months were 20 (68%) and 21 (84%), respectively.

Conclusions:

Cadaveric saphenous vein allograft may be used as a bypass conduit as a viable surgical option before limb amputation. Despite the poor patency rates, the limb salvage rates of cadaveric vein grafts demonstrate that this alternate conduit may be considered when no autogenous vein is available.
Major Depressive Disorder Classification Based on Different Convolutional Neural Network Models: Deep Learning Approach
Authors: Uyulan Caglar , Ergüzel Türker Tekin , Unubol Huseyin , Cebi Merve , Sayar Gokben Hizli , Nezhad Asad Mahdi , Tarhan Nevzat
Published: June 2020

The human brain is characterized by complex structural, functional connections that integrate unique cognitive characteristics. There is a fundamental hurdle for the evaluation of both structural and functional connections of the brain and the effects in the diagnosis and treatment of neurodegenerative diseases. Currently, there is no clinically specific diagnostic biomarker capable of confirming the diagnosis of major depressive disorder (MDD). Therefore, exploring translational biomarkers of mood disorders based on deep learning (DL) has valuable potential with its recently underlined promising outcomes. In this article, an electroencephalography (EEG)-based diagnosis model for MDD is built through advanced computational neuroscience methodology coupled with a deep convolutional neural network (CNN) approach. EEG recordings are analyzed by modeling 3 different deep CNN structure, namely, ResNet-50, MobileNet, Inception-v3, in order to dichotomize MDD patients and healthy controls. EEG data are collected for 4 main frequency bands (Δ, θ, α, and β, accompanying spatial resolution with location information by collecting data from 19 electrodes. Following the pre-processing step, different DL architectures were employed to underline discrimination performance by comparing classification accuracies. The classification performance of models based on location data, MobileNet architecture generated 89.33% and 92.66% classification accuracy. As to the frequency bands, delta frequency band outperformed compared to other bands with 90.22% predictive accuracy and area under curve (AUC) value of 0.9 for ResNet-50 architecture. The main contribution of the study is the delineation of distinctive spatial and temporal features using various DL architectures to dichotomize 46 MDD subjects from 46 healthy subjects. Exploring translational biomarkers of mood disorders based on DL perspective is the main focus of this study and, though it is challenging, with its promising potential to improve our understanding of the psychiatric disorders, computational methods are highly worthy for the diagnosis process and valuable in terms of both speed and accuracy compared with classical approaches.
Long-term Outcomes of MCP Surface Replacement Arthroplasty in Patients With Rheumatoid Arthritis
Authors: Claxton Matthew R. , Wagner Eric R. , Rizzo Marco
Published: June 2020

Background: Surface replacement arthroplasty (SRA) can be used in the treatment of rheumatoid arthritis (RA) affecting the metacarpophalangeal (MCP) joint. The authors of this study sought to investigate the outcomes of MCP SRA in patients with RA. Methods: Retrospective review of medical records and an institutional joint registry were used to gather data on 80 MCP SRAs performed in 27 patients with RA. Data collected included demographics, SRA revisions, reoperations, complications, pain, and MCP arc of motion. Results: The mean postoperative follow-up was 9.5 years (range, 2.1-20.5 years), with all SRAs achieving at least 2 years of follow-up. Thirteen digits (16%) underwent revision arthroplasty, and 29 (36%) required reoperation. The 5-, 10-, 15-, and 20-year rates of survival from implant revision were 95%, 85%, 80%, and 69%, respectively. The 5-, 10-, 15-, and 20-year rates of survival from overall reoperation were 80%, 65%, 55%, and 46%, respectively. Metacarpophalangeal joint arc of motion, grip strength, and pain levels significantly improved following surgery. Conclusions: Metacarpophalangeal SRA can offer benefit to patients with RA for improvement in function and pain. High overall reoperation rates remain concerning; however, most do not involve arthroplasty revision.
A new universal multi-stress acceleration model and multi-parameter estimation method based on particle swarm optimization
Authors: Liu Yao , Wang Yashun , Fan Zhengwei , Chen Xun , Zhang Chunhua , Tan Yuanyuan
Published: June 2020

High reliability and long-lifetime products usually work in multi-stress environment such as temperature, humidity, electricity, and vibration. How to evaluate the reliability of the product under multi-stress condition is an urgent problem to ensure the safe and reliable operation of the product. Accelerated test provides an efficient and feasible way; however, the existing acceleration models have some shortcomings, such as less stress type, neglecting the stress coupling, and multi-parameter estimation difficulties. Therefore, in this article, first, a new universal multi-stress acceleration model is derived based on the classical Arrhenius model. Second, a multi-parameter estimation method for multi-stress model is proposed by combining particle swarm optimization and maximum likelihood estimation. Six simulation cases are used to verify the effectiveness of the proposed multi-parameter estimation method. The results of Case 1 to Case 3 show that the maximum mean square error of five parameters in the multi-stress model without considering stress coupling is 3.71%. The results of Case 4 to Case 6 show that the maximum mean square error of nine parameters in the multi-stress model considering stress coupling is 7.69%. Finally, an application example is performed to investigate the performance of the universal multi-stress acceleration model and multi-parameter estimation method.
Internal cultural imperialism: The case of the Kurds in Turkey
Authors: Salih Mohammed A
Published: June 2020

The cultural imperialism thesis that emerged in late 20th century focused on inequalities in the West driven global flow of culture and communication, and how that adversely affected the cultural conditions of nations in the so called Third World. However, the core–periphery dynamic at the root of cultural imperialism has not merely been confined to the transnational level, from the West to the Rest. It has existed at the national level as well. Conducting a historical examination of state policy vis-à-vis Kurdish culture in Turkey, and drawing on the theories of cultural imperialism, internal colonialism and nationalism, I develop the concept of internal cultural imperialism to capture the state of severe center peripheral cultural imbalance that has been a product of Turkish nationalist ideology and its policies of cultural homogenization. In hegemonic condition, the state’s ultimate goal has been to subjugate and/or possibly eradicate the cultures of non-core groups within its territory.
Autoimmune glial fibrillary acidic protein astrocytopathy with lesions distributed predominantly in the entire spinal cord
Authors: Li Xue-Lin , Han Jinming , Zhao Hao-Tian , Long You-Ming , Zhang Bing-Wei , Wang Hai-Yang
Published: June 2020

Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy has been considered a novel central nervous system autoimmune disease characterized by relapse and responsiveness to corticosteroid with a specific GFAP-Immunoglobulin G (IgG) being noted in cerebrospinal fluid. We report the case of a 21-year-old girl presenting with dysuria and weariness, who subsequently developed blurry vision, slight dysphagia, slurred speech, and sensory abnormality. GFAP-IgG was detected in her cerebrospinal fluid. Magnetic resonance imaging using both T2-weighted and contrast-enhanced T1-weighted images revealed a rare finding of lesions distributed mainly in the entire spinal cord rather than typical brain lesions. After treating with corticosteroids, her clinical symptoms were alleviated, and the spinal cord lesion enhancement was reduced. Our observations extend the clinical spectrum of autoimmune GFAP astrocytopathy. We suggest that rare distributed lesions in the entire spinal cord in patients with autoimmune GFAP astrocytopathy cannot be ignored by neurologists. The identification of potential atypical lesions broadens the understanding of autoimmune GFAP astrocytopathy.
Development of nestling blue tits (Cyanistes caeruleus) is affected by experimental addition of aromatic plants
Authors: Pires Bárbara A , Belo Anabela DF , Diamantino Fernanda , Rabaça João E , Merino Santiago
Published: June 2020

Some passerines incorporate aromatic plants in their nest cups, and several hypotheses have been formulated to explain this behaviour. One of those, the Drug Hypothesis, states that aromatic plants present in nests have positive effects on nestlings’ development through increased immune function. In this study, we aimed to examine if experimental addition of aromatic plants had positive effects on reproductive performance (the number of fledglings produced and nestling survival rate) and nestling development (weight and tarsus length). In addition, we study whether those potential effects were more noticeable in different brood sizes–small and large–through an observational approach. We expect that large broods, due to increased resource competition between nestlings, will benefit more from aromatic plant incorporation, as compared to small broods. Nestlings were significantly heavier in 2015 as compared to 2016 and 2017 and in small broods. No effect of treatment was observed in nestling weight. Although there was no overall effect of treatment on nestling tarsus length, nestlings from aromatic nests had significantly longer tarsi as compared to nestlings from control nests, in large broods.
Low skill fibreoptic intubation using i-gel™ and air-Q™ in simulated difficult airways: A randomised study in manikin and in patients
Authors: Sim Jacqueline Xiu Ling , Liew Geoffrey Haw Chieh , Abdullah Hairil , Wong Theodore Gar Ling , Wong Patrick
Published: June 2020

Background:

Fibreoptic intubation via a supraglottic device (SAD) is ‘low skill fibreoptic intubation’ (LSFOI). ‘Standard’ second generation SADs (i-gelTM) have a gastric port. ‘Specialised’ second generation SADs (air-QTM) are designed to facilitate LSFOI and have wider ventilation ports. Our hypothesis was that performance of LSFOI differs between i-gelTM and air-QTM in a manikin with a simulated difficult airway.

Methods:

Our primary outcome was fibreoptic intubation success rate. Our secondary outcomes included SAD insertion and LSFOI times. A difficult airway was simulated by applying a hard cervical collar to a manikin. Anaesthetists performed LSFOI serially using both SADs in a random sequence. In the manikin study, 80 anaesthetists were recruited. To test the robustness of the conclusion from our manikin study, we repeated the study in 22 anaesthetised patients. Patients were fitted with the same cervical collar and randomly allocated to either devices. We used McNemar’s statistical test to analyse our primary outcome of successful intubations and paired nominal data. A Wilcoxon signed-ranks test was used to analyse nonparametric paired data and a Mann–Whitney U test was used for unpaired data analysis where appropriate. A p-value of <0.05 was considered statistically significant.

Results:

In the manikin study, the i-gelTM was superior to the air-QTM for successful tracheal intubation (98.8% vs 83.8%, respectively; p=0.002) and LSFOI times (34.0 s vs 36.0 s, respectively; p=0.012). In the patient study, LSFOI success rates were not significantly different between i-gelTM and air-QTM (100% vs 91.6%, respectively; p=0.545) but intubation times were shorter (52.5 s vs 60.0 s, respectively; p=0.036).

Conclusion:

In conclusion, we obtained LSFOI success rates for the i-gelTM or air-QTM of 98.8% and 83.8% respectively in a manikin; and 100% and 91.6% respectively in patients. It is in fact ‘low skill’ as many participants were successful despite no prior experience with LSFOI. The i-gelTM is superior for LSFOI compared with the air-QTM. This is despite being a ‘standard’ second generation SAD as compared to a ‘specialised’ second generation SAD (air-QTM).

Trial Registration:

The manikin and patient studies were conducted after being approved by the SingHealth Centralised Institutional Review Board (CRB reference number 2014/2039 and 2016/2069, respectively). The patient study was registered at ClinicalTrials.gov (ID: NCT02663843).
Optimising implementation of European guidelines on cardiovascular disease prevention in clinical practice: what is needed?
Authors: Uchmanowicz Izabella , Hoes Arno , Perk Joep , McKee Gabrielle , Svavarsdóttir Margrét Hrönn , Czerwińska-Jelonkiewicz Katarzyna , Janssen Arne , Oleksiak Anna , Dendale Paul , Graham Ian M
Published: June 2020

Cardiovascular disease is a model example of a preventable condition for which practice guidelines are particularly important. In 2016, the joint task force created by the European Society of Cardiology (ESC) together with 10 other societies released the new version of the European guidelines on cardiovascular disease prevention. To facilitate the implementation of the ESC guidelines, a dedicated prevention implementation committee has been established within the European Association of Preventive Cardiology. The paper will first explore potential barriers to the guidelines’ implementation. It then develops a discussion that seeks to inform the future development of the committee’s work, including a new definition of the guidelines’ stakeholders (health policy-makers, healthcare professionals and health educators, patient organisations, entrepreneurs and the general public), future activities within four specific areas: strengthening awareness of the guidelines among stakeholders; supporting organisational changes to facilitate the guidelines’ implementation; motivating stakeholders to utilise the guidelines; and present ideas on new implementation strategies. Providing multifaceted cooperation between healthcare professionals, healthcare management executives and health policy-makers, the novel approach proposed in this paper should contribute to a wider use of the 2016 ESC guidelines and produce desired effects of less cardiovascular disease morbidity and mortality. Furthermore, the solutions presented within the paper may constitute a benchmark for the implementation of practice guidelines in other medical disciplines.
Descriptive study of discharge medications in pediatric patients
Authors: Nguyen Thao T , Bergeron Erica , Lewis Teresa V , Miller Jamie L , Hagemann Tracy M , Neely Stephen , Johnson Peter N
Published: June 2020

Background:

Limited studies have evaluated medications in children discharged from hospitals. Knowledge of the number of medications and dosage forms could provide a baseline to establish a medication discharge prescription program.

Objectives:

To identify the median number of discharge prescriptions per patient. Secondary objectives included an evaluation of the dosage formulations and frequency, and comparisons of the prevalence of unrounded medication doses between service type (medical vs surgical) and physician provider level (trainees vs attendings).

Methods:

This retrospective study included children <18 years receiving >1 discharge prescription during 4 selected months over a 1-year time frame. Comparisons were made via Pearson’s chi-square tests, Fisher’s Exact tests, and Kruskal–Wallis nonparametric rank tests as appropriate with a priori p value of <0.05.

Results:

A total of 852 patients were evaluated, with most (78.8%) on a medical service. The median (interquartile range) number of new medications at discharge was 2 (1–3), with the median total number of discharge medications of 3 (2–6). There was no difference in the net change of the median number of home medications stopped and new medications started between service types. The majority (72.2%) received >1 oral liquid medications. There was no difference in prescribing rates per service type and provider level. There was a difference in the number of unrounded doses between trainees versus attendings, 17.8% versus 9.5%, p = 0.048.

Conclusion:

Patients were discharged on a median of three medications, and most received >1 oral liquid medications. These data can be used to target children who would benefit from medication discharge prescription programs.
A cross-sectional study of the portrayal of childhood speech and language disorders in YouTube videos
Authors: Bellon-Harn Monica L , Manchaiah Vinaya , Shashikanth Shriya
Published: June 2020

Purpose

This study examined meta-data, source, type of informational content, understandability, and actionability of YouTube content related to speech and/or language disorders.

Method

The 100 most widely viewed videos related to children with speech and/or language disorders were obtained. Meta-data and sources of each upload were identified. Type of informational content within the videos was analyzed. The Patient Education Material Assessment Tool for Audiovisual Materials was used to assess understandability and actionability.

Results

A significant difference between video source groups was found for length of video, thumbs-up, and thumbs-down, but not for number of views. The YouTube videos related to speech and/or language disorders covered a range of issues, although a majority of the content focused on signs/symptoms and treatment. Videos had close-to-adequate understandability (i.e. 68%), although poor actionability scores (i.e. 32%) were noted. Videos uploaded by professionals were superior to other upload sources in understandability, but no difference was noted between video source for actionability.

Conclusions

Study insights about meta-data, source, type of informational content, understandability, and actionability of YouTube videos may help professionals understand the nature of online content related to speech and/or language disorders. Study implications and recommendations for further research are discussed.
Supporting lives lived whilst protecting lives saved during COVID-19: The relational invariant in person-centred care
Authors: Edvardsson David , Baxter Rebecca , Birkett Peter , Dunlop Andrea
Published: June 2020

There has been an impressive development of nursing knowledge around the ethics, principles, frameworks, models and practices of person-centred care over the last 15 years, with colleagues from the Nordic countries making significant contributions to global knowledge across the discipline of nursing and beyond. A disciplinary challenge remains to map the variability in person-centred care with an aim to empirically clarify the invariant in person-centred care. Based on current research and practice, as well as the COVID-19 pandemic, this article argues that the relational aspect of person-centred care is such an invariant, building on the socially constructive notion of ‘personhood’ being a standing or status that is bestowed on one human being by another in the context of relationship and social being. During the current COVID-19 pandemic, several of the key determinants of person-centred care are under threat due to health service responses and/or infection control measures, such as keeping older adults safe, imposing relationship restrictions, social distancing and isolation (or the lack thereof). Clinical examples from an Australian health service are used to show how recognizing the relational invariant of person-centred aged care facilitated supporting lives lived whilst also protecting lives saved. The relational invariant to person-centred care is who we are, constructed or deconstructed by and with others; something that may have become more visible through the relational restrictions imposed due to COVID-19. Protecting relationality in life and care and advocating for both safe and person-centred care for those who need it most is now more important than ever.
A Case-Control Study: The Impact of Unintentional Discrepancies and Pharmacist Discharge Prescription Review on 30-Day Hospital Readmission
Authors: Elbeddini Ali , Yang Lucy , Aly Ahmed
Published: June 2020

Introduction: Medication discrepancies on hospital discharge are common and occur despite the use of technology to generate electronically created discharge (e-discharge) prescriptions, justifying pharmacist involvement. No published studies have focused on medication discrepancies as a risk factor for readmission. The aim was to explore the relationship between medication discrepancies on discharge and readmission rates, and how both are affected by pharmacist intervention. Objectives: The primary objective was to establish the relationship between medication discrepancies on the e-discharge prescription and hospital readmissions within 30 days of discharge. Secondary objectives were to determine the 30-day readmission rate with and without pharmacist involvement, and risk factors for 30-day readmission. Methods: This was a matched case-control study where cases and controls consisted of patients readmitted and not readmitted to hospital within 30 days of discharge from the general medicine service, respectively. Case patients were defined as patients who had been readmitted to the hospital within 30 days of discharge from the general medicine unit. Control patients were defined as patients who had not been readmitted to the hospital within 30 days of discharge. Chi-square statistics was used to analyze the association between the presence of medication discrepancy at discharge and 30-day readmission. Multivariate logistic regression was used to further analyze the associations to determine which risk factors best relate to 30-day readmission. Results: Between January 1, 2017 and December 31, 2017, a total of 401 e-discharge prescriptions were reviewed, and 194 cases were readmitted within 30 days of discharge. Similar proportions of patients were readmitted compared with not readmitted regardless of whether discrepancies were identified on the e-discharge prescriptions, and there was no relationship identified between medication discrepancies and readmission within 30 days (odds ratio [OR] = 1.04; P = .854). The readmission rate with and without pharmacist involvement was similar between the case group (50%) and control group (48.0%). The proportion of discharge prescriptions with discrepancies was 48.8% in the group that had pharmacist involvement and 47.0% in the group that had no pharmacist involvement. Additionally, a LACE score of 12 or greater was identified as a statistically significant risk factor for readmission (OR = 2.13; P < .001). Conclusions: Pharmacist review of the e-discharge prescription did not affect the readmission rate. A LACE score of 12 or greater was associated with a higher risk of readmission. Future studies are needed to identify patient groups at high risk of readmission and to determine pharmacist interventions that could reduce readmission rates.
Strategies of Advanced Practice Providers to Reduce Stress at Work
Authors: Klein Colleen J. , Dalstrom Matthew D. , Weinzimmer Laurence G. , Cooling Melinda , Pierce Lisa , Lizer Shannon
Published: June 2020

Background: High levels of stress and burnout, documented among healthcare professionals, result in high levels of job turnover. However, little is known about personal strategies employed by advanced practice providers (APPs) to mitigate stress. Methods: 3,939 APPs were invited to complete an online, anonymous, cross-sectional survey to examine work stress and burnout among APPs using quantitative and qualitative analyses. The Maslach Burnout Inventory (MBI) served as the measure for burnout. Work-stress reduction strategies were identified by an open-ended question. Findings: 854 APPs (70% of 1,218 respondents) (nurse practitioners, physician assistants, nurse midwives, anesthetists, and clinical nurse specialists) from four different United States health systems completed the free text portion of the survey. Qualitative analyses revealed that almost all of the APPs (94%) reported at least one stress reduction strategy. Four main themes were derived from the free-text responses: “Self-focused” (67.5%), “relational-focused”(16.1%), “job-focused” (11.5%) and “nothing” (4.9%). Quantitative results from the MBI revealed high levels of burnout among APPs with insignificant differences between those who provided a response to the qualitative question and those who did not: emotional exhaustion ( p = .188); depersonalization ( p = .265); personal accomplishment ( p = .213). Conclusion/Application to Practice: Qualitative results highlighted strategies, many evidence-based, that APPs use to mitigate stress. Further research is needed to determine the frequency and consistency of APPs’ enactment of personal strategies. These initial findings provide insights for occupational health practitioners and researchers planning primary prevention and secondary interventions for improving workplace health, enhancing personal wellness, and reducing job-related stressors.
On Entrepreneurial Stories: Tolkien’s Theory of Fantasy and the Bridge between Imagination and Innovation
Authors: Roundy Philip T.
Published: June 2020

Innovations are the product of entrepreneurs’ imaginations. To turn imaginations into realized innovations, entrepreneurs must attract the resources necessary to create the innovations they envision. Resource acquisition involves crafting and communicating compelling narratives that persuade stakeholders to provide resources. However, there is not a clearly articulated theory linking entrepreneurial imagination, narratives, and the production of innovations. To construct such a theory, this paper extends work on narratives in literary theory and, specifically, Tolkien’s theory of narrative fantasy. It is proposed that entrepreneurs’ narratives about innovations are, initially, “fantasies” because they describe possible worlds in which the imagined innovations exist. As fantasies, the characteristics of persuasive fantasy narratives, such as the degree to which narratives achieve an inner consistency of reality and suspend audiences’ disbelief, influence entrepreneurs’ ability to convince stakeholders about the viability of imagined innovations. The proposed theory contributes to entrepreneurship scholarship by developing a process model that articulates how entrepreneurs’ imaginations manifest in their narratives, which, in turn, influence the realization of innovations. The theory generates concrete implications for entrepreneurs and suggests that as the novelty of an imagined innovation increases, it becomes more critical for entrepreneurs to construct compelling narratives to describe the innovation. Thus, entrepreneurs and scholars should be attentive to the role narratives play in moving beyond the idea phase of entrepreneurship and bridging imagination and innovation.
Partial Rotator Cuff Repair With Superior Capsular Reconstruction Using the Biceps Tendon Is as Effective as Superior Capsular Reconstruction Using a Tensor Fasciae Latae Autograft in the Treatment of Irreparable Massive Rotator Cuff Tears
Authors: Kocaoglu Baris , Firatli Goktug , Ulku Tekin Kerem
Published: June 2020

Background:

Several treatment options are available for stable massive rotator cuff tears, including partial repair with or without tissue augmentation, tendon transfer, superior capsular reconstruction (SCR), and reverse shoulder arthroplasty.

Purpose/Hypothesis:

The purpose of this study was to compare the outcomes and effectiveness of partial rotator cuff repair with SCR using the long head of the biceps tendon (PRCR-SCRB) and SCR with a tensor fasciae latae autograft (SCRTF) for the treatment of rotator cuff tears with severe fatty degeneration. The hypothesis of this study was that SCRTF would be superior to PRCR-SCRB in functional and anatomic outcomes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 26 consecutive patients with massive and fatty degenerative rotator cuff tears were treated surgically. Patients were divided into either the PRCR-SCRB group (n = 14) or SCRTF group (n = 12). Functional outcomes were assessed at final follow-up, and the acromiohumeral distance (AHD) was measured.

Results:

All functional scores significantly improved in both groups at final follow-up. The PRCR-SCRB group showed better overall outcomes in terms of the visual analog scale for pain; American Shoulder and Elbow Surgeons score; and Quick Disabilities of the Arm, Shoulder and Hand, but these differences were not statistically significant. Better outcomes were found for only the AHD for the PRCR-SCRB group without statistical significance ( P = .4). No statistical difference was found in terms of retear rate.

Conclusion:

PRCR-SCRB had comparable outcomes and improvement in AHD compared with SCRTF without the need for additional graft harvesting.
Influencers on deprescribing practice of primary healthcare providers in Nova Scotia: An examination using behavior change frameworks
Authors: Kennie-Kaulbach Natalie , Cormier Rachel , Kits Olga , Reeve Emily , Whelan Anne Marie , Martin-Misener Ruth , Burge Fred , Burgess Sarah , Isenor Jennifer E.
Published: June 2020

Background:

Deprescribing is a complex process requiring consideration of behavior change theory to improve implementation and uptake.

Aim:

The aim of this study was to describe the knowledge, attitudes, beliefs, and behaviors that influence deprescribing for primary healthcare providers (family physicians, nurse practitioners (NPs), and pharmacists) within Nova Scotia using the Theoretical Domains Framework version 2 (TDF(v2)) and the Behavior Change Wheel.

Methods:

Interviews and focus groups were completed with primary care providers (physicians, NPs, and pharmacists) in Nova Scotia, Canada. Coding was completed using the TDF(v2) to identify the key influencers. Subdomain themes were also identified for the main TDF(v2) domains and results were then linked to the Behavior Change Wheel—Capability, Opportunity, and Motivation components.

Results:

Participants identified key influencers for deprescribing including areas related to Opportunity, within TDF(v2) domain Social Influences, such as patients and other healthcare providers, as well as Physical barriers (TDF(v2) domain Environmental Context and Resources), such as lack of time and reimbursement.

Conclusion:

Our results suggest that a systematic approach to deprescribing in primary care should be supported by opportunities for patient and healthcare provider collaborations, as well as practice and system level enhancements to support sustainability of deprescribing practices.
Enabling Innovation: Organizational Culture and Structure to the Fore
Authors: Peri Srinivas
Published: June 2020

Innovation is high on every CEO’s agenda across all industries. In some sectors, where disruption is prominent, innovation is critical to survival. But as many surveys have highlighted, the majority of innovation efforts in organisations fail. There is a clear mismatch between ambitions and achievements. The argument I put across in this article is that HR leaders have a strategic and critical role to play in making innovation happen. Innovation and Digital transformation are not about technology, but about people and processes. The crucial drivers for innovation are organisational culture, structure and communicating success.
Procedures and devices for bariatric and metabolic endoscopy
Authors: Orlandini Beatrice , Gallo Camilla , Boškoski Ivo , Bove Vincenzo , Costamagna Guido
Published: June 2020

Obesity is a leading cause of preventable death in developed countries, with a rising incidence over time. Lifestyle modification, pharmacotherapy, and bariatric surgery are the mainstays of bariatric therapy, even though burdened by several limitations in terms of efficacy or safety. Bariatric endoscopy has been developed in the last decades as a minimally invasive alternative, aimed to bridge the gap between conservative and interventional conventional therapies. This review aims to provide an updated overview of the bariatric and metabolic available endoscopic procedures and to drive the choice of the right procedure for the right patient.
Anastomotic leakage with abscess after laparoscopic sleeve gastrectomy for obesity: report of a series and review of literature
Authors: Liu Yang , Yang Ning-Ning , Guan Yong-Song , He Qing
Published: June 2020

Anastomotic leakage with abscess is a rare but severe complication of bariatric surgery. However, there is currently a lack of attention regarding this complication. This study aimed to investigate the risk factors for this complication and relevant treatment strategies to call attention to this severe complication. We retrospectively reviewed the patients who were rehospitalized for anastomotic leakage with abscess after bariatric surgeries in West China Hospital of Sichuan University from November 2017 to November 2018. The clinical profiles analyzed included body mass index, body weight before and after surgery, postoperative hospital stay, diet prescriptions, treatment strategies, and outcomes. A total of six patients (two men and four women) were included. The mean baseline body mass index was 37.52 (29.84–43.37), and the mean weight was 104.95 kg (74.5–127.5). The chief complaints leading to rehospitalization were fever and dull abdominal pain. The average postoperative hospital stay was 3.3 (3–4) days, and the onset time ranged from 7 to 15 days. Finally, revision surgeries were performed in two of the six patients (33%), and they were all cured by percutaneous drainage-based treatments. The postoperative fever and abdominal pain were the signs of leakage and abscess. Similar patients should be followed up once a week for 3 weeks after bariatric surgery to facilitate the early recognition of this complication. A longer hospital stay and sufficient parenteral nutrition plus a later implementation of diet should be helpful to minimize this severe complication. Percutaneous drainage played a significant role in the treatment of these patients.
The promise of implementing machine learning in earthquake engineering: A state-of-the-art review
Authors: Xie Yazhou , Ebad Sichani Majid , Padgett Jamie E , DesRoches Reginald
Published: June 2020

Machine learning (ML) has evolved rapidly over recent years with the promise to substantially alter and enhance the role of data science in a variety of disciplines. Compared with traditional approaches, ML offers advantages to handle complex problems, provide computational efficiency, propagate and treat uncertainties, and facilitate decision making. Also, the maturing of ML has led to significant advances in not only the main-stream artificial intelligence (AI) research but also other science and engineering fields, such as material science, bioengineering, construction management, and transportation engineering. This study conducts a comprehensive review of the progress and challenges of implementing ML in the earthquake engineering domain. A hierarchical attribute matrix is adopted to categorize the existing literature based on four traits identified in the field, such as ML method, topic area, data resource, and scale of analysis. The state-of-the-art review indicates to what extent ML has been applied in four topic areas of earthquake engineering, including seismic hazard analysis, system identification and damage detection, seismic fragility assessment, and structural control for earthquake mitigation. Moreover, research challenges and the associated future research needs are discussed, which include embracing the next generation of data sharing and sensor technologies, implementing more advanced ML techniques, and developing physics-guided ML models.
Transition and Temporalities: Spanning Temporal Boundaries as Projects End and Operations Begin
Authors: Whyte Jennifer , Nussbaum Tamara
Published: June 2020

As projects end and operations begin, we argue that transition involves boundary-spanning work to ensure continuity across changing forms of organizing. A study of transition in the London megaproject ecology (Heathrow Terminal 5, London 2012 Olympics, and Crossrail) is used to build new theoretical insight into how transition is accomplished. We find that multiple temporalities meet and disjunctures emerge, with stability to close projects sought as interorganizational futures shift. Our work extends the research on temporal boundary spanning, to articulate how disjunctures and shifts are managed, and continuity is enhanced, through the use of artifacts, procedures, soft landings, and tests.
The Management of Values in Project Business: Adjusting Beliefs to Transform Project Practices and Outcomes
Authors: Martinsuo Miia
Published: June 2020

Project value is an important topic of debate in project studies, and previous research has identified challenges in value management. This article reveals the challenges of subjectivity, dynamics, and tensions stemming from multistakeholder involvement and competing values over the project life cycle. This research seeks solutions to the management of values by exploring values as beliefs to supplement their treatment as worth. Management of values is portrayed as an exercise in sensemaking, negotiation, and co-creation when adjusting beliefs to transform project practices and outcomes. A research agenda is proposed to cover the social and behavioral aspects of values in project studies.
Young adult outcomes of childhood prophylaxis for severe hemophilia A: results of the Joint Outcome Continuation Study
Authors: Warren Beth Boulden , Thornhill Dianne , Stein Jill , Fadell Michael , Ingram J. David , Funk Sharon , Norton Kristi L. , Lane Heidi D. , Bennett Carolyn M. , Dunn Amy , Recht Michael , Shapiro Amy , Manco-Johnson Marilyn J.
Published: June 2020

The Joint Outcome Study (JOS), a randomized controlled trial, demonstrated that children with severe hemophilia A (HA) initiating prophylactic factor VIII (FVIII) prior to age 2.5 years had reduced joint damage at age 6 years compared with those treated with episodic FVIII for bleeding. The Joint Outcome Continuation Study (JOS-C) evaluated early vs delayed prophylaxis effects on long-term joint health, following JOS participants to age 18 years in an observational, partially retrospective study. Index joint magnetic resonance imaging (MRI) scores of osteochondral (OC) damage (primary outcome), joint physical examination scores, and annualized rates of joint/other bleeding episodes (secondary outcomes) were collected. Thirty-seven of 65 JOS participants enrolled in JOS-C, including 15 randomized to prophylaxis at mean age 1.3 years (“early prophylaxis”); 18 initially randomized to episodic treatment, starting “delayed prophylaxis” at mean age 7.5 years; and 4 with high-titer inhibitors. At JOS-C exit, MRI OC damage was found in 77% of those on delayed and 35% of those on early prophylaxis for an odds ratio of OC damage, in the delayed vs early prophylaxis group, of 6.3 (95% confidence interval, 1.3, 29.9; P = .02). Annualized bleeding rates were higher with delayed prophylaxis (mean plus or minus standard deviation, 10.6 ± 6.6 vs 3.5 ± 2.1; P < .001), including when only comparing time periods on prophylaxis (6.2 ± 5.3 vs 3.3 ± 1.9; P < .05). In severe HA, early initiation of prophylaxis provided continued protection against joint damage throughout childhood compared with delayed initiation, but early prophylaxis was not sufficient to fully prevent damage. This trial was registered at www.clinicaltrials.gov as #NCT01000844.
Novel mouse model resistant to irreversible BTK inhibitors: a tool identifying new therapeutic targets and side effects
Authors: Estupiñán H. Yesid , Bouderlique Thibault , He Chenfei , Berglöf Anna , Gupta Dhanu , Saher Osama , Daza Cruz Miguel Ángel , Peña-Perez Lucia , Yu Liang , Zain Rula , Karlsson Mikael C. I. , Månsson Robert , Smith C. I. Edvard
Published: June 2020

Pharmacological inhibitors of Bruton tyrosine kinase (BTK) have revolutionized treatment of B-lymphocyte malignancies and show great promise for dampening autoimmunity. The predominant BTK inhibitors tether irreversibly by covalently binding to cysteine 481 in the BTK catalytic domain. Substitution of cysteine 481 for serine (C481S) is the most common mechanism for acquired drug resistance. We generated a novel C481S knock-in mouse model and, using a battery of tests, no overt B-lymphocyte phenotype was found. B lymphocytes from C481S animals were resistant to irreversible, but sensitive to reversible, BTK inhibitors. In contrast, irreversible inhibitors equally impaired T-lymphocyte activation in mice, mimicking the effect of treatment in patients. This demonstrates that T-lymphocyte blockage is independent of BTK. We suggest that the C481S knock-in mouse can serve as a useful tool for the study of BTK-independent effects of irreversible inhibitors, allowing for the identification of novel therapeutic targets and pinpointing potential side effects.
Association between apolipoprotein B XbaI polymorphisms and coronary heart disease: A meta-analysis
Authors: Feng Ya Yun , Chen Lu Yang , Liu Yang , Luo Meng , Yang Tian Tian , Hu Yu Hao , Chang Jing , Mao Min
Published: June 2020

Background

To evaluate the association between apolipoprotein B gene polymorphism and coronary heart disease in some populations at home and abroad by means of meta-analysis.

Methods

Using the strict exclusion criteria for primary screening of the literature and applying the Hardy-Weinberg equilibrium to test the genetic balance of the selected literature. The corresponding models were selected according to the results of the heterogeneity test. The Begg’s test and Egger’s test were used to evaluate publication bias, and meta-analysis was performed using Stata 12.0.

Results

The study included twelve articles. In the literature, a total of 1596 patients with coronary heart disease and 1431 controls.Meta-analysis results showed no statistical value in the following three genetic models: allelic comparison (a vs A,P = 0.811,OR = 0.95, 95%CI = 0.62–1.46), recessive genetic models (aa vs Aa/AA,P = 0.86,OR = 0.94, 95%CI = 0.45–1.96), or dominant genetic models (aa/Aa vs AA,P = 0.73,OR = 0.92, 95%CI = 0.58–1.47). Subgroup analysis based on ethnicity showed allelic comparison (a vs A,P = 0.464,OR = 1.32, 95%CI = 0.63–2.78), recessive genetic models (aa vs Aa/AA,P = 0.422,OR = 1.52, 95%CI = 0.55–4.21), and dominant genetic models (aa/Aa vs AA,P = 0.551,OR = 1.26, 95%CI = 0.58–2.73) in Asians, allelic comparison (a vs A,P = 0.410,OR = 0.79, 95%CI = 0.45–1.39), recessive genetic models (aa vs Aa/AA,P = 0.041,OR = 0.75,95%CI = 0.57–0.99),dominant genetic models (aa/Aa vs AA,P = 0.385,OR = 0.75, 95%CI = 0.40–1.43) in Caucasian;

Conclusion

The ApoB(apolipoprotein B) XbaI locus is not a risk factor when it comes to the development of coronary heart disease in the domestic and international populations included in this paper. In Caucasians, people carrying the aa genotype may be less susceptible to CHD (coronary heart disease). The results of recessive genetic models have to take the effect of heterogeneity and sample sizes into account. Further research may require a larger and more rigorous research design.