bluuebunny/crossref_metadata_2025 huggingface dataset:
Australian pharmacy perspectives on increasing access to medicines through reclassification
Authors: Mey Amary , King Michelle , Kelly Fiona , Grant Gary , Townshend James , Baumann-Birkbeck Lyndsee , Woods Phillip , Hope Denise
Published: October 2018

Objectives

Availability of medicines without prescription can increase consumers’ timely access to treatment and promote self-management of minor ailments and adherence to long-term medications. Globally, access to relevant medicines has improved through increased reclassification of medicines from prescription to non-prescription availability. However, Australian reclassification lags behind countries with comparable health systems, and the factors influencing this are poorly understood.

Methods

Semi-structured interviews were conducted during May 2015 to explore the perspectives of Australian pharmacists and support staff on future reclassification. Interview responses were transcribed verbatim, and the data were analysed thematically, primarily informed by the general inductive approach.

Results

Participants identified a broad range of medicines as candidates for future reclassification by applying risk versus benefit judgements, assessing any medicines with potential for misuse and hazardous medicines as unsuitable. Key drivers for change in classification were underpinned by participants’ desire to support consumers’ management of minor ailments and adherence for those on long-term therapy. Barriers to reclassification were identified by pharmacy staff as internal, negatively impacting pharmacists’ readiness for reclassification and external, negatively impacting the overall progress of change.

Conclusions

While the research provided valuable insights to inform the ongoing discussion on future reclassification, a larger, more representative sample is needed to confirm these findings.
Ideal telestroke time targets: Telestroke-based treatment times in the United States stroke belt
Authors: Nalleballe Krishna , Sharma Rohan , Brown Aliza , Joiner Renee , Kapoor Nidhi , Morgan Tiffany , Benton Tina , Williamson Conelia , Culp William , Lowery Curtis , Onteddu Sanjeeva
Published: October 2018

Background

Studying critical time interval requirements can enhance thrombolytic treatment for stroke patients in telestroke networks. We retrospectively examined 12 concurrent months of targeted time interval information in the South Central US telemedicine programme, Arkansas Stroke Assistance through Virtual Emergency Support (AR SAVES). Hypothesis: We hypothesised that consult data analysis would highlight areas for improvement to shorten overall door to Intra venous (IV) tissue plasminogen activator (tPA) administration time.

Methods

We analysed critical time targets for 238 consecutive telestroke neurology consults obtained over 12 months from AR SAVES spoke sites when tPA was administered. The following time intervals were analysed: emergency department (ED) door to Computed Tomography (D-CT); ED door to call centre (D-CC) for initiation of consult; ED door to neurology call (D-NC); neurology call to camera (NC-Cam); tele consult time (Con); ED door to tissue plasminogen activator (tPA)/needle (DTN).

Results

The median times of D-CT (13 min, inter quartile range (IQR) 6–22 min), D-CC (34 min, IQR 20–45 min), D-NC (40 min, IQR 21–71 min), NC-Cam (4 min, IQR 2–8 min), and Con (25 min, IQR 17–37 min) all contributed to a DTN median time of 71 min (IQR 50–104 min). A total of 238 patients received tPA with a 29.4% treatment rate and a DTN time of ≤60 min was achieved in 25.2% of patients.

Conclusions

Focusing on reducing D-CC and Con times may help to achieve the DTN time of < 60 min for the majority of patients. Having ideal time targets for telestroke patients akin to traditional patients will help identify and improve the overall goal of a DTN time < 60 min.
Pathogenesis of large vessel vasculitis: Implications for disease classification and future therapies
Authors: Harky Amer , Fok Matthew , Balmforth Damian , Bashir Mohamad
Published: October 2018

Despite being recognised over a century ago, the aetiology and pathogenesis of large vessel vasculitis (LVV) still remains elusive. Takayasu’s arteritis (TA) and giant cell arteritis (GCA) represent the two major categories of LVV, each with distinctive clinical features. Over the last 10 years an increased understanding of the immunopathogenesis of the inflammatory cascade within the aortic wall has revived the view that LVVs may represent subtypes of the same pathological process, with implications in the treatment of this disease. In this review, the histological, genetic and immunopathological features of TA and GCA will be discussed and the evidence for a common underlying disease mechanism examined. Novel markers of disease activity and therapies based on advances in our understanding of the immunopathogenesis of these conditions will also be discussed.
The Kids4Dementia education program is effective in improving children’s attitudes towards dementia
Authors: Baker Jess R , Goodenough Belinda , Jeon Yun-Hee , Bryden Christine , Hutchinson Karen , Low Lee-Fay
Published: October 2018

Improving children’s understanding of people with dementia is essential for tackling societal stigma around dementia. Kids4Dementia is a teacher-led multimedia dementia education resource for 9–12 year olds (approximately 150 minutes duration). A non-randomised, waitlist-controlled, mixed-methods design examined whether Kids4Dementia was (1) efficacious in improving students” attitudes towards people with dementia and (2) engaging and acceptable for teachers and students. Students who completed Kids4Dementia (n = 136) showed improved scores on the Kids Insight into Dementia Survey, relative to the control school (n = 67), especially students who had not heard of dementia before (Time × Group × Dementia Familiarity interaction, F(1, 191) = 5.28, p = .023, partial η2 = .027). Qualitative reports indicated that the program was acceptable and engaging for teachers and students and corroborated improvement in student empathy and behavioural intentions towards people with dementia. The findings provide preliminary evidence for the efficacy of Kids4Dementia as an engaging, stakeholder-directed, curriculum-aligned dementia education program.
The effect of polyester recycled tire fibers mixed with ground tire rubber on polyethylene composites. Part I
Authors: Moghaddamzadeh Siavosh , Rodrigue Denis
Published: October 2018

The effect of polyester recycled tire fibers (RTFs) mixed with ground tire rubber (GTR) in linear low-density polyethylene (LLDPE) with and without styrene–ethylene–butylene–styrene-grafted maleic anhydride was studied. In particular, different RTF contents (10, 25, and 50 wt%) and compounding screw speed (110, 180, and 250 r min−1), as well as temperature profiles (extrusion and injection molding) were used to optimize the processing conditions. In this first part, a complete physical and morphological analysis for the RTF fibers and GTR particles was performed. The results show that the compatibilized compounds have lower RTF length and GTR particle size but better distribution of rubber particles in the LLDPE matrix. Overall, lower processing temperatures used in both extrusion and injection molding showed better interfacial adhesion between the components due to higher shear and mechanical energy imparted on the different particles.
Stereotactic Radiotherapy for Oligometastases in Lymph Nodes—A Review
Authors: Matsushita Haruo , Jingu Keiichi , Umezawa Rei , Yamamoto Takaya , Ishikawa Yojiro , Takahashi Noriyoshi , Katagiri Yu , Kadoya Noriyuki
Published: October 2018

In recent years, the concept of oligometastases has become accepted and reports on stereotactic body radiotherapy as a treatment method have been published. Lesions in the brain, lung, and liver have been reported as target lesions. However, lymph node oligometastases could be a good candidate for stereotactic body radiotherapy as well. In this study, the usability of stereotactic body radiotherapy for oligometastases to lymph nodes is assessed by researching for each primary site. As a result, we could consider that stereotactic body radiotherapy could be almost well applied for lymph node oligometastases from the breast, gynecological organs, and prostate. However, doubts remain concerning the usefulness of stereotactic body radiotherapy for cervical node metastases from head and neck cancer or for mediastinal node metastases from lung or esophageal cancer since late toxicities have occurred with a large radiation dose at hypofractionation to major vessels or the central respiratory tract, especially in patients with irradiation histories. In addition, high-dose irradiation is required to control lymph node metastases from colorectal cancer due to its radioresistance, and severe late adverse events would therefore occur in adjacent organs such as the gastrointestinal tract. In cases of lymph node oligometastases with a primary tumor in the stomach or esophagus, stereotactic body radiotherapy should be used limitedly at present because this patient population is not so large and these metastases are often located close to organs at risk. Because of the varied status of recurrence and varied conditions of patients, it is difficult to determine the optimal dose for tumor control. It might be reasonable to determine the treatment dose individually based on dose constraints of adjacent organs. The oligometastatic state is becoming more frequently identified with more sensitive methods of detecting such oligometastases. In addition, there seems to be another type of oligometastases, so-called induced oligometastases, following successful systemic treatment. To determine the optimal indication of stereotactic body radiotherapy for lymph node oligometastases, further investigation about the mechanisms of oligometastases and further clinical studies including a phase III study are needed.
Stereotactic Body Radiotherapy for Spinal Metastases: Clinical Experience in 134 Cases From a Single Japanese Institution
Authors: Ito Kei , Ogawa Hiroaki , Shimizuguchi Takuya , Nihei Keiji , Furuya Tomohisa , Tanaka Hiroshi , Karasawa Katsuyuki
Published: October 2018

Object:

This study aimed to clarify the outcomes of stereotactic body radiotherapy for spinal metastases with a uniform dose fractionation schedule in our institution.

Materials and Methods:

Patients treated with spine stereotactic body radiotherapy were retrospectively reviewed. The prescribed dose was 24 Gy in 2 fractions. End points were local control, pain control, and adverse events. Local control was defined as elimination, shrinkage, or stable disease in the tumor on imaging evaluations. Pain status was measured on a scale of 0 to 10 by patients’ self-reports, and pain response was defined as the time at which pain scale score decreased by 2 or more from the baseline score without increase in analgesics. In addition, various treatment- and tumor-specific factors were evaluated to determine predictive values for local and pain control.

Results:

This study included 134 lesions in 131 patients, with: lesion histopathology, lung/colorectal/thyroid/renal/breast/prostate/sarcoma/other cancer, 24/22/18/14/12/10/6/25; reirradiation stereotactic body radiotherapy, 82 (61.2%) cases; and postoperative stereotactic body radiotherapy for epidural spinal cord compression, 45 (33.6%) cases. Median follow-up after stereotactic body radiotherapy was 9 months. The 1-year local control rate was 72.3%. Seventy (79.5%) of the 88 cases with pain from spinal metastases achieved pain response. The 1-year pain progression-free rate was 61.7%. Regarding metastases from colorectal cancer, local and pain control rates at 1 year were significantly lower compared with other cancer types (local control rate, 34.1% vs 81.8%; P < .01; pain progression-free rate, 36.9% vs 69.9%; P = .02). On multivariate analysis, colorectal cancer metastases and radiation history were identified as independent predictors of lower local and pain control rates. Radiation-induced myelopathy, radiculopathy, and vertebral compression fractures were observed in 0, 2 (1.5%), and 16 (11.9%) cases, respectively.

Conclusions:

This study showed that spine stereotactic body radiotherapy achieved good local and pain control, with a clinically acceptable safety profile. However, stereotactic body radiotherapy may be less effective against spinal metastases from colorectal cancer.
Effects of Aerobic and Resistance Exercises on Physical Symptoms in Cancer Patients: A Meta-analysis
Authors: Nakano Jiro , Hashizume Kaori , Fukushima Takuya , Ueno Kazumi , Matsuura Emi , Ikio Yuta , Ishii Shun , Morishita Satoru , Tanaka Koji , Kusuba Yoko
Published: October 2018

Objective. This study aimed to conduct a meta-analysis to establish the effect of exercise interventions on physical symptoms, including fatigue, nausea/vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, and diarrhea in cancer patients and survivors. Methods. We searched articles published before April 2017 using the following databases: Cochrane Library, PubMed/MEDLINE, CINAHL, Scopus, PEDro, Health & Medical Collection, and Psychology Database. Randomized controlled trials (RCTs) of exercise intervention in cancer patients, which evaluated cancer-related physical symptoms using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, were included. Symptom scale data were extracted for meta-analysis. Subgroup analyses were performed for exercise types (aerobic, resistance, and mixed exercise programs). Results. Of the 659 articles, 10 RCTs were included in the meta-analysis, of which the mean PEDro score was 5.43 (SD = 1.28). Fatigue, pain, dyspnea, and insomnia were significantly lower in the intervention group than in the control group at postintervention in cancer patients. However, exercise intervention did not promote or suppress nausea/vomiting, loss of appetite, constipation, and diarrhea in cancer patients. The effect of exercise type on each symptom was not different. Conclusion. Exercise intervention was confirmed to improve fatigue, pain, and insomnia and might have reduced dyspnea in cancer patients. However, the benefits of exercise on nausea/vomiting, loss of appetite, constipation, and diarrhea were not shown in any exercise type. Further research is warranted to examine the effects of exercise interventions on physical symptoms in cancer patients.
Perceptions of Myeloproliferative Neoplasm Patients Participating in an Online Yoga Intervention: A Qualitative Study
Authors: Huberty Jennifer , Eckert Ryan , Larkey Linda , Gowin Krisstina , Mitchell Jules , Mesa Ruben
Published: October 2018

Myeloproliferative neoplasms (MPNs) are rare hematological malignancies with a significant symptom burden often left unresolved despite recent advances in pharmacological therapy. Yoga is a nonpharmacological strategy that has been shown to improve symptoms in other cancers and may be effective for improving symptoms in MPN patients. Online yoga helps address many of the commonly reported barriers of cancer patients to in-person interventions and may make yoga more accessible to MPNs. An exploration of MPN patient perceptions of participation in online yoga is needed to tailor interventions to patient needs and inform future studies. The purpose of this study was to explore the perceptions of MPN patients participating in a 12-week online yoga intervention. This article represents the combined qualitative interview data from two studies. Participants were asked to complete 60 min/wk of online, home-based yoga and were asked to participate in a 15- to 20-minute phone interview postintervention. The qualitative data was coded in NVivo 11 for content analysis. The total sample included 39 MPN patients. Online yoga was well accepted and liked among these patients. They reported physical (eg, improved sleep, reduced fatigue) and mental (eg, reduced stress) health benefits and liked the convenience of being able to do yoga at home. Online yoga provides a feasible and attractive format through which to deliver a nonpharmacological intervention among MPN patients. Randomized controlled trials are needed to confirm the effects of online yoga on MPN patient symptoms. The qualitative findings presented here help inform the development of these future trials.
Subcortical Brain Involvement Is Associated With Impaired Performance on the Psychomotor Vigilance Task After Minor Stroke
Authors: Malik Peter R. A. , Muir Ryan T. , Black Sandra E. , Gao Fuqiang , Swartz Richard H. , Murray Brian J. , Boulos Mark I.
Published: October 2018

Objective. Impaired attentional processes have been linked with poor outcomes after stroke, but their radiographical correlates have been infrequently studied. Our objective was to assess the relationship between stroke location and vigilant attention. Methods. A total of 39 patients presenting within 2 weeks of a minor stroke were prospectively recruited. Vigilant attention was assessed using the psychomotor vigilance task (PVT), and neuroimaging was used to assess stroke location, white matter hyperintensity (WMH) burden, and ischemic stroke involvement within lateral cholinergic projections. Correlational analyses and linear regression models tested the association between PVT performance and our neuroimaging parameters of interest. Subtractions of lesion overlays were used to identify brain regions of acute stroke patients who performed most poorly on the PVT. Results. Subcortical stroke location was a predictor of PVT performance in this cohort of acute stroke patients. Patients who performed most poorly on the PVT had lesions in the corona radiata, internal capsule, globus pallidus, and thalamus. Global WMH burden and cerebrovascular disease in lateral cholinergic pathways were not significant predictors of PVT performance. Interpretation. Subcortical stroke location was associated with impaired vigilant attention. The poorest PVT performers had stroke lesions involving the corona radiata, internal capsule, globus pallidus, and thalamus, suggesting that vigilance depends on the integrity of subcortical structures and their connections with cortical brain regions.
Privacy of Clinical Research Subjects: An Integrative Literature Review
Authors: Nurmi Sanna-Maria , Kangasniemi Mari , Halkoaho Arja , Pietilä Anna-Maija
Published: October 2018

With changes in clinical research practice, the importance of a study-subject’s privacy and the confidentiality of their personal data is growing. However, the body of research is fragmented, and a synthesis of work in this area is lacking. Accordingly, an integrative review was performed, guided by Whittemore and Knafl’s work. Data from PubMed, Scopus, and CINAHL searches from January 2012 to February 2017 were analyzed via the constant comparison method. From 16 empirical and theoretical studies, six topical aspects were identified: the evolving nature of health data in clinical research, sharing of health data, the challenges of anonymizing data, collaboration among stakeholders, the complexity of regulation, and ethics-related tension between social benefits and privacy. Study subjects’ privacy is an increasingly important ethics principle for clinical research, and privacy protection is rendered even more challenging by changing research practice.
Does the innate relative size of the humeral head and glenoid affect the risk of anterior shoulder instability?
Authors: Willigenburg NW , Bouma RA , Scholtes VAB , van der Hulst VPM , van Deurzen DFP , van den Bekerom MPJ
Published: October 2018

Background

Bony lesions after shoulder dislocation reduce the joint contact area and increase the risk of recurrent instability. It is unknown whether the innate relative sizes of the humeral head and glenoid may predispose patients to shoulder instability. This study evaluated whether anterior shoulder instability is associated with a larger innate humeral head/glenoid ratio (IHGR).

Methods

We evaluated CT scans of 40 shoulders with anterior shoulder instability and 48 controls. We measured axial humeral head diameter and glenoid diameter following native contours, discarding any bony lesions, and calculated IHGR by dividing both diameters. Multivariate logistic regression determined whether the IHGR, corrected for age and gender as potential confounders, was associated with anterior shoulder instability.

Results

Mean IHGR was 1.48 ± 0.23 in the group with anterior shoulder instability and 1.42 ± 0.20 in the group without anterior shoulder instability. Measurements for axial humeral head and axial glenoid diameters demonstrated excellent intra-rater reliability (ICC range: 0.94–0.95). IHGR was not significantly associated with anterior shoulder instability (OR = 1.105, 95%CI = 0.118–10.339, p = 0.930).

Discussion

The innate ratio of humeral head and glenoid diameters was not significantly associated with anterior shoulder instability in this retrospective sample of 88 shoulder CT scans.
Stories of Care Leaving: The Experiences of a Group of Resilient Young Adults on Their Journey to Interdependent Living in Ghana
Authors: Frimpong-Manso Kwabena
Published: October 2018

Emerging adulthood is the developmental period from 18 to 25 years of age when young people explore the possibilities of life with support from their parents. However, young people with an out-of-home care background usually navigate this life stage with little or no support. As a result, many care leavers experience poor outcomes including homelessness and low educational achievements. These narratives fuel low expectations and a negative stereotype toward care leavers. This study offers an alternative perspective by sharing positive stories of care leavers. Specifically, it explores the factors that promote the successful transition to emerging adulthood for care leavers in Ghana. Four key themes emerged from the thematic analysis: networks of social support, personal capacities, preparation for adulthood, and positive relationships. These are the factors facilitating the care leavers’ successful transition into emerging adulthood. The study has offered recommendations for policy-making and practice including extending the statutory leaving care age.
The Dynamics of Pain During Nonsuicidal Self-Injury
Authors: Selby Edward A. , Kranzler Amy , Lindqvist Janne , Fehling Kara B. , Brillante Julia , Yuan Fengpeng , Gao Xianyi , Miller Alec L.
Published: October 2018

The experience of pain during nonsuicidal self-injury (NSSI) remains enigmatic. Ultimately, there is a dearth of evidence regarding whether pain is actually experienced during NSSI behavior and, if it is, to what extent that pain offsets following cessation of the NSSI episode. Using a smartphone app to collect information on self-injury episodes reported by adolescents and young adults in their daily lives, we found that across 143 NSSI episodes comprising 442 NSSI behaviors, most participants reported feeling significant and substantial pain onset during most NSSI episodes. A small effect was established for pain offset, with pain diminishing somewhat for most at NSSI completion. Furthermore, those who had higher negative emotion at the start of NSSI episodes but experienced less pain onset reported more NSSI behaviors during such episodes. The evidence supports a dynamic experience of pain during self-injury that can vary between people and episodes.
Converting sports diplomacy to diplomatic outcomes: Introducing a sports diplomacy model
Authors: Abdi Kambiz , Talebpour Mahdi , Fullerton Jami , Ranjkesh Mohammad Javad , Jabbari Nooghabi Hadi
Published: October 2018

As sport has become an integral part of society, it has also become a tool for diplomacy around the world. The purpose of this study is to introduce a sports diplomacy model and identify “the critical abilities” for converting sport soft power tools into resources for diplomatic outcomes. The data for this research comprise 30 online surveys completed by international experts in the fields of sports and public diplomacy. The responses were qualitatively analyzed using the fuzzy Delphi method (FDM). After running two rounds of fuzzy Delphi, two main strategies for sports diplomacy emerged—maintaining “official and sports diplomacy solidarity” and using sport figures as “competent cultural ambassadors.” The proposed model includes the most applicable sports diplomacy resources, the most expected diplomatic outcomes, and the major conversion tools (skillful strategies) in the viewpoint of sports and public diplomacy experts. The application of the model finds that states can expect diplomatic outcomes if appropriate sports diplomacy resources and conversion strategies are implemented in an orderly, innovative and accurate manner.
PrideVel: Preparing and Expanding Talent Pool for Emerging Technologies
Authors: Jha Sumi , Sangle Purnima S.
Published: October 2018

The case discusses the organisation’s pro-activeness in responding to changing needs of market. Steps PrideVel took to identify, prepare and retain employees for future market’s need is remarkable. The leadership of the organisation believe that new approach would help in shared value creation.
Effect of Crowdsourcing on Consumer Brand Perceptions and Behavioral Intentions
Authors: Kumar Prashant , Meng Tao , Kabiraj Sajal
Published: October 2018

Crowdsourcing has gained a lot of traction since it was christened way back in 2006, and its growing embracement across the industries augurs well for its future growth. As the ultimate target of any marketing activity is the consumer, it becomes highly imperative to gauge the effect of a crowdsourcing activity on the consumers’ perception and behavior. The present study desires to achieve the same through an experimental research methodology and uses the brand equity framework to assess the non-participants (consumers who do not participate in crowdsourcing activity) perceptions and behavioral intentions toward the crowdsourcing brand. Moreover, as crowdsourcing is also being labeled and criticized as an exploitative form of activity, so as to further accentuate the findings, the difference in the effect on brand equity and behavioral intention on the basis of crowdsourcing campaigns (in context of social and non-social campaigns) is also measured. Overall, the study reveals that crowdsourcing as a concept per se creates favorable consumer brand perceptions and behavioral intentions, provided crowdsourcing involve social initiative.
The efficiency of the posterior-only approach using shaped titanium mesh cage for the surgical treatment of spine tuberculosis in children: A preliminary study
Authors: Zhang Hongqi , Guo Qiang , Wang Yunjia , Guo Chaofeng , Tang Mingxing
Published: October 2018

Purpose:

The study aimed to evaluate the efficiency of the posterior-only approach using shaped titanium mesh cage for surgical treatment of spinal tuberculosis (TB) in children.

Methods:

Between January 2011 and July 2013, 22 children with a single motion spinal segment involved, including 10 with thoracic, 4 with thoracolumbar, and 8 with lumbar, were enrolled in the study. The patients were treated by the posterior-only approach using the shaped titanium mesh cages. Their medical records and radiographs were retrospectively analyzed.

Results:

The mean operating time was 163 min (ranging from 120 min to 200 min). Blood loss was 210–550 ml with an average of 300 ml. The mean follow-up period was 41.1 months. At the final follow-up, all patients showed a solid bony fusion without the infection recurrence. The average bone fusion time was 6.2 months. The average correction of the local segment kyphosis angle was 6.9° (from 9.2° preoperative to 2.3° postoperative). Minimal loss in correction angle was noted in these patients at the final follow-up (only 1.5°). Changes in erythrocyte sedimentation rate, local segment kyphosis angle, and neurological status demonstrated a significant clinical improvement in all children at their last follow-up.

Conclusion:

Children with spinal TB of a single motion spinal segment involved can be successfully treated by the posterior-only approach using shaped titanium mesh cage. It is a minimally invasive, safe, and effective surgical procedure.
A “Buildup” of Speech Intelligibility in Listeners With Normal Hearing and Hearing Loss
Authors: Best Virginia , Swaminathan Jayaganesh , Kopčo Norbert , Roverud Elin , Shinn-Cunningham Barbara
Published: October 2018

The perception of simple auditory mixtures is known to evolve over time. For instance, a common example of this is the “buildup” of stream segregation that is observed for sequences of tones alternating in pitch. Yet very little is known about how the perception of more complicated auditory scenes, such as multitalker mixtures, changes over time. Previous data are consistent with the idea that the ability to segregate a target talker from competing sounds improves rapidly when stable cues are available, which leads to improvements in speech intelligibility. This study examined the time course of this buildup in listeners with normal and impaired hearing. Five simultaneous sequences of digits, varying in length from three to six digits, were presented from five locations in the horizontal plane. A synchronized visual cue at one location indicated which sequence was the target on each trial. We observed a buildup in digit identification performance, driven primarily by reductions in confusions between the target and the maskers, that occurred over the course of three to four digits. Performance tended to be poorer in listeners with hearing loss; however, there was only weak evidence that the buildup was diminished or slowed in this group.
Healthy Cities or Unhealthy Islands? The Health and Social Implications of Urban Inequality
Authors: Stephens Carolyn
Published: October 2018

This paper suggests that governments and international agencies must address the large and often growing levels of inequality within most cities if health is to be improved and poverty reduced. It describes the social and health implications of inequalities within cities and discusses why descriptions of the physical symptoms of poverty (and their health implications) are more common than analyses of the structural systems which produce and perpetuate poverty. It also describes the health problems from which low-income groups in urban areas suffer more than richer groups including those that are not linked to poor sanitary conditions and those that are more linked to relative poverty (and thus the level of inequality) than to absolute poverty.
Food dissemination in ants: Robustness of the trophallactic network against resource quality
Authors: Bles Olivier , Deneubourg Jean-Louis , Nicolis Stamatios C.
Published: October 2018

Insect societies are often composed of many individuals, achieving collective decisions that depend on environmental and colonial characteristics. For example, ants are able to focus their foraging effort on the most rewarding food source. While this phenomenon is well known, the link between the food source quality and the intranidal food dissemination networks and its dynamics has been neglected. Here we analysed the global dynamics of the food dissemination in Camponotus cruentatus workers, after feeding on a low (0.1M) or on a high (1M) sucrose concentration food source. We also analysed the trophallaxis activity at the individual level and built the complete network of trophallaxis. The results reveal that the dynamics of food dissemination and the structure of the trophallaxis network are robust and independent of the food concentration. We then discuss these results in the light of recent advances in the study of efficiency in food management in ants.
Prophylaxis of complications in venous surgery
Authors: Leo M. , Di Mitri R. , Romano R.
Published: October 2018

Aim: The purpose of this article is to underline complications in venous surgery during the past 30 years and new ones arising with the introduction of technologies. We also discuss the “natural reduction” of some of these and how to prevent complications.

Methods: We have analysed different types of studies on different surgical procedures in the treatment of varicose veins and compared them with own outcomes.

Results: Considering all techniques, we have wound infections in 2,3–4 % of cases, cellulitis in 2,6–16 %, lymphatic complications in 1,3–60 %, pain in 2–23 %, neurologic disease including nerve damages, bruising and numbness in 0–50 %, thrombophlebitis in 0,3–20 %, deep vein thrombosis with or without pulmonary embolism in 0–5,7 %, injury of major vessel in 0,17 %, haematoma in 1,3–31 %, oedema in <1–15 %, hyperpigmentation in 3–11 %, ecchymosis in 0,8–9 %, skin burns in 0,2–8 %, erythema in 2–33 % and endothermal heat-induced-thrombosis (HEIT) in 0–7,5 % of cases.

Conclusion: Our outcomes confirmed literature results. We conclude that new technologies improve results and reduce complications, as do tumescent anaesthesia, medical stockings, early mobilization and low weight heparin prophylaxis (LMWH) in high risk patients.
Avoiding aesthetic complications after endovenous radiofrequency ablation
Authors: Stegher S. , Calliari F. M. , Viani M. P. , Bissacco D.
Published: October 2018

Radiofrequency endovenous ablation treatment is a safe, effective and durable technique for the treatment of great saphenous vein truncal incompetence. However, it is associated with relatively rare complications, such as ecchymosis, paresthesia, hyperpigmentation, phlebitis, haematoma, deep vein thrombosis and pulmonary embolism. Among these, aesthetic complications are the most frequent minor complications occurred after the procedure. This brief review defines and describes aesthetic complications after endovenous radiofrequency ablation of great saphenous vein and provides useful tips to minimize their incidence. Aesthetic complications can be avoided with a careful and accurate preoperative patient and vein evaluation, proper operative indication, adherence to procedure and device instruction for use and best postoperative management.
Das subfasziale venöse Ödem im NMR
Authors: Stumptner T.
Published: October 2018

Das venöse Blut der Beine wird über ein Venensystem zurück zum Herzen transportiert, wobei die subfaszialen Venen mit einem Anteil von ca. 80% die Hauptlast tragen. Eine Insuffizienz im System wird über die venöse Hypertonie somit vorwiegend den subfaszialen Raum betreffen. Dieses Drainagedefizit erklärt über die dabei vorliegende extravasale Volumenüberlastung und die daraus folgende vermehrte Faszienspannung die Beschwerden und die klinischen Befunde als Folge der Ödembildung. Das Ödem konnte im MRT dargestellt und seine therapeutische Beeinflussbarkeit mittels unelastischer Kompressionsverbände nach H. Fischer objektiviert werden.
Hautpflege bei chronisch venöser Insuffizienz
Authors: Erfurt-Berge C. , Mahler V. , Geier J.
Published: October 2018

An Hand von Daten des Informationsverbundes Dermatologischer Kliniken (IVDK) der Jahre 2012–2016 wird das Spektrum von Kontaktsensibilisierungen bei 2011 Patienten mit Ulcus cruris venosum, Stauungsekzem und/oder einem Kontaktekzem bei chronisch venöser Insuffizienz (CVI) beschrieben, und mit dem Sensibilisierungsspektrum einer Kontrollgruppe (n=30 924) im ähnlichen Alter, aber ohne diese Erkrankungen verglichen. Unverändert zu früheren IVDK-Auswertungen zeigten CVI Patienten gehäuft Sensibilisierungen gegen das folgende Allergenspektrum: Perubalsam, Bestandteile von Salbengrundlagen, insbesondere Wollwachsalkohole, Antioxidantien, insbesondere tert-Butylhydrochinon, Kolophonium, Duftstoffe und Parabene. Für die Hautpflege bei entsprechenden Patienten empfehlen sich daher duftstoff- und parabenfreie Produkte ohne Perubalsam (Myroxylon pereirae), Wollwachsalkohole (Lanolin alcohol) und tert-Butylhydrochinon (TBHQ). Dabei ist das sogenannte Parabenund Wollwachs-Paradox zu berücksichtigen: CVI Patienten können an ekzematös veränderter Haut am Unterschenkel auf Parabene oder Wollwachsalkohole reagieren, während diese Stoffe auf normaler Haut an anderen Körperregionen vertragen werden.
Appositionsthrombus als Komplikation endovenöser Katheterverfahren (Post ablation thrombus extension [PATE])
Authors: Weingard I. , Kiderlen M. , Theodoridis A. , Schuler L. , Kriechenbauer N. , Hartmann K. , Schäffer N.
Published: October 2018

Appositionsthromben sind mit einer Prävalenz von 0,2–6% eine nicht seltene Komplikation nach endovenösen Katheterverfahren. Mögliche Risikofaktoren wurden bislang noch nicht ausreichend untersucht, außerdem fehlen Standards für eine angemessene Prophylaxe und ein einheitliches Therapieschema. Wir haben eine retrospektive Analyse von 2015–2017 bezüglich der Prävalenz sowie möglicher Risikofaktoren für das Auftreten eines Appositionsthrombus nach endovenösen Verfahren im Venenzentrum Freiburg durchgeführt. Die in der Literatur beschriebenen Risikofaktoren wie, Gefäßdurchmesser> 7,5mm, simultane Miniphlebektomien sowie ein erhöhter BMI konnten nicht verifiziert werden. Die Stadieneinteilung und die Bezeichnungen des Appositionsthrombus im internationalen Gebrauch wie EHIT (endovenöse hitzeinduzierte Thrombose) und PASTE (post ablation superficial thrombus extension) sind irreführend, da diese Komplikation auch bei nicht-thermischen Verfahren auftreten kann und es sich um eine Thrombusextension ins tiefe Venensystem handelt. Daher empfehlen wir die modifizierte Bezeichnung PATE (post ablation thrombus extension). Ein PATE 0 entspricht einem planen Verschluss und ist somit ein Therapieerfolg. PATE I beschreibt eine Thrombusextension mit Einengung des Lumens der tiefen Vene bis zu 25%, PATE II bis 50% und PATE III >50%. Eine therapeutische Antikoagulation empfehlen die Autoren ab PATE II mit einer Dauer bis zum Verschwinden des Appositionsthrombus.
Ist die Differenzialdiagnostik des Lipödems mittels hochauflösender Sonografie möglich?
Authors: Schleinitz J. , Marshall M. , Faerber G. , Hirsch T.
Published: October 2018

Einleitung: Die aktuelle deutsche Leitlinie zur Behandlung des Lipödems empfiehlt neben der Therapie mit flachgestrickten Kompressionsmaterialien und manueller Lymphdrainage auch die Liposuktion. Die Abgrenzung zu Adipositas und asymptomatischer Lipohypertrophie stellt dabei häufig ein differenzialdiagnostisches Problem dar. Eine reproduzierbare und objektivierbare Differenzialdiagnostik ist aber die Grundlage für eine zielführende und wirtschaftliche Behandlung. Material und Methoden: Im Rahmen einer multizentrischen Registerstudie (5 Zentren) wurden im Zeitraum von 01/2016 bis 05/2017 die Beine (n=294) von Patientinnen mit Lipödem (n=136), Lymphödem (n=20), Lipödem mit sekundärem Lymphödem (n=30), Lipohypertrophie (n=42) und Adipositas (n=30) sowie von Gesunden (n=36) sonografisch untersucht. Es wurden Messungen der Dicke von Kutis und Subkutis an den Unter- und Oberschenkeln sowie von deren Komprimierbarkeit durchgeführt. Zusätzlich erfolgte eine Analyse der Sonomorphologie. Ergebnisse: Spezielle sonomorphologische Eigenschaften, die ein Lipödems von den anderen Krankheitsentitäten bzw. vom Gesunden abgrenzen lassen, konnten bislang nicht übereinstimmend und überzeugend herausgearbeitet werden. Die Komprimierbarkeit des Kutis-Subkutis-Komplexes ist vollkommen unspezifisch und lässt keinen Rückschluss auf die Diagnose Lipödem zu. Der Nachweis von Flüssigkeitseinlagerungen bei Patienten mit einer „schmerzhaften Lipohypertrophie” gelingt nicht, sodass die Krankheitsbezeichnung Lipödem irreführend ist und überdacht werden sollte.
The Humanitarian Pickup and Distribution Problem
Authors: Eisenhandler Ohad , Tzur Michal
Published: October 2018

Food rescue—the collection of perishable products from food suppliers who are willing to make donations, and their distribution to welfare agencies that serve individuals in need—has become increasingly widespread in recent years. This phenomenon is a result of economic crises, but it is also encouraged by the tax and good image it provides to donor companies. The problem we study in this paper focuses on the logistic challenges of a food bank that on a daily basis uses vehicles of limited capacity to distribute food collected from suppliers in the food industry to welfare agencies, under an imposed maximal traveling time. We model this problem as a routing resource allocation problem, with the aim of maintaining equitable allocations to the different agencies while delivering overall as much food as possible. We introduce an innovative objective function that satisfies desired properties of the allocation, that is easy to compute and implement within a mathematical formulation, and that balances effectiveness and equity acceptably. We present both an exact solution method and a heuristic approach, based on the large neighborhood search framework, which relies on the fact that a certain subproblem is easy to solve. Numerical experiments on several real-life and randomly generated data sets confirm that high-quality solutions may be obtained.

The online appendices are available at https://doi.org/10.1287/opre.2018.1751 .
Shoulder apprehension
Authors: Lädermann Alexandre , Tirefort Jérome , Zanchi Davide , Haller Sven , Charbonnier Caecilia , Hoffmeyer Pierre , Cunningham Gregory
Published: October 2018

Shoulder apprehension is related to changes in functional cerebral networks induced by dislocations, peripheral neuromuscular lesions and persistent mechanical glenohumeral instability consisting of micro-motion. All the damage to the osseous and soft-tissue stabilizers of the shoulder, as well as neurologic impairment persisting even after stabilization, must be properly identified in order to offer the best possible treatment to the patient. There is growing evidence supporting the use of a global multimodal approach, involving, on the one hand, shoulder ‘reafferentation’, including proprioception, mirror therapy and even cognitive behavioural approaches, and, on the other hand, surgical stabilization techniques and traditional physical therapy in order to minimize persistent micro-motion, which may help brain healing. This combined management could improve return to sport and avoid dislocation arthropathy in the long term.

Cite this article: EFORT Open Rev 2018;3:550-557. DOI: 10.1302/2058-5241.3.180007
A Preferência pelo Consumo de Produtos de Luxo Falsificados
Authors: Abreu von Borell de Araújo Diana , Mainardes Emerson Wagner , Ronqueti Terra Silva Érika
Published: October 2018

O objetivo deste estudo foi entender as razões pelas quais os consumidores preferem comprar produtos de luxo falsificados, com base na sua percepção de luxo, de marca de luxo ou premium e de produtos falsificados de luxo. Para tal, fez-se uma pesquisa qualitativa em que os significados das percepções dos consumidores sobre esses temas foram explorados a partir de entrevistas individuais semiestruturadas. As entrevistas foram realizadas com mulheres que declararam consumir esses produtos. Após a transcrição, os dados foram codificados, categorizados e interpretados por meio de análise de conteúdo. O produto de marca de luxo falsificado foi visto como um substituto do produto de luxo original, ao ser atribuído a ele características como a qualidade e o refinamento. O preço foi apontado como principal fator da compra. E a facilidade de acesso à internetfoi abordada por todas as participantes.
Capacidades Estatais e Programas de Promoção dos Biocombustíveis no Brasil
Authors: Sampaio Renata Martins , Bonacelli Maria Beatriz Machado
Published: October 2018

O artigo compara políticas de incentivos aos bicombustíveis no Brasil, o Programa Nacional do Álcool (Proálcool) e o Programa Nacional de Produção e Uso de Biodiesel (PNPB), e pontua a participação da Petrobras nessas políticas. Para tanto, está apoiado nas discussões conceituais e teóricas relacionadas às Capacidade Estatais, tomando como elementos de análise o contexto institucional, os mecanismos formatados e os resultados alcançados por esses programas. Os resultados indicam cenários internacional e nacional, assim como ambientes institucionais distintos na implementação dos programas com reflexos na arquitetura dos mecanismos, na execução e na participação da estrutura do Estado. Os pontos de aproximação entre os programas reúnem os incentivos fiscais e financeiros e a inserção de conteúdo social nos objetivos, além do avanço da produção vinculado a agroindústrias anteriormente estabelecidas.
Current preoperative antisepsis in neurosurgery: an example of the challenges in implementing evidence-based medicine to surgical practice
Authors: Bobby Sachdev , Michael D Jenkinson , Hiren Patel , Benjamin Davies
Published: October 2018

Introduction

Surgical site infection is associated with significant morbidity and mortality. Effective preoperative skin decolonisation is an important preventative strategy. The National Institute for Health and Care Excellence clinical guidelines recommend decolonisation using chlorhexidine gluconate (CHG) or povidone iodine (PVI). Current evidence indicates that CHG is more effective, while the combination of CHG and PVI is greater still. This study describes current practice among neurosurgeons in the UK, including differences between trainees and consultants, to review compliance with the latest evidence.

Materials and methods

A Society of British Neurosurgical Surgeons approved national, multicentre questionnaire was circulated online. A total of 74 complete responses were obtained from 27 trainees and 47 consultants, representing 28 of 37 neurosurgical centres.

Results

Of the total responding centres, 36 (49%) used a single agent and 38 (51%) used a dual-agent preparation. One respondent used Tisept®. Seventy (95%) used alcohol in some form and none used aqueous CHG. Trainees were more likely to use a dual-agent preparation (P = 0.025). Forty-seven (63%) prepared the skin three or more times, with trainees preparing the skin more times than consultants (P = 0.002).

Conclusion

Neurosurgical practice adheres to national clinical guidelines but not the latest evidence from the literature. Given the weighting placed on randomised controlled trials, such a trial may be required to standardise practice that is likely to reduce surgical site infection.
Survival after non-resection of colorectal cancer: the argument for including non-operatives in consultant outcome reporting in the UK
Authors: Abdel-Halim M , Wu H , Poustie M , Beveridge A , Scott N , Mitchell PJ
Published: October 2018

Introduction

Although the mainstay of colorectal cancer treatment remains operative, a significant proportion of patients end up without surgery. This is because they are either deemed to have no oncological benefit from the resection (too much disease) or to be unfit for major surgery (too frail). The aim of this study was to assess the proportion and survival of these two groups among the totality of practice in a tertiary unit and to discuss the implications on the conceptual understanding of outcome measures.

Methods

Data was collected over two study periods with the total duration of four years. Patient demographics, comorbidities, cancer staging and management pathways were all recorded. The primary endpoint was all-cause mortality.

Results

The total of 909 patients were examined. In the 29% who did not undergo resectional surgery, 6.5% had too little disease, 13.8% had too much disease, while 8.7% were deemed too frail. The highest two-year mortality was observed in the too much (83.2%) and too frail (75.9%) groups, whereas in patients with too little cancer the rate was 5.1%, and in those undergoing a resection it was 19.2% (P < 0.001).

Conclusions

The study has expectedly shown poor survival in the too much and too frail groups. We believe that understanding the prognosis in these subgroups is vital, as it informs complex decisions on whether to operate. Moreover, an overall reporting taking into account the proportion of these groups in an multidisciplinary team practice (the non-surgical index) is proposed to render individual surgeon's mortality results meaningful as a comparative measure.