bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-Effectiveness of Pharmacological Treatments for Osteoporosis Consistent with the Revised Economic Evaluation Guidelines for Canada
Authors: Coyle Doug
Published: January 2019

Introduction. Given the lack of independent analyses comparing numerous pharmacotherapies for osteoporosis, the study objective was to identify the optimal osteoporosis treatment based on a woman’s age, fracture history, and ability to tolerate oral bisphosphonates adopting practices recommended in the recently revised Canadian guidelines. Methods. A cost utility analysis from the health care system perspective compared alendronate, etidronate, risedronate, zoledronate, denosumab, and no pharmacotherapy using a Markov model incorporating data on fracture risk and their associated costs, mortality, and disutility and treatment effect. Stratified analysis was conducted based on age, fracture history, and ability to tolerate oral bisphosphonates. Expected lifetime outcomes were obtained through probabilistic analysis with scenario analyses addressing methodological and structural uncertainty. Results. For women able to tolerate oral bisphosphonates, risedronate and etidronate were dominated. Compared to no therapy, alendronate was either dominant or was associated with a low incremental cost per QALY (quality-adjusted life years) gained (ICER)—less than CAN$3,751 based on age and fracture history. In comparison with alendronate, both zoledronate and denosumab were either dominated or associated with a high ICER—greater than CAN$660,000 per QALY. For women unable to tolerate bisphosphonates, dependent on age and fracture history, the ICER for zoledronate versus no therapy ranged from CAN$17,770 to CAN$94,365 per QALY. For all strata, denosumab was dominated by zoledronate or had an ICER greater than CAN$3.0 million. Scenario analyses found consistent findings. Conclusions. Based on a threshold of CAN$50,000 per QALY, alendronate is optimal for osteoporotic women who can tolerate oral bisphosphonates regardless of age or fracture history. For women unable to tolerate oral bisphosphonates, zoledronate is optimal for women with previous fracture or aged 80 to 84 or over 90 with no previous fracture.
MHC class II cell-autonomously regulates self-renewal and differentiation of normal and malignant B cells
Authors: Merkenschlager Julia , Eksmond Urszula , Danelli Luca , Attig Jan , Young George R. , Nowosad Carla , Tolar Pavel , Kassiotis George
Published: January 2019

Best known for presenting antigenic peptides to CD4+ T cells, major histocompatibility complex class II (MHC II) also transmits or may modify intracellular signals. Here, we show that MHC II cell-autonomously regulates the balance between self-renewal and differentiation in B-cell precursors, as well as in malignant B cells. Initiation of MHC II expression early during bone marrow B-cell development limited the occupancy of cycling compartments by promoting differentiation, thus regulating the numerical output of B cells. MHC II deficiency preserved stem cell characteristics in developing pro-B cells in vivo, and ectopic MHC II expression accelerated hematopoietic stem cell differentiation in vitro. Moreover, MHC II expression restrained growth of murine B-cell leukemia cell lines in vitro and in vivo, independently of CD4+ T-cell surveillance. Our results highlight an important cell-intrinsic contribution of MHC II expression to establishing the differentiated B-cell phenotype.
Randomized study of imatinib for chronic myeloid leukemia: comparing standard dose escalation with aggressive escalation
Authors: Miyamura Koichi , Ohnishi Kazunori , Ohtake Shigeki , Usui Noriko , Nakaseko Chiaki , Fujita Hiroyuki , Fujisawa Shin , Sakura Toru , Okumura Hirokazu , Iriyama Noriyoshi , Emi Nobuhiko , Fujimaki Katsumichi , Honda Sumihisa , Miyazaki Yasushi , Naoe Tomoki
Published: January 2019

In 2007, we conducted a prospective randomized study to compare an aggressive dose escalation (group B, n = 123) with the standard dose escalation proposed by European LeukemiaNet (group A, n = 122). In group B, if patients did not achieve a complete cytogenetic response (CCyR) at 3 months or did not achieve a major molecular response (MR3) at 6 months, imatinib was increased to 600 mg. At 6 months CCyR was achieved in 69.4% and 78.7% of patients in groups A and B, respectively. The rate of MR3 at 12 months and 24 months were similar in group A (52.1% and 70.0%) and group B (58.7% and 68.3%). The cumulative incidence of withdrawal by failure without accelerated/blast phase was higher in group A than in group B (9.2% vs 2.5% at 24 months). At 3 and 6 months, the protocol called for the imatinib dose to increase to 600 mg in 90 patients (74.4%) in group B. Among the 42 patients who received increased dose according to the protocol, 25 (60.0%) achieved MR3 at 12 months, whereas only 14 (35.0%) of 40 patients who did not receive an increased dose achieved MR3 (P < .05). The number of patients who withdrew from this study was similar (group A, 20%; group B, 21%). The early aggressive dose escalation failed to produce a better molecular response at 12 months. However, for patients who tolerate imatinib well, but show inadequate response at an early time point, aggressive dose escalation may contribute to achieving a better outcome. This study was registered at http://www.umin.ac.jp/ctr/ as #R000000965.
Gene-based FVIIa prophylaxis modulates the spontaneous bleeding phenotype of hemophilia A rats
Authors: Zintner Shannon M. , Small Juliana C. , Pavani Giulia , Dankner Lynn , Marcos-Contreras Oscar A. , Gimotty Phyllis A. , Kjelgaard-Hansen Mads , Wiinberg Bo , Margaritis Paris
Published: January 2019

A sizable proportion of hemophilia inhibitor patients fails immune tolerance induction and requires bypass agents for long-term bleed management. Recombinant human-activated coagulation Factor VII (rhFVIIa) is an on-demand bypass hemostatic agent for bleeds in hemophilia inhibitor patients. Prophylactic use of rhFVIIa may enable sustained hemostatic management of inhibitor patients, but the critical relationship of rhFVIIa circulating levels and clinical outcome in that setting remains unclear. To address this in vivo, we used the rat hemophilia A (HA) model that exhibits spontaneous bleeds and allows longitudinal studies with sufficient statistical power. We simulated activated Factor VII (FVIIa) prophylaxis by adeno-associated virus (AAV) gene transfer of a rat FVIIa transgene. Compared with naive HA animals, rat FVIIa continuous expression affected the overall observed bleeds, which were resolved with on-demand administration of recombinant rat FVIIa. Specifically, although 91% of naive animals exhibited bleeds, this was reduced to 83% and 33% in animals expressing less than 708 ng/mL (<14 nM) and at least 708 ng/mL (≥14 nM) rat FVIIa, respectively. No bleeds occurred in animals expressing higher than 1250 ng/mL (>25 nM). Rat FVIIa expression of at least 708 ng/mL was also sufficient to normalize the blood loss after a tail vein injury. Continuous, AAV-mediated rat FVIIa transgene expression had no apparent adverse effects in the hemostatic system of HA rats. This work establishes for the first time a dose dependency and threshold of circulating FVIIa antigen levels for reduction or complete elimination of bleeds in a setting of FVIIa-based HA prophylaxis.
Non-base wage components as a source of wage adaptability to shocks: evidence from European firms, 2010–2013
Authors: Babecký Jan , Berson Clémence , Fadejeva Ludmila , Lamo Ana , Marotzke Petra , Martins Fernando , Strzelecki Pawel
Published: January 2019

This paper provides evidence on the role of non-base wage components as a channel for firms to adjust labour costs in the event of adverse shocks. It uses data from a firm-level survey for 25 European countries that covers the period 2010–2013. We find that firms subject to nominal wage rigidities, which prevent them from adjusting base wages, are more likely to cut non-base wage components when they are hit by negative shocks. Firms thus use non-base wage components as a strategic margin to overcome base wage rigidity. We also show that while non-base wage components exhibit some degree of downward rigidity this is smaller than that observed for base wages.
Evaluating the Impact of Treatment Care Planning on Quality Measures
Authors: Rocque Gabrielle B. , Williams Courtney P. , Hathaway Amanda R. , Halilova Karina I. , Stricker Carrie T. , Coombs Nicholas C. , Dudley William N. , Thomas Kathryn A. , Gaguski Michele , Crist Stéphanie , Kozlik Mary May , Larkin Patti , Cadden Austin , Jones Meredith I.
Published: January 2019

PURPOSE:

The Center for Medicare & Medicaid Innovation Oncology Care Model (OCM) requires documentation of a 13-point Institute of Medicine care management plan for Medicare patients. In addition, OCM includes evaluation of quality using key performance measures that align with the ASCO Quality Oncology Practice Initiative (QOPI). Both efforts are designed to improve patient-centered care and foster patients’ engagement in their care plan.

METHODS:

A multicenter quality improvement project was conducted to develop a strategy to meet the OCM treatment planning (TP) requirement (Plan), pilot clinician education coupled with use of electronic TP in early-stage breast cancer (Do), evaluate the impact of TP on QOPI measures (Study), and develop recommendations for future implementation (Act).

RESULTS:

Thirty-three clinical providers and 171 women with breast cancer were included. Improved performance on several QOPI measures was observed for the intervention group compared with the historical control group.

CONCLUSION:

Meeting the OCM TP requirement through incorporating a technology solution provided an opportunity for quality improvement and preparation for full-scale TP within the OCM. TP delivery was associated with improved performance on select ASCO QOPI measures, which is likely to correspond with improved performance on quality measures within OCM.
Economists (and Economics) in Tech Companies
Authors: Athey Susan , Luca Michael
Published: January 2019

As technology platforms have created new markets and new ways of acquiring information, economists have come to play an increasingly central role in tech companies—tackling problems such as platform design, strategy, pricing, and policy. Over the past five years, hundreds of PhD economists have accepted positions in the technology sector. In this paper, we explore the skills that PhD economists apply in tech companies, the companies that hire them, the types of problems that economists are currently working on, and the areas of academic research that have emerged in relation to these problems.
Variation in Women’s Success across PhD Programs in Economics
Authors: Boustan Leah , Langan Andrew
Published: January 2019

We document wide and persistent variation in women’s representation and success across graduate programs in economics. Using new data on early career outcomes for recent graduates, including first job placement, publications, and promotion, we rank (anonymized) departments on outcomes for women relative to men graduating from the same program. We then conduct interviews with faculty and former students from five programs with better and worse relative outcomes. We find that departments with better outcomes for women also hire more women faculty, facilitate advisor–student contact, provide collegial research seminars, and are notable for senior faculty with awareness of gender issues. We offer our qualitative evidence as the first step in learning about “what works” in expanding women’s representation in economics.
Prone to Fail: The Pre-Crisis Financial System
Authors: Duffie Darrell
Published: January 2019

The financial crisis that began in 2007 was triggered by over-leveraged homeowners and a severe downturn in US housing markets. However, a reasonably well-supervised financial system would have been much more resilient to this and other types of severe shocks. Instead, the core of the financial system became a key channel of propagation and magnification of losses suffered in the housing market. Critical financial intermediaries failed, or were bailed out, or dramatically reduced their provision of liquidity and credit to the economy. In short, the core financial system ceased to perform its intended functions for the real economy at a reasonable level of effectiveness. As a result, the impact of the housing-market shock on the rest of the economy was much larger than necessary. In this essay, I will review the key sources of fragility in the core financial system. I discuss the weakly supervised balance sheets of the largest banks and investment banks; the run-prone designs and weak regulation of the markets for securities financing and over-the-counter derivatives; the undue reliance of regulators on “market discipline; and the interplay of too-big-to-fail and the failure of market discipline. Finally, I point to some significant positive strides that have been made since the crisis: improvements in the capitalization of the largest financial institutions, a reduction of unsafe practices and infrastructure in the markets for securities financing and derivatives, and a significantly reduced presumption that the largest financial firms will be bailed out by taxpayer money in the future. But I will also mention some remaining challenges to financial stability that could be addressed with better regulation and market infrastructure.
India Research Management Initiative (IRMI) – an initiative for building research capacity in India
Authors: Ayyar Savita , Jameel Shahid
Published: January 2019

Research and innovation are growing in India with significant investments being made towards institutions, researchers and research infrastructure. Although still under 1% of GDP, funding for science and technology in India has increased each year for over two decades. There is also increasing realization that public funding for research should be supplemented with that from industry and philanthropy.

Like their counterparts worldwide, Indian researchers require access to professional research management support at their institutions to fully leverage emerging scientific opportunities and collaborations. However, there are currently significant  gaps in the research management support available to these researchers and this has implications for research in India.

The India Research Management Initiative (IRMI) was launched by the Wellcome Trust/DBT (Department of Biotechnology, Government of India) India Alliance (hereafter India Alliance) in February 2018 to narrow these gaps. A 12-month pilot phase has enabled conversations across multiple stakeholders. In this Open Letter, we share some insights from the IRMI pilot phase, which could aid systemic development and scaling up of research management as a professional support service across India. We anticipate these will stimulate dialogue and guide future policy and interventions towards building robust research and innovation ecosystems in India.
Returning ‘learning’ to education: Toward an ecological conception of learning and teaching
Authors: Campbell Cary
Published: January 2019

This article describes a notion of learning as adaptive semiotic-growth. In line with the theme of this special issue, learning will be approached on a broad ecological and evolutionary continuum – most generally expressed as a form of adaptation to the environment. Viewing learning through the criterion of signification (semiosis) means that learning is continuous across the entire biological realm. Both the life process and the learning process are expressed through forms of semiotic-engagement and involve continual adaptation and meaning-making. Thus, learning cannot be seen as unique to humans. Learning is more broadly ecological before it is “cultural”. From here we can imagine educational institutions as forms of exaptation, that evolved naturally to channel learning more effectively. Thinking of learning on an ecological continuum means that learning cannot be “located” or pinned down easily in educational research or practice. Rather, learning has a sporadic identity; it is emergent in the specificity of events and must be discerned within the practices that enact it. Realizing learning as something emergently enacted in the educative encounter, and not something that can be determined and implemented, allows us to resist turning learning into an accountability tool that can easily be used towards ideological ends.
Two decades of ecosemiotics in Tartu
Authors: Maran Timo
Published: January 2019

Two decades of ecosemiotics in Tartu
The Generalized Johnson Quantile-Parameterized Distribution System
Authors: Hadlock Christopher C. , Bickel J. Eric
Published: January 2019

Johnson quantile-parameterized distributions (J-QPDs) are parameterized by any symmetric percentile triplet (SPT) (e.g., the 10th–50th–90th) and support bounds. J-QPDs are smooth, highly flexible, and amenable to Monte Carlo simulation via inverse transform sampling. However, semibounded J-QPDs are limited to lognormal tails. In this paper we generalize the kernel distribution of J-QPD beyond the standard normal, generating new fat-tailed distribution systems that are more flexible than J-QPD. We also show how to augment the SPT/bound parameters with a tail parameter, lending separate control over the distribution body and tail. We then present advantages of our new generalized system over existing systems in the contexts of both expert elicitation and fitting to empirical data.
corpo, técnica e jogo na infância: notas da teoria crítica de theodor w. adorno
Authors: Salgado Mara
Published: January 2019

O artigo apresenta considerações acerca da infância na Teoria Crítica de Theodor Adorno, com foco nas reflexões acerca do corpo, da técnica e do jogo que marcam a infância como um outro da razão. A infância é retratada por Adorno como um lugar das primeiras utopias, a pátria ansiada e, desde sempre inabitada, que se torna falsa a qualquer tentativa de resgate, mas ilumina o desejo outrora experimentado num jogo com o corpo e o pensamento, o sonho e a realidade, a experiência de outra ordem da razão que alimenta a memória da natureza animal do humano, sem, contudo, estar isenta das forças históricas dominantes que incidem sobre os processos de subjetivação. Tais reflexões partem de escritos de Adorno e daquilo que seus diálogos com interlocutores, como Walter Benjamin, Freud e Huizinga, podem suscitar na análise do tema. Num segundo movimento do texto, para a compreensão dos limites e potencialidades da dinâmica atual da brincadeira mediada pela tecnologia, tomou-se como exemplo alguns estudos acerca da realidade virtual, em especial, dos jogos eletrônicos em contraposição com a teoria de Huizinga sobre o caráter sagrado no jogo. Conjecturas sobre como o contato com a realidade está danificado já na infância pela relação com a tecnologia, estabelecendo a busca por satisfação imediata, podem revelar a qualidade da atenção que as crianças recebem nos processos educativos e dar pistas sobre a crescente manifestação de transtornos sócio afetivos, que culminam na preferência por dispor o tempo e o corpo às brincadeiras eletrônicas em detrimento do contato real com as outras crianças.
partir da infância ou a arché do pensamento
Authors: Silva Carla patrícia
Published: January 2019

Desde o lugar de nascimento da infância, este texto busca, através de Giorgio Agamben (2005), Heráclito (fragmento 52) e Paulo Freire (1982;1986; 2001; 2015), elucidar a coexistência entre infância e tempo. Desse modo, trabalha com a hipótese de que infância e tempo são indefiníveis conceitualmente e diluidoras da ideia de estabilidade, a qual escapa à compreensão de continuidade. É nesse sentido que o presente texto parte da leitura de que a infância é, fundamentalmente, condição de existência da história da humanidade, o que torna possível a passagem da língua ao pensamento e provoca a inventividade para todo estado de coisas. Para pensar a infância que está em questão neste texto, consideramos uma certa experiência do tempo diferente da experiência tradicional; fruto de uma compreensão concebida como cronologia e acabamento, presente nas diversas leituras feitas da infância. Ao colocarmos esses apontamentos, algumas perguntas impõem-se: existe algo como uma infância do pensamento? A insistência com a infância é uma forma de não renunciar a um novo conceito de experiência?
'why teachers’ beliefs and values are important in p4c research: a victorian perspective
Authors: Kilby Ben
Published: January 2019

This paper argues that there is an absence of current research in Philosophy for Children (P4C) that focusses on teachers’ perspectives, particularly in relation to their beliefs and values. The paper will look briefly at the programmatics of P4C, and its current mandated status in the education system in the state of Victoria, Australia. It will then move to exploring how the study of teachers’ perspectives, through analyses of their beliefs and values, adds significant value in education, particularly in the context of P4C. It concludes by analysing some recent P4C research that has begun to explore teachers’ perspectives, before finishing with suggesting future research directions that build on these previous studies, and which promise lay important groundwork for extending the reach of P4C into educational systems.
CONTRIBUIÇÃO SINDICAL: O RECOLHIMENTO PODE SER FACULTATIVO? / UNION CONTRIBUTION: CAN COLLECTION BE OPTIONAL?
Authors: Felicio Raphael Maleque , Mendonça Marcelo Otávio De Albuquerque Benevides
Published: January 2019

A reforma trabalhista aprovada trouxe, entre outras coisas, a facultatividade do pagamento da contribuição sindical. Ocorre que por se tratar de tributo, traz a compulsoriedade como um dos elementos intrínsecos. Assim, serve o presente artigo para abordar a (in)constitucionalidade da Lei 13.467/2017, que tornou facultativo o pagamento da contribuição sindical.
O OUTRO LADO DA MOEDA NA NOVA RELACAO ENTRE FISCO E CONTRIBUINTES – A OBRIGACAO DE REVELAR PLANEJAMENTOS FISCAIS AGRESSIVOS / THE OTHER SIDE OF THE COIN IN THE NEW RELATIONSHIP BETWEEN TAX AUTHORITIES AND TAX PAYERS – MANDATORY DISCLOSURE RULES ON AGGRESSIVE TAX PLANNING
Authors: Parada Marcio Henrique Sales
Published: January 2019

A tributação, enquanto elemento primordial na atividade estatal, é sempre um campo fértil para discussões acadêmicas, frequentemente de caráter multidisciplinar. A relação entre Fisco e contribuintes, especialmente no que diz respeito a transparência e confiança, vem sendo desenvolvida, há anos, em vários países que decidiram migrar de um modelo baseado nas auditorias e aplicação de punições para um modelo fundado na autorregularização, muitas vezes com supervisão ou acompanhamento da administração tributária. Este artigo, partindo das propostas de uma nova dimensão nessa relação, no caminho que finalmente a Administração Tributária brasileira encontra  no sentido de fortalecer o cumprimento voluntário de obrigações fiscais, dispõe-se a analisar a possibilidade da introdução, no sistema tributário, de ações com o escopo de determinar a revelação de planejamentos tributários agressivos, assim entendidos aqueles que produzam vantagens fiscais, conforme proposto pela Organização para a Cooperação e o Desenvolvimento Econômico. O trabalho reconhece que tal modelo contém nuances ainda não exploradas. A análise descritiva realiza uma comparação entre sistemas em vigor e propostas recentes nesse sentido, em países europeus, focando no tempo da informação e nos sujeitos da obrigação, para concluir que conjuntos de regras que determinam a revelação de planejamento tributário agressivo devem estar ligadas a dois outros tipos de programas: a troca de informação entre as administrações tributárias e programas de compliance cooperativo. Além disso, analisando uma experiência frustrada brasileira, o artigo reflete sobre possíveis questões envolvendo princípios constitucionais que precisam ser considerados na aplicação desse tipo de sistema e endereça para futuros estudos no tocante a sigilo profissional, privacidade e intimidade.
What does the NHS Long Term Plan mean for diabetes care?
Authors: Phillips Anne
Published: January 2019

The NHS Long Term Plan, launched in January 2019, outlined several targets and schemes to improve patient care. However, practice nurses need to be aware of what these changes might mean for their practice, particularly in diabetes care

This is an exciting time of transformation and engagement in diabetes care for general practice. The King's Fund (2018) reported ‘a shared responsibility for health’ which echoes this vision for transformation in terms of diabetes care and supporting more avenues to enable people to gain the skills and knowledge to live well with their condition. Furthermore, the new NHS Long Term Plan ( NHS, 2019 ) announced several initiatives for people living with diabetes, which are detailed in this article.
Atopic eczema and dermatitis: What's the difference?
Authors: Onselen Julie Van
Published: January 2019

Eczema and dermatitis are both terms that are used to describe the inflammation of the skin, but the differences between them can be confusing. Practice nurses manage patients with eczema and dermatitis in primary care, and therefore they need to understand the definitions and differences between them. Atopic eczema is diagnosed by a clinical history-taking, assessing clinical signs and symptoms, whereas patch testing is required for a diagnosis of allergic contact dermatitis.
Double-level fixator-assisted nailing (DL-FAN)
Authors: Chaudhary M. M. , Lakhani P. H.
Published: January 2019

Aims

Double-level lengthening, bone transport, and bifocal compression-distraction are commonly undertaken using Ilizarov or other fixators. We performed double-level fixator-assisted nailing, mainly for the correction of deformity and lengthening in the same segment, using a straight intramedullary nail to reduce the time in a fixator.

Patients and Methods

A total of 23 patients underwent this surgery, involving 27 segments (23 femora and four tibiae), over a period of ten years. The most common indication was polio in ten segments and rickets in eight; 20 nails were inserted retrograde and seven antegrade. A total of 15 lengthenings were performed in 11 femora and four tibiae, and 12 double-level corrections of deformity without lengthening were performed in the femur. The mean follow-up was 4.9 years (1.1 to 11.4). Four patients with polio had tibial lengthening with arthrodesis of the ankle. We compared the length of time in a fixator and the external fixation index (EFI) with a control group of 27 patients (27 segments) who had double-level procedures with external fixation. The groups were matched for the gain in length, age, and level of difficulty score.

Results

The mean gain in length was statistically similar in the two groups: 3.9 cm (1.5 to 9.0) in the study group and 4.2 cm (3.4 to 5.0) in the control group (p = 0.350). The mean time in a fixator was significantly less in the study group compared with the control group: 8.6 weeks (2.0 to 22.8) versus 30.2 weeks (25.0 to 35.4; p < 0.001). The mean EFI was significantly lower in the study group compared with the control group: 17.7 days/cm (10.6 to 35.6) versus 73.4 days/cm (44.5 to 102.3; p < 0.001). The ASAMI (Association for the Study and Application of the Method of Ilizarov) bone score was excellent in 22, good in four, and fair in one. The ASAMI functional score was excellent in 20 and good in seven. There were no infections, superficial or deep.

Conclusion

Double-level osteotomies or two procedures using a custom-made straight nail and external fixation can be used to correct deformities or to treat nonunion or malunion and may be combined with arthrodesis of the ankle with lengthening. It is a reasonably safe procedure that allows accurate and cost-effective treatment with a relatively short time in a fixator.
Transfemoral amputation following total knee arthroplasty
Authors: Ryan S. P. , DiLallo M. , Klement M. R. , Luzzi A. J. , Chen A. F. , Seyler T. M.
Published: January 2019

Aims

The aim of this study was to characterize the factors leading to transfemoral amputation after total knee arthroplasty (TKA), as well as the rates of mortality and functional independence after this procedure in these patients.

Patients and Methods

This was a multicentre retrospective review with a prospective telephone survey for the assessment of function. All patients with a TKA who subsequently required transfemoral amputation between January 2001 and December 2015 were included. Demographic information, medical comorbidities, and postoperative mortality data were collected. A 19-item survey was used for the assessment of function in surviving patients.

Results

A total of 111 patients were included. Their mean age was 61.0 years (42.0 to 88.0) at the time of TKA, with a subsequent mean of 3.7 operations (0 to 15) over a mean period of 6.1 years (0.05 to 30.1) before amputation. The indication for amputation was chronic infection in 97 patients (87.4%). The rate of five-year survival was 51.7%, and advanced age (p = 0.001) and renal failure (p = 0.045) were associated with an increased risk of mortality. Of the 62 surviving patients, 34 completed the survey; 32 (94.1%) owned a prosthesis but only 19 (55.9%) used it; 19 (55.9%) primarily used a wheelchair for mobility; 27 (79.5%) had phantom pain; and 16 (47.1%) required chronic pain medication. Only 18 patients (52.9%) were satisfied with the quality of life.

Conclusion

Patients with complications after TKA, in whom transfemoral amputation is considered, should be made aware of the high rate of mortality and the poor functional outcome in the survivors. Alternative forms of treatment including arthrodesis of the knee should be investigated.
Neoadjuvant denosumab
Authors: Puri A. , Gulia A. , Hegde P. , Verma V. , Rekhi B.
Published: January 2019

Aims

The aims of this study were to evaluate the efficacy of preoperative denosumab in achieving prospectively decided intention of therapy in operable giant cell tumour of bone (GCTB) patients, and to document local recurrence-free survival (LRFS).

Patients and Methods

A total of 44 patients received preoperative denosumab: 22 to facilitate curettage, 16 to facilitate resection, and six with intent of converting resection to curettage. There were 26 male and 18 female patients. The mean age was 27 years (13 to 47).

Results

The mean number of denosumab treatments was five (2 to 7) per patient. In 42 of 44 patients (95%), denosumab helped to achieve prospectively decided intention. A total of 41 patients were available for follow-up at a mean follow-up of 34 months (24 to 48). There were 12 local recurrences (29%), in 11 patients (11/25, 44%) who had curettage and in one patient (1/16, 6%) who had resection. The mean time to local recurrence was 16 months (8 to 25). The LRFS was 76% at two years: 94% for cases with resection and 64% for cases with curettage (p = 0.013).

Conclusion

Although local control rates are unlikely to improve with use of preoperative denosumab, a short preoperative course of denosumab can facilitate surgery in certain cases of operable GCTB, with a high risk of local recurrence making curettage or resection technically easier. It may also help in converting a lesion requiring resection to a lesion that could possibly be treated with curettage.
The influence of developmental spinal stenosis on the risk of re-operation on an adjacent segment after decompression-only surgery for lumbar spinal stenosis
Authors: Cheung P. W. H. , Fong H. K. , Wong C. S. , Cheung J. P. Y.
Published: January 2019

Aims

The aim of this study was to determine the influence of developmental spinal stenosis (DSS) on the risk of re-operation at an adjacent level.

Patients and Methods

This was a retrospective study of 235 consecutive patients who had undergone decompression-only surgery for lumbar spinal stenosis and had a minimum five-year follow-up. There were 106 female patients (45.1%) and 129 male patients (54.9%), with a mean age at surgery of 66.8 years (sd 11.3). We excluded those with adult deformity and spondylolisthesis. Presenting symptoms, levels operated on initially and at re-operation were studied. MRI measurements included the anteroposterior diameter of the bony spinal canal, the degree of disc degeneration, and the thickness of the ligamentum flavum. DSS was defined by comparative measurements of the bony spinal canal. Risk factors for re-operation at the adjacent level were determined and included in a multivariate stepwise logistic regression for prediction modelling. Odds ratios (ORs) with 95% confidence intervals were calculated.

Results

Of the 235 patients, 21.7% required re-operation at an adjacent segment. Re-operation at an adjacent segment was associated with DSS (p = 0.026), the number of levels decompressed (p = 0.008), and age at surgery (p = 0.013). Multivariate regression model (p < 0.001) controlled for other confounders showed that DSS was a significant predictor of re-operation at an adjacent segment, with an adjusted OR of 3.93.

Conclusion

Patients with DSS who have undergone lumbar spinal decompression are 3.9 times more likely to undergo future surgery at an adjacent level. This is a poor prognostic indicator that can be identified prior to index decompression surgery.
Representing the ‘older end user’? Challenging the role of social scientists in the field of ‘active and assisted living’
Authors: Gallistl Vera , Wanka Anna
Published: January 2019

As digital technologies have gained vast relevance in contemporary societies, technological assistance and support has also become an important topic in the field of care. Despite the fact that older adults are often framed as ‘laggards’ in the innovation process, they have become one major target group for technology development. This poses challenges to care recipients and infrastructures, but also to research in the field of gerontechnologies. In this debate article, we raise some fundamental questions about the role that social sciences play in the field of active assisted living and propose new directions for research on ageing and technologies.
The Australian Royal Commission into the Aged Care Industry 2019
Authors: Harvey Peter W.
Published: January 2019

In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.
Plasma MicroRNA Signature Validation for Early Detection of Colorectal Cancer
Authors: Herreros-Villanueva Marta , Duran-Sanchon Saray , Martín Ana Carmen , Pérez-Palacios Rosa , Vila-Navarro Elena , Marcuello María , Diaz-Centeno Mireia , Cubiella Joaquín , Diez Maria Soledad , Bujanda Luis , Lanas Angel , Jover Rodrigo , Hernández Vicent , Quintero Enrique , José Lozano Juan , García-Cougil Marta , Martínez-Arranz Ibon , Castells Antoni , Gironella Meritxell , Arroyo Rocio
Published: January 2019

OBJECTIVES:

Specific microRNA (miRNA) signatures in biological fluids can facilitate earlier detection of the tumors being then minimally invasive diagnostic biomarkers. Circulating miRNAs have also emerged as promising diagnostic biomarkers for colorectal cancer (CRC) screening. In this study, we investigated the performance of a specific signature of miRNA in plasma samples to design a robust predictive model that can distinguish healthy individuals from those with CRC or advanced adenomas (AA) diseases.

METHODS:

Case control study of 297 patients from 8 Spanish centers including 100 healthy individuals, 101 diagnosed with AA, and 96 CRC cases. Quantitative real-time reverse transcription was used to quantify a signature of miRNA (miRNA19a, miRNA19b, miRNA15b, miRNA29a, miRNA335, and miRNA18a) in plasma samples. Binary classifiers (Support Vector Machine [SVM] linear, SVM radial, and SVM polynomial) were built for the best predictive model.

RESULTS:

Area under receiving operating characteristic curve of 0.92 (95% confidence interval 0.871–0.962) was obtained retrieving a model with a sensitivity of 0.85 and specificity of 0.90, positive predictive value of 0.94, and negative predictive value of 0.76 when advanced neoplasms (CRC and AA) were compared with healthy individuals.

CONCLUSIONS:

We identified and validated a signature of 6 miRNAs (miRNA19a, miRNA19b, miRNA15b, miRNA29a, miRNA335, and miRNA18a) as predictors that can differentiate significantly patients with CRC and AA from those who are healthy. However, large-scale validation studies in asymptomatic screening participants should be conducted.
Design Of A Femtosecond Blue Pulse Generation System By Pumping Of Kn Crystal With Cr:LiSAF Lasers
Authors:   Department of Physics, Islamic Azad University (IAU),Varamin, Pishva Branch, Iran, Karami Hosein
Published: January 2019

In this paper we described and simulated generation of blue pulse (460nm) by nonlinear KN(KNbO3) crystal ,that pumped by femtosecond diode pumped Cr:LiSAF lasers. Our simulation show that, by focusing of laser oscillator output pulses with characteristics such as 860nm wavelength, 200fs,330MHz repetition rate 14o Pico joule( PJ) energy in KN crystal with 3mm length at 22 0C by 15 mm lens in less than 20 micrometer spot size with single pass produce pulses with 42pJ energy ,425fs , 30% optical efficiency and 1% total efficiency.
The Effect of Concept Learning with Embedded Instruction to the Students with Intellectual Disabilities
Authors: ALTUN KÖNEZ Nilüfer , ÇELİK ŞAHİN Ayşenur , APAYDIN Gamze , YILMAZ Betül , AYKUT Çığıl
Published: January 2019

The
aim of this research is to analyse the effect of teaching half concept embedded
in sandwich making skills for the students with intellectual disabilities. The
participants of this research consists of three students between the ages of 11
and 14 with mild intellectual disabilities and continue their education in a
practice school in Ankara province. In this research, multiple probe design
method is used in this single subject experimental design research model. At
the end of the research, the concept teaching embedded in sandwich making skill
is effective in acquiring the half concept by two participants in the material
of concept measure, but did not work in one participant. Furthermore, the
received findings showed that participants acquire and maintain half concept
and generalize it to the different people after four and six weeks later when
the practice session is completed. When social validity of the research is
analysed, the practisers stated that embedded instruction is an easy and
effective method to apply. Research findings are discussed within the scope of
relevant literature and suggestions are provided for implementation.
Music, Dance and the Sama-Bajau ‘Diaspora’: Understanding Aspects of Links among Communities through Ethnochoreomusicological Perspectives
Authors: Santamaria Matthew Constancio Maglana
Published: January 2019

Rituals in establishing the cultural as well as links among Sama-Bajau communities across Nusantaraor the region that we know as maritime Southeast Asia.  Ritual, however, cannot be fully understood unless it is broken into component parts of tangible (material) and intangible (non-material) properties. In this paper, I argue that an ethnochoreo-musicological approach, particularly through the examination of specific music pieces and dance forms or styles, can help scholars understand how the seemingly disparate and widely-spread Sama-Bajau communities in Nusantaraare related to each other. Three cases are presented revolving around ritual, music, and dance. The first case is about the magpai-bahauor ritual of the new rice which is shared by most Sama-Bajau communities in the Sulu-Sulawesi region. Rice from one community is passed on to another, constituting a virtual chain link that reaffirms the bonds between two groups of people. Corollary to this shared ritual practice is the shared repertoire of music(s) and dance(s). The second case concerns the musical model of Titik Tabawan, a kulintangan(aka tagunggo’an) graduated bossed-gong ensemble music piece composed of a distinct combination of melodic and rhythmic patterns that is observed as a ‘universally-shared’ intangible property in the central region of Nusantara.  Although known by different names across communities, this music piece, which is used for accompanying secular forms belonging to the Sama-Bajau igalor pansak(aka pamansak) dance traditions, retains its distinct qualities of rhythmic patterns and remains discernible as a musical model to both practitioners and scholars alike. Finally, the third case illustrates how variants of Igal Tarirai, a percussive dance using bamboo clappers called bola’-bola,’ may be used to glean relative distance or proximity in terms of dance performance practice.
Rodin, czyli świat. Dwie kosmogonie – Rainera Marii Rilkego i Georga Simmla
Authors: Popiel Magdalena
Published: January 2019

The article is a comparative analysis of the modernist aesthetics of creation. It describes how Rilke and Georg Simmel discovered August Rodin’s rules of modern perception, sensitivity and creative imagination. In the work of both writers we see them striving to interpret works of art as a creative process that is the effect of their astute diagnosis of contemporary culture. A new approach to aisthesis restores value to aesthetic experience and opens up broader learning opportunities.
Z historii polskiego performansu. Happening, performans, intermedialność
Authors: Hendrykowski Marek
Published: January 2019

Marek Hendrykowski’s case study shows the original idea of The Salon Niezależnych’s performances, one of the most spectacular events of 1970s Polish student counter-culture.
System identification of a robot arm with extended Kalman filter and artificial neural networks
Authors: Horvath Sabine , Neuner Hans
Published: January 2019

The development of an algorithm to describe a dynamic system and to predict its future behaviour in further consequence is the aim of the present study. Non parametric models provide a general description of object dynamics and artificial neural networks (ANN), which are a very flexible and universal learning method, belong to it. However, the standard estimation procedures for ANN like Levenberg-Marquardt (LM) do not consider that data is observed and consequently is uncertain. The combination with the extended Kalman filter (EKF) enables the consideration of the uncertainty in the estimation process. The analogies between EKF and LM are discussed and thereon the advantages of the EKF are outlined.

The integration of ANN into EKF will be evaluated on an industrial robot arm. At first, a simplified model is determined; the ANN describes the robot position deviations as a function of the joint encoder values. The robot reference positions are measured by a laser tracker. In order to compare it with the robot outputs, the observations need to be transformed to the robot frame and the offset between the end-effector and the robot flange has to be determined. A method to estimate both parameters simultaneously is developed and the results are verified on basis of simulated data.

This paper comprises two novel approaches. First, uncertainty is considered in the ANN estimation on basis of the combination with the EKF. Considering the full covariance matrix of the robot deviations leads to a better prediction of the robot’s behaviour. Second, an integrated transformation and lever arm determination is introduced and the robot’s repeatability presents the limiting factor of the achievable parameter uncertainty.
Performance Enhancement in Colorless WDM–PON Using SSB-SC
Authors: Bharti Manisha
Published: January 2019

In this manuscript, an attempt has been made to enhance the performance of colorless wavelength division multiplexed-passive optical network (WDM–PON) system using a combination of dual-drive Mach–Zehnder modulator and single sideband-suppressed carrier (SSB-SC) technique along with splicing. The proposed design makes use of SSB-SC technique for optical line terminal (OLT) as well as for optical network unit (ONU) that is generated by using dual-drive modulator which in turn reduces the expense for complete communication process. Suppressed RF signals with four channels at a bit rate of 10 Gbps for each channel are multiplexed before injecting into fiber span of 25 km at OLT side. Half of the downlink power is consumed for re-modulating the data signal at ONU side. The performance is further improved by using signal splicing method. Due to suppression in the carrier in this technique, there is no carrier Rayleigh scattering problem. The proposed model is compared with the existing one for error-free transmission of signal. The results revealed that the proposed model possess less value of bit error rate with the same value of received optical power as well as channel.
Contrasting variations in the diet of the Andean fox Lycalopex culpaeus Molina, 1782 on geographical and environmental scales in the Atacama Desert
Authors: Carevic Felipe S. , Carmona Erico R. , Cartes Francisco , Taucare Felipe
Published: January 2019

We determined the seasonal diet of the Andean fox Lycalopex culpaeus in three habitats in the Atacama Desert, northern Chile, by analyzing their scat contents. We estimated the biomass and the number of individuals of each prey species consumed and compared our results with those of other studies on Lycalopex foxes in Chile and South America. In general, the L. culpaeus diet was characterized by a generalist behavior and higher dietary breadth than those in other ecosystems. In contrast with the other biomes of southern Chile and South America, insects represented the most frequent prey species in the present study and the main food item, comprising more than 50% of all prey at the three study sites; however, in terms of biomass, rodent and reptile prey showed the highest percentage from summer to winter. Significant differences were found between the biomass consumed among sites. Likewise, we found a relationship between the niche breadth of the diet and the primary productivity of the sites. Statistically significant differences in prey items consumed were noted across seasons and sites located at different altitudes, which reflected an opportunistic response to the availability of prey. Our report contributes to current data about the natural history of L. culpaeus in hyper-arid habitats.