bluuebunny/crossref_metadata_2025 huggingface dataset:
segmentary mechanical work as a new instrument to postural control evaluation
Authors: Castro Pedro Cláudio Gonsales de , Goroso Daniel Gustavo , Coelho Daniel Boari , Lopes José Augusto Fernandes , Ayres Denise Vianna Machado , Battistella Linamara Rizzo
Published: November 2020

Objectie: Calculate the mechanical work (W), applying the total mechanical work (Wtot) and segmental work (Wseg) as a new complementary evaluation resource of the postural control mechanisms in subjects undergoing  motor and visual disturbance. Methods: Ten healthy adult male volunteers were selected with ages 25.6 (±2.26) years, whose height was 1.69 (± 0.25) m and body weight was 68.22 (± 0.25) kg. Kinematic data of trunk extension with eyes open and blindfolded were captured with a frequency of 200 Hz. This way the post perturbation interval has been selected and the  Wseg (i.e. trunk, head, etc) and the total mechanical work (Wtot) calculated, which were obtained by means of total integral mechanical energy. Results: The statistical analyzing of information was done by paired-data Student's t test.  There has been no significant difference  (p<0,08)  for the Wtot during the post perturbation interval. On the other hand, there has been a significant difference (p<0.05) in the post perturbation interval of Wseg. However, there were significant differences in interval (p<0.05). This difference is related to Wseg of head (Whead) and lower limbs (Wleg and Wthigh ) in the post-perturbation interval with early range of [0. 60] ms and [0. 100] ms after the self-perturbation. Conclusion: These differences that were found in Whead between the two conditions can be associated with modulations of the vestibulo-ocular-motor system. On the other hand, the differences that were found in Wleg and Wthigh can be associated with somato-sensory adjustment mechanisms.
Thoughts on the discussion about the revision of the International Classification of Functioning, Disability and Health (ICF) scheme
Authors: Castro Shamyr Sulyvan , Almeida Filho Paulo Sergio Batista , Bonates Mara Franklin , Silva Maria Caroline , Ribeiro Luciana Castaneda
Published: November 2020

The International Classification of Functioning, Disability and Health (ICF) presents an innovative approach to functioning: the biopsychosocial model. Since then, the ICF framework and its explanatory scheme has been used in many settings, including health, social security, and education. Recently, some criticism has arisen and proposals have ensued regarding its revisions. Objective: This paper discusses previous proposals for revisions to the ICF scheme and present suggestions of a new one. Methods: We outline some of the suggestions of ICF alternative functioning schemes, and present some of their features. Results: We also propose our own scheme, highlighting its advantages over predecessors. In our proposal, current scheme components are kept and arranged equidistantly along a three dimension ‘ball shell’ structure connected by double-headed arrows. Our scheme is innovative in that it does not present any component as central, allowing the scheme to be more adaptable to the reality of each functioning profile. It is also dynamic, by rotating on 3 axes, making possible the central positioning of the most important component. The spheres for each component can be enlarged, demonstrating ​​the magnitude of each component. Conclusion: We hope to contribute to the current discussion on ICF scheme and its revision.
Do literário ao fílmico: “A Vida Invisível” e a universalização do discurso a partir do uso do melodrama
Authors: Rodrigues Laís
Published: November 2020

A partir do estudo comparativo entre o filme A Vida Invisível e o livro que inspira o roteiro, este artigo tem como objetivo entender as nuances da construção narrativa de ambos, buscando se aprofundar, principalmente, na utilização da estrutura do subgênero melodrama para se transpor o enredo literário em produção cinematográfica.
Traditional Attenuation of Inequality: Neutral Meaning of Body Size among the Yorùbá of Southwestern Nigeria
Authors: Ibrahim Fausat M. , Jegede Ayodele S.
Published: November 2020

Body size is a profound ground of inequality in modern global society. Moreover, constructions of body size are racially polarized, with blacks being reputed for venerating large body. Proceeding with a triangulation of qualitative methods, this phenomenological study featured forty-two in-depth interviews, eight focus group discussions and eighteen key informant interviews among men and women of varying body sizes in two of the six states of southwestern Nigeria. Findings reflect dominantly neutral meaning of body size among the Yorùbá. This neutrality is dominantly reflected in the literal questioning of meaning that Yorùbá attach to body size, and who becomes a king in Yorùbá land but partially neutral in acceptability of prospective son or daughter in-law. Divinity, orí (fate), ìwà (good behavior) and ọmọlúàbí (good person) are among phenomena that counts in discerning people’s worth. Meaning attached to body size is opposed to common-place attitude to body size, making this attitude to be profane while meaning is solemn. This meaning is tremendously in favour of optimum health, and attenuating inequality, for which even black societies are perpetrating in the globalized world. Traditional Yorùbá value of human person is irrespective of body size.
Contributions of cholinergic receptor muscarinic 1 and CYP1A2 gene variants on the effects of plasma ratio of clozapine/N-desmethylclozapine on working memory in schizophrenia
Authors: Islam Farhana , Maciukiewicz Malgorzata , Freeman Natalie , Huang Eric , Tiwari Arun , Mulsant Benoit H , Pollock Bruce G , Remington Gary , Kennedy James L , Müller Daniel J , Rajji Tarek K
Published: November 2020

Background:

Clozapine has heterogenous efficacy in enhancing working memory in schizophrenia. We have previously hypothesized that this is due to opposing effects of clozapine and its metabolite, N-desmethylclozapine, at the muscarinic M1 receptor and demonstrated that a lower clozapine/ N-desmethylclozapine ratio is associated with better working memory than clozapine or N-desmethylclozapine levels alone.

Aims:

In this study, we expanded the above hypothesis to explore whether genetic variation in the cholinergic receptor muscarinic 1 gene, encoding the M1 receptor, affects the relationship between clozapine/ N-desmethylclozapine and working memory. Further, we explored whether CYP1A2 gene variants affect the ratio of clozapine/ N-desmethylclozapine and by this, working memory performance.

Methods:

We evaluated two functionally significant single nucleotide polymorphisms, rs1942499 and rs2075748, in cholinergic receptor muscarinic 1, with the haplotype T-A associated with lower transcriptional activity than the haplotype C-G. Further, we examined CYP1A2 *1F, with *1F/*1F conferring high inducibility in the presence of smoking.

Results:

In a sample of 30 patients with schizophrenia on clozapine monotherapy, clozapine/ N-desmethylclozapine was correlated with working memory only in non-carriers of the haplotype T-A of the cholinergic receptor muscarinic 1 gene. Interaction of CYP1A2 genotype and smoking status significantly affected clozapine concentrations, but there were no significant effects of CYP1A2 genotype and smoking status on the relationship between clozapine/ N-desmethylclozapine on working memory.

Conclusions:

Our finding that the relationship between clozapine/ N-desmethylclozapine and working memory is specific to patients with potentially higher transcription of M1 receptor (i.e. non-carriers of the haplotype T-A of cholinergic receptor muscarinic 1) supports a cholinergic mechanism underlying this relationship.
Elevated serum granzyme B levels are associated with disease activity and joint damage in patients with rheumatoid arthritis
Authors: Qiao Junjie , Zhou Meng , Li Zheng , Ren Jie , Gao Guanghan , Zhen Jumei , Cao Guanglei , Ding Lixiang
Published: November 2020

Objectives

Little is known about the roles of granzyme B in rheumatoid arthritis (RA). We aimed to evaluate the serum level of granzyme B in patients with RA and determine relationships with clinical features and joint destruction of RA.

Methods

We enrolled 100 patients with RA, 50 patients with osteoarthritis (OA), and 50 healthy controls (HC). Granzyme B serum concentrations were measured by ELISA; we then analyzed associations between granzyme B levels, clinical features, and joint destruction by calculating Sharp scores and disease activity as measured by Disease Activity Score-28 based on erythrocyte sedimentation rate (DAS28-ESR) in patients with RA.

Results

Compared with HC and patients with OA, serum granzyme B levels in patients with RA were remarkably elevated. Serum granzyme B levels did not differ between patients with OA and HC. Granzyme B levels correlated with ESR, rheumatoid factor, swollen joint counts, joint erosion scores, total Sharp scores, and DAS28-ESR. Moreover, patients with RA with high disease activity had higher granzyme B levels.

Conclusions

Serum granzyme B levels were elevated significantly in patients with RA and correlated positively with disease activity and joint destruction. Serum granzyme B may have potential applications in laboratory evaluation of patients with RA.
Market differences and adjustment speed of debt, equity, and debt maturity
Authors: Tekin Hasan
Published: November 2020

This article investigates the role of market differences and the global financial crisis 2007–2009 (GFC) on the adjustment speed of debt issuance, equity issuance, and debt maturity. The sample of 9731 firm-years from highly regulated Main Market (MAIN) and slightly unregulated Alternative Investment Market (AIM) in the United Kingdom was used. Employing system generalized methods of moments, the findings show that AIM firms have a faster adjustment speed of debt and equity before the GFC than MAIN firms. However, it is vice versa after the GFC because AIM firms face greater problems in accessing finance due to the shrinkage of bank credits during the recession. Besides, MAIN firms have faster adjustments on long-term debt over the time, whereas AIM firms have faster adjustment speed of trade credits. Overall, investors should consider market differences and recessions to take accurate decisions on debt-equity and debt maturity to invest where and when.

JEL Classification: C26, G01, G32
Medication overuse in a subgroup analysis of phase 3 placebo-controlled studies of galcanezumab in the prevention of episodic and chronic migraine
Authors: Dodick David W , Doty Erin G , Aurora Sheena K , Ruff Dustin D , Stauffer Virginia L , Jedynak Jakub , Dong Yan , Pearlman Eric M
Published: November 2020

Introduction

Acute medication overuse is prevalent in patients with migraine.

Methods

In three phase 3, double-blind, randomized, placebo-controlled studies, patients with episodic migraine (EVOLVE-1 and EVOLVE-2) or chronic migraine (REGAIN) were randomized 2:1:1 to monthly subcutaneous injections of placebo or galcanezumab 120 or 240 mg for 3 or 6 months. This subgroup analysis evaluated mean changes in the number of monthly migraine headache days in each treatment among patients with versus without baseline acute medication overuse via mixing modelling with repeated measures.

Results

The percentages of patients with baseline medication overuse in placebo, galcanezumab 120-mg and 240-mg groups, respectively, were 19.4%, 17.3%, and 19.3% for EVOLVE-1/-2 (pooled; post hoc), and 63.4%, 64.3%, and 64.1% for REGAIN ( a priori). Both galcanezumab doses demonstrated significant improvement compared with placebo for overall least squares mean change in monthly migraine headache days in patients with baseline medication overuse in both the episodic and chronic migraine studies ( p ≤ 0.001). Furthermore, both galcanezumab doses reduced average monthly medication overuse rates compared to placebo ( p < 0.001) in both patient populations with medication overuse at baseline.

Conclusions

Galcanezumab appears to be effective for the preventive treatment of episodic and chronic migraine in patients who overuse acute medications. Trial registration: ClinicalTrials.gov Identifiers: NCT02614183, NCT02614196, and NCT02614261
Headache associated with COVID-19: Frequency, characteristics and association with anosmia and ageusia
Authors: Sampaio Rocha-Filho Pedro Augusto , Magalhães João Eudes
Published: November 2020

Objectives

To assess the frequency and characteristics of headache in patients with COVID-19 and whether there is an association between headache and anosmia and ageusia.

Methods

This was a cross-sectional study. Consecutive patients admitted to hospital with COVID-19, confirmed by reverse transcription polymerase chain reaction (RT-PCR) technique, were assessed by neurologists.

Results

Seventy-three patients were included in the study, 63% were male; the median age was 58 years (IQR: 47–66). Forty-seven patients (64.4%) reported headaches, which had most frequently begun on the first day of symptoms, were bilateral (94%), presenting severe intensity (53%) and a migraine phenotype (51%). Twelve patients (16.4%) presented with headache triggered by coughing. Eleven (15%) patients reported a continuous headache. Twenty-eight patients (38.4%) presented with anosmia and 29 (39.7%) with ageusia. Patients who reported hyposmia/anosmia and/or hypogeusia/ageusia experienced headache more frequently than those without these symptoms (OR: 5.39; 95% CI:1.66–17.45; logistic regression). Patients with anosmia and ageusia presented headache associated with phonophobia more often compared to those with headache without these complaints (Chi-square test; p < 0.05). Headache associated with COVID-19 presented a migraine phenotype more frequently in those experiencing previous migraine ( p < 0.05).

Conclusion

Headaches associated with COVID-19 are frequent, are generally severe, diffuse, present a migraine phenotype and are associated with anosmia and ageusia.
Effect of Exposure Conditions and Internal Curing on Pore Water Potential Development in Cement-Based Materials
Authors: Vosoughi Payam , Taylor Peter , Najimi Meysam , Horton Robert
Published: November 2020

Moisture availability is a crucial factor for ongoing hydration reactions and controlling capillary pore water potential (PWP) development in cement-based mixtures. Harsh exposure conditions (such as low relative humidity, high temperature, or high wind speed) or incorporating fine cementitious materials may increase the mixture susceptibility to PWP development, and thus, early-age shrinkage. This study aims to investigate PWP and electrical conductivity development in cement paste and mortar mixtures with various water-to-cement ratios (from 0.25 to 0.4), silica fume substitutions, and internal curing in both sealed and harsh exposure conditions (ambient temperature from 10 to 35°C and relative humidity from 25% to 75%). The results indicate that high ambient temperature and silica fume incorporation substantially accelerate moisture loss and PWP development. The outcome of this study also shows the capability of internal curing using lightweight fine aggregate to delay PWP development in mixtures containing silica fume or exposure to low relative humidity and high-temperature ambient environments.
One rationality to rule them all
Authors: Leeson Peter T.
Published: November 2020

The claim that rationality is ‘limited, falsified and unhelpful’ for explaining norms is false, for it does not apply to rationality as conceptualized by rational choice theory. Rationality as conceptualized by rational choice theory is not limited: it can be used to develop explanations of any observed human behavior. Rationality as conceptualized by rational choice theory has not been falsified: indeed, it is not falsifiable. Rationality as conceptualized by rational choice theory is not unhelpful for explaining norms: it is often used to develop explanations of observed norms, including norms that seem most puzzling. Rationality as conceptualized by rational choice theory provides a universal framework for developing explanations of human behavior.
Testing for the human capital value of daily newspaper journalists in the era of newsroom downsizing
Authors: Massey Brian L.
Published: November 2020

This study tested the contrarian proposition that market-driven newspapers value rank-and-file newsworkers as human capital assets. Data from a national survey of U.S. daily newspaper editors partially support the proposition. Newspapers see positive value in the know-how and abilities of their newsworkers, but they do not see enough of it to invest in training and rewards for them.
Distributing Reflexivity through Co-laborative Ethnography
Authors: Bieler Patrick , Bister Milena D. , Hauer Janine , Klausner Martina , Niewöhner Jörg , Schmid Christine , von Peter Sebastian
Published: November 2020

In ethnographic research and analysis, reflexivity is vital to achieving constant coordination between field and concept work. However, it has been conceptualized predominantly as an ethnographer’s individual mental capacity. In this article, we draw on ten years of experience in conducting research together with partners from social psychiatry and mental health care across different research projects. We unfold three modes of achieving reflexivity co-laboratively: contrasting and discussing disciplinary concepts in interdisciplinary working groups and feedback workshops; joint data interpretation and writing; and participating in political agenda setting. Engaging these modes reveals reflexivity as a distributed process able to strengthen the ethnographer’s interpretative authority, and also able to constantly push the conceptual boundaries of the participating disciplines and professions.
Optimal track geometry maintenance limits using machine learning: A case study
Authors: Kasraei Ahmad , Zakeri Jabbar Ali , Bakhtiary Arash
Published: November 2020

The aim of this study has been to determine the optimal maintenance limits for one of the main railway lines in Iran in such a way that the total maintenance costs are minimized. For this purpose, a cost model has been developed by considering costs related to preventive maintenance activities, corrective maintenance activities, inspection, and a penalty costs associated with exceeding corrective maintenance limit. Standard deviation of longitudinal level was used to measure the quality of track geometry. In order to reduce the level of uncertainty in the maintenance model, K-means clustering algorithm was used to classify track sections with most similarity. Then, a linear function was used for each cluster to model the degradation of track sections. Monte Carlo technique was used to simulate track geometry behavior and determine the optimal maintenance limit which minimizes the total maintenance costs. The results of this paper show that setting an optimal limit can affect total annual maintenance cost about 27 to 57 percent.
Malaysian research-support librarians’ self-directed learning traits: Examining demographic differences and their relationship with competencies
Authors: Samah Nazrinda A. , Mohd Tahir Lokman , Wan Mamat Wan Ali @ Wan Yusoff , Talib Rohaya , Abdul Latif Adibah
Published: November 2020

Research-support librarians have to play an effective role in supporting learning, providing services and anticipating the requirements of academic researchers. However, previous studies revealed that these librarians lacked the competencies to keep abreast of new resources, services and technologies. Although there is a large body of literature discussing the comprehensive competencies required of research-support librarians, very few have attempted to investigate this issue in the Malaysian context. Based on this situation, this study attempts to investigate the self-directed learning traits and competencies of research-support librarians in Malaysian public universities. This study also aims to identify the influence of self-directed learning on competencies. A total of 215 research-support librarians from Malaysian public universities were selected. The findings revealed that the competencies of these librarians are still at medium level. The most noticeable and lowest competency was in information technology skills, followed by research and contributions to the profession and library management. The most prevalent competencies were interpersonal skills, followed by information literacy, entrepreneurialism, foundational knowledge and collections development.
Study of failure symptoms of a single-tube MR damper using an FEA-CFD approach
Authors: Elsaady Wael , Oyadiji S Olutunde , Nasser Adel
Published: November 2020

A new magnetorheological (MR) damper has been designed, manufactured, modelled and tested under cyclic loads. A faulty behaviour of the damper was accidentally detected during the experiments. It was deduced that the presence of air bubbles within the MR fluid is the main reason for that failure mode of the damper. The AMT-Smartec+ MR fluid used in the current study, a new MR fluid whose characteristics are not available in the literature, exhibits good magnetic properties. However, the fluid has a very high viscosity in the absence of magnetic field. It is assumed that this high viscosity enables the retention of air bubbles in the damper and causes the faulty behaviour. To prove this assumption, a coupled numerical approach has been developed. The approach incorporates a Finite Element Analysis (FEA) of the magnetic circuit and a Computational Fluid Dynamics (CFD) analysis of the fluid flow. A similar approach was presented in a previous publication in which an ideal behaviour of an MR damper (no effect of air bubbles) was investigated. The model has been modified in the current study to include the effect of air bubbles. The results were found to support the assumptions for the reasons of the failure symptoms of the current MR damper. The results are shown in a comparative way between the former and current studies to show the differences in flow parameters, namely: pressure, velocity and viscosity, in the faultless and faulty modes. The results indicate that the presence of air bubbles in MR dampers reduces the damper force considerably. Therefore, the effect of the high yield stress of MR fluids due to the magnetic field is reduced.
The role of government’s ‘Owned Media’ in fostering cultural inclusion: a case study of the NSW Department of Education’s online and social media during COVID-19
Authors: Gorfinkel Lauren , Muscat Tanya , Ollerhead Sue , Chik Alice
Published: November 2020

This article examines government approaches to public communications at the time of the coronavirus disease 2019 (COVID-19) pandemic, with a focus on how one state government body, namely, the New South Wales (NSW) Department of Education in Australia, has engaged with key stakeholders at a time when home–school communications has been heavily impacted by COVID-19. Through analysis of the Department’s ‘owned’ online communications platforms, such as websites, podcasts and social media, the article specifically focuses on how the Department has represented and invited engagement among its culturally and linguistically diverse (CALD) stakeholders with a view to understanding the extent to which it has been able to create a sense of connection and belonging for parents and caregivers. It shares examples of positive practice by the Department as well as suggestions for further research that may help uncover best practices for multicultural and multilingual government–stakeholder engagement.
Thermal damage and fatigue estimation in heavily loaded lubricated rolling/sliding contacts with Micro-Geometry
Authors: Morales-Espejel Guillermo E
Published: November 2020

A previously developed model for heavily loaded Elastohydrodynamically lubricated (EHL) contacts with surface micro-geometry for the calculation of surface distress (micropitting), based on high-cycle fatigue and mild wear competition, is herewith further extended. It now includes the effects of frictional heating with a sharp temperature rise developed in the rolling contact. For this, a new surface damage model, originated in creep modelling, is included. With this modification, the detrimental effect of high temperature developed in the rolling/sliding contact can now be accounted for. This model can consider sharp or moderate surface temperature rise during over-rolling is found in bearings and gears operating at high speeds or under the combination of speeds, loads and unfavourable environmental aspects. The present model introduces a threshold limit made of the combination of temperature and (heating time under stress) load cycles above which the conditions in the rolling contact are deemed damaging for the steel microstructure and the tribological functionality of the rolling contact. The surface damage model is first compared with laboratory experiments in rolling/sliding conditions and then applied to study combinations of loads, sliding speeds and the effect in rolling bearings. The ability of the present model to include damaging mechanisms, other than classical metal fatigue, increases the flexibility in contact surface damage modelling and allows for the accounting of phenomena up to now excluded from better estimation of the machine elements surface life.
The essential state: Pandemic, norms and values, and the new authoritarianism
Authors: Wray Ian
Published: November 2020

America’s long post war boom was underpinned by the state, by Roosevelt’s New Deal, by its wartime economy, and by Roosevelt’s plans for investment in post war science and infrastructure. In the 1970s America abandoned its developmental model, as critics from left and right attacked plans and planners: yet in the fast rising states of Asia it was embraced. Is it too late for a wakeup call in America and Britain, the champions of anti-planning and the small state? This paper looks for explanations, examines consequences and suggests that the Covid pandemic may trigger a sea change in norms, values and attitudes towards planning and governance.
Short Take: Lowering the Access Barriers to Ethnographic Methodology
Authors: Pham Tony V
Published: November 2020

Researchers based in low- and middle-income countries (LMIC) often cannot access conventional but high-priced ethnographic tools. I developed a low-cost methodology as an exercise in meeting the needs of both LMIC-based researchers and the broader qualitative community. As demonstrated in this proof of concept, ethnographic researchers should strive for a suite of open access software tools and common and affordable hardware to reduce inequities in knowledge generation and dissemination.
Rural Wage-Earners’ Attitudes Towards Diverse Wildlife Groups Differ Between Tropical Ecoregions: Implications for Forest and Savanna Conservation in the Brazilian Amazon
Authors: Michalski Fernanda , Boulhosa Ricardo Luiz Pires , Nascimento Yuri Nascimento do , Norris Darren
Published: November 2020

Understanding people’s attitudes towards wildlife species is key for developing and effectively implementing conservation initiatives. Although attitudes towards different wildlife classes have been examined separately within a variety of regions, there have been no comprehensive comparisons of attitudes towards wildlife between different tropical ecoregions over large spatial scales. Here, we examined attitudes of 106 rural wage-earners from two ecoregions in the eastern Brazilian Amazon. We used generalized Linear Models (GLMs) to examine the influence of socioeconomic variables and ecoregion type on attitudes towards wildlife species, grouped into three classes (liked, disliked, and damage income). Overall we obtained attitudes regarding 57 wildlife species that were organized into 11 faunal groups (amphibians, ants, bats, birds, fishes, medium-bodied mammals, large-bodied mammals, primates, snakes, tortoises and turtles, and other invertebrates). Ecoregions where wage-earners lived was the strongest predictor of the total number of liked and disliked wildlife species. The total number of species damaging income was explained by socioeconomic variables related to the number of people living in the property and level of education. Medium and large-bodied mammals were most frequently reported both as liked and causing damage, while snakes were most frequently reported as disliked in both ecoregions. Although socioeconomic variables were important predictors to wage-earners’ attitudes towards wildlife species, the environment (ecoregion) was the strongest predictor affecting human-wildlife attitudes. Our findings contribute with information about the importance of considering differences in local attitudes across a representative spectrum of wildlife species to inform the identification of effective focal species in different tropical regions.
Quality of Life Evaluation After Trans-Nasal Endoscopic Surgery for Skull Base Tumors
Authors: Molteni Gabriele , Sacchetto Andrea , Saccardo Tommaso , Gulino Antonio , Marchioni Daniele
Published: November 2020

Background

The excellent surgical results obtained with transnasal endoscopic approach to the anterior skull base (ASB) are universally recognized; less is known about the quality of life of patients after surgery.

Objective

The aim of this study is to analyze the quality of life of patients after endoscopic transnasal surgery for the treatment of neoplasms of the ASB.

Methods

We conducted a retrospective review of patients who underwent transnasal endoscopic surgery for treatment of ASB tumors at the Tertiary Referral Center University Hospital of Verona. All patients were asked to complete the Anterior Skull Base Questionnaire (ASBQ), the Skull Base Inventory (SBI), and the Sino-nasal Outcome Test – 22 Items (SNOT-22) after surgical treatment. The study population was divided into subgroups; a statistical analysis of the overall results and of the different questionnaire domains was performed.

Results

51 patients were enrolled in this study. The average score was 3.04 for ASBQ, 4.05 for SBI and 28.88 for SNOT-22. Analysis of the overall results for the ASBQ showed a lower quality of life in patients after recurrent surgery and in female patients. The SBI showed similar results in relation to recurrent surgery and radiotherapy. Similarly, the results for SNOT-22 highlighted the negative impact of recurrent surgery and radiotherapy.

Conclusion

Our results confirmed that the endoscopic transnasal approach shows excellent results not only in terms of surgical outcome, but also for the possibility of ensuring a good QoL after treatment. Recurrent surgery and radiation treatments were the most important negative prognostic factors.
Satellite phone development through an off-shore, outsourcing partnership: Client and vendor experiences
Authors: Sridhar V , Vadivelu Selvaraj
Published: November 2020

Product development outsourcing and off-shoring, especially in a high-technology industry such as Satellite Communications, is done by carefully considering the choice of the partner and the operating business model. From the satellite communications company’s (Client’s) perspective, outsourcing and off-shoring work is a strategic decision that involves considering whether to have a captive off-shore center for resource augmentation or outsource to a third-party partner organization. Furthermore, there are decisions regarding choosing a suitable trustworthy partner organization, pricing models, and the viability of a long-term relationship that involves in-life product management and protection of Intellectual Property ownership. From the partner’s (Vendor’s) viewpoint, there are several strategic and tactical decisions involving technical solution and engineering development strategy, selecting a mutually acceptable pricing model, and analyzing the risks involved in developing the high-tech product away from customer location. This case analyzes the outsourcing and off-shoring engagement between a leading provider of satellite communications and a product engineering services company in India. This case brings out the strategic perspectives of the client–vendor engagement in building a satellite communications product.
The Nexus Between Trade Openness and GDP Growth: Analyzing the Role of Human Capital Accumulation
Authors: Fatima Sumbal , Chen Bateer , Ramzan Muhammad , Abbas Qamar
Published: November 2020

The objective of this study is to explore the empirical impact of trade openness on gross domestic product (GDP) growth. Researchers have not given the externalities of trade openness the deserved scholarly attention. In this work, we propose to account for human capital accumulation (HCA) as an additional dimension of economic trade integration. To address the potential endogeneity issue, we use the system generalized method of moments (GMM) estimator developed for dynamic panel data models. The results outline an intriguing indirect relationship between trade openness and GDP growth. If HCA is taken into account as an intervening variable, trade may have a negative impact on GDP growth when countries exhibit a low level of HCA. Thus, the indirect relationship between trade openness and HCA was studied in depth, and to the best of our knowledge, this research is the first to examine this relationship in both developed and developing countries over a 34-year period (1980–2014). The established GMM-centric thresholds are robust to alternative estimation techniques and measurements of trade openness. Policy implications are discussed.
Clinical and Radiological Outcomes After Autologous Matrix-Induced Chondrogenesis Versus Microfracture of the Knee: A Systematic Review and Meta-analysis With a Minimum 2-Year Follow-up
Authors: Kim Jun-Ho , Heo Jae-Won , Lee Dae-Hee
Published: November 2020

Background:

Microfracture (MFx) is the most common procedure for treating chondral lesions in the knee; however, initial improvements decline after 2 years. Autologous matrix-induced chondrogenesis (AMIC) may overcome this shortcoming by combining MFx with collagen scaffolds. However, the outcomes of AMIC and MFx in the knee have not been compared.

Purpose:

To compare the clinical and radiological outcomes of AMIC and MFx over a minimum 2-year follow-up.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic search of the MEDLINE, Embase, and Cochrane Library databases identified studies of patients who underwent AMIC or MFx and that reported validated clinical outcome measure and/or radiological evaluation findings at a follow-up of ≥2 years. There were 2 reviewers who performed study selection, a risk of bias assessment, and data extraction.

Results:

Overall, 29 studies were included in this systematic review. The mean improvement on the Lysholm score, Tegner activity scale, and visual analog scale for pain did not differ significantly between the 2 procedures. The mean improvement on the International Knee Documentation Committee (IKDC) subjective score was significantly greater in the AMIC (45.9 [95% CI, 36.2-55.5]) than in the MFx (27.2 [95% CI, 23.3-31.1]) group ( P < .001). In addition, the mean magnetic resonance observation of cartilage repair tissue score was significantly higher in the AMIC (69.3 [95% CI, 55.1-83.5]) versus MFx (41.0 [95% CI, 27.3-54.7]) group ( P = .005), and the mean adequate defect filling rate on magnetic resonance imaging scans was significantly better in the AMIC (77.3% [95% CI, 66.7%-87.9%]) versus MFx (47.9% [95% CI, 29.2%-66.6%]) group ( P = .008) (odds ratio, 1.58 [95% CI, 1.07-2.33]).

Conclusion:

No significant differences in clinical outcomes, except for the IKDC subjective score, were found between the AMIC and MFx groups. Greater improvement in IKDC subjective scores and magnetic resonance imaging findings were seen in patients treated with AMIC compared with MFx at a minimum 2-year follow-up.
Anterior Shoulder Instability in the Professional Athlete: Return to Competition, Time to Return, and Career Length
Authors: Dekker Travis J. , Goldenberg Brandon , Lacheta Lucca , P. Horan Marilee , Millett Peter J.
Published: November 2020

Background:

Anterior shoulder instability is a common condition in professional athletes, yet little is known about the success of surgery. Return to competition (RTC) is a metric indicative of a successful outcome for professional athletes who undergo anterior shoulder stabilization surgery.

Purpose:

To determine the rate of RTC, time to RTC, recurrence rate, and length of career after surgery in professional athletes who had undergone surgical treatment for anterior shoulder instability.

Study Design:

Case series; Level of evidence, 4.

Methods:

We evaluated professional athletes who underwent surgical treatment for anterior shoulder instability by a single surgeon between 2007 and 2018. Data from patients’ medical records, a patient data registry, basic search engines, sports websites, and individual team websites were used to determine length of professional play before injury, duration of career after surgery, and RTC level.

Results:

Overall, 23 professional athletes (25 shoulders from 12 contact and 13 noncontact athletes) were identified. The mean age at the time of surgery was 24.3 ± 4.9 years (range, 16-35 years). Primary procedures included arthroscopic Bankart repair (76%; 19/25), open Latarjet (20%; 5/25), and bony Bankart repair (4%; 1/25). Of the 23 athletes, 22 returned to their previous level of competition (96%; 95% CI, 78%-100%). The mean time between surgery and RTC was 4.5 months (range, 3-8 months). There was no difference in time to RTC between contact and noncontact athletes (4.1 vs 4.4 months). There was no difference in RTC rates and time to return for players who received a Bankart repair versus a Latarjet procedure (4.6 vs 4.2 months). A total of 12 participants were still actively engaged in their respective sport at an average of 4.3 years since surgery, while 11 athletes went on to retire at an average of 4.8 years. Duration of play after surgery was 3.8 years for contact athletes and 5.8 years for noncontact athletes ( P > .05).

Conclusion:

In this series, professional athletes who underwent surgical shoulder stabilization for the treatment of anterior glenohumeral instability returned to their presurgical levels of competition at a high rate. No differences in RTC rate or time to RTC were observed for contact versus noncontact athletes or for those who received arthroscopic Bankart repair versus open Latarjet. However, contact athletes had shorter careers after surgery than did noncontact athletes.
Daytime sleepiness and napping in nursing-home eligible community dwelling older adults: A mixed methods study
Authors: McPhillips Miranda V. , Li Junxin , Hodgson Nancy A. , Cacchione Pamela Z. , Dickson Victoria V. , Gooneratne Nalaka S. , Riegel Barbara
Published: November 2020

Objectives:

To describe perceptions and beliefs about daytime sleepiness and napping along with subjective and objective daytime sleep characteristics in nursing-home eligible community dwelling older adults.

Methods:

A mixed methods study; we conducted semi-structured interviews and measured sleep variables via Actigraphy, sleep diary, and Epworth Sleepiness Scale (ESS). Napping was defined as >10 minutes; anything less was considered dozing.

Results:

Final sample ( n = 40) was primarily female (85%), Black (100%), with a mean age of 72 ± 9.5 years. Few (25%) reported daytime sleepiness (ESS >10). However, average duration of napping per day was 33.1 ± 11.5 minutes with a nap frequency of 2.5 ± 1.5 naps.

Conclusion:

Our sample napped frequently throughout the day, yet the majority reported no daytime sleepiness. These older adults did not always recognize napping or how much they napped.
A Case of Grover’s Disease Secondary to Brodalumab Therapy for Psoriasis
Authors: Muzumdar Sonal , Radfar Arash , Payette Michael
Published: November 2020

Background:

Grover’s disease has been associated with a number of medications including sulfadoxine-pyrimethamine, recombinant interleukin (IL)-4, ipilimumab, and BRAF inhibitors. To our knowledge, Grover’s disease has not been reported in association with interleukin-17 inhibitors.

Case Description:

A 47-year-old female with plaque psoriasis developed Grover’s disease 3 months following initiation of brodalumab. Discontinuation of brodalumab and initiation of certolizumab pegol and methotrexate led to resolution of her rash.

Conclusion:

This case highlights Grover’s disease as a potential adverse effect of brodalumab therapy. In patients who develop Grover’s disease with brodalumab, modification of therapy may be considered due to the bothersome nature of the rash.
Case Report: Acute Stroke in Young Adult Patient with Moyamoya Syndrome Secondary to Sickle Cell Disease
Authors: Cole Oladipo , Filatov Asia , Khanni Javed , Espinosa Patricio
Published: November 2020

Moyamoya disease, well described in literature, is a chronic cerebrovascular occlusive disorder. It is characterized by progressive stenosis/occlusion of the terminal portions of the internal carotid arteries (ICA) and the proximal portions of the middle cerebral arteries (MCA). Less frequently described is Moyamoya syndrome, the name given to radiographic findings consistent with Moyamoya disease, but with an identifiable cause. The diseases associated with Moyamoya Syndrome include Sickle Cell Disease (SCD), Thalassemias, and Down's Syndrome to name a few. Common complications of Moyamoya include both ischemic and hemorrhagic strokes. Upon literature review, Moyamoya syndrome caused by SCD is not well described. When it is, the discussion is centered around the pediatric patient population and surgical management. Our case report describes a 22-year-old African American female with SCD who initially presented with Acute Chest Syndrome. Her hospital course was complicated by development of overt debilitating neurologic deficits. Subsequently, she was found to have Moyamoya Syndrome on neuroimaging. She was successfully treated with medical management without any surgical intervention. This case highlights the necessity of thorough examination, differential diagnosis, imaging findings, and consideration of predisposing syndromes in the work-up for Moyamoya syndrome; especially individuals with Sickle Cell Disease.

Disclosures

No relevant conflicts of interest to declare.
Native T1 Values and Cardiac Involvement in Patients with Thalassemia Major
Authors: Pepe Alessia , Martini Nicola , De Luca Antonio , Positano Vincenzo , Pistoia Laura , Borsellino Zelia , Carrai Valentina , Sanna Maria Grazia , Bitti Pier Paolo , Gentili Sara , Maggio Aurelio , Sinagra Gianfranco , Meloni Antonella
Published: November 2020

Background.The T2* cardiovascular magnetic resonance (CMR) is the gold standard for the non invasive detection of myocardial iron overload (MIO). The native myocardial T1 mapping has been proposed as a complementary tool, thanks to its higher sensitivity in presence of small amounts of iron, but no data are available in literature about its clinical impact.

Objective:To explore the clinical impact of T1 mapping for detecting cardiac complications in thalassemia major (TM).

Methods.We considered 146 TM patients (87 females, 38.7±11.1 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network. Three parallel short-axis slices of the left ventricle (LV) were acquired with the Modified Look-Locker Inversion recovery (MOLLI) sequence. The native T1 values in all 16 myocardial segments were obtained and the global value was the mean.

Results.Twenty-one patients had an history of cardiac complications: 11 heart failure, 8 arrhythmias (7 supraventricular and 1 ventricular), and 2 pulmonary hyperthension.

Patients with cardiac complications had significantly lower global heart T1 values (879.3±121.9 ms vs 963.2±98.5 ms; P<0.0001) (Figure) but comparable T2* values (33.32±11.66 ms vs 37.17±9.15 ms; P=0.116). Cardiac complications were more frequent in the group of patients with reduced global heart T1 value (<928 ms for males and <989 ms for females) compared to the group with normal global heart T1 value (71.4% vs 39.5%; P=0.009). Odds ratio (OR) for cardiac complications was 3.8 (95%CI=1.3-10.9) for patients with reduced global heart T1 value versus patients with normal global heart T1 value.

Conclusion:We found out a significant association between decreased native global heart T1 values and a history of cardiac complications, suggesting that an early detection of myocardial iron burden by native T1 can support the clinicians in modifing chelation therapy earlier.

Figure

Disclosures

Pepe: ApoPharma Inc.:Other: no profit support;Bayer:Other: no profit support;Chiesi Farmaceutici S.p.A.:Other: no profit support and speakers' honoraria.Pistoia:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.Meloni:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.
Association between Native Myocardial T1 Mapping and Cardiac Function and Macroscopic Fibrosis in Thalassemia Major
Authors: Pepe Alessia , Martini Nicola , De Luca Antonio , Positano Vincenzo , Pistoia Laura , Ruffo Giovan Battista , Serra Marilena , Gerardi Calogera , Benni Monica , Argento Crocetta , Maggio Aurelio , Sinagra Gianfranco , Meloni Antonella
Published: November 2020

Background.Cardiovascular magnetic resonance (CMR) is the only available technique for the non-invasive quantification of MIO. The native T1 mapping has recently been proposed as an alternative to the universally adopted T2* technique, due to the higher sensitivity for detection of changes associated with mild or early iron overload.

Objective.To study the association between T1 values and left ventricular (LV) function in thalassemia major (TM) and to evaluate for the first time if T1 measurements quantifying MIO are influenced by macroscopic myocardial fibrosis.

Methods.146 TM patients (87 females, 38.7±11.1 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network underwent CMR. Native T1 values were obtained by Modified Look-Locker Inversion recovery (MOLLI) sequence in all 16 myocardial segments and the global value was the mean. LV function parameters were quantified by cine images. Late gadolinium enhancement (LGE) technique was used to detect macroscopic myocardial fibrosis.

Results.No correlation was detected between global heart T1 values and LV volume indexes, LV mass index, or LV ejection fraction.

Foourteen (9.6%) patients had an abnormal LV motion (13 hypokinesia and 1 dyskinesia) and they showed significantly lower global heart T1 values than patients without LV motion abnormalities (883.8±139.7 ms vs 959.0±91.3 ms; P=0.049).

LGE images were acquired in 88 patients (60.3%) and macroscopic myocardial fibrosis was detected in 36 patients (40.9%). The 72.2% of patients had two or more foci of fibrosis. Patients with macroscopic myocardial fibrosis had significantly lower global heart T1 values (921.3±100.3 ms vs 974.5±72.7 ms; P=0.027) (Figure 1A). Data about the LGE was present for 1408 segments (88 patients x 16 segments) and 105 (7.5%) were positive. Segments with LGE had significantly lower T1 values than segments LGE-negative (905.6±110.6 ms vs 956.9±103.8 ms; P<0.0001) (Figure 1B).

Conclusion.No correlation between T1 values and LV function parameters was detected, probably because the majority of the patients had normal or mild abnormal LV parameters. TM patients with macroscopic myocardial fibrosis showed significantly lower T1 values suggesting that T1 measurements for quantifying MIO are not influenced by macroscopic myocardial fibrosis and an association between myocardial iron and macroscopic fibrosis, previously detected only in pediatric TM patients.

Figure

Disclosures

Pepe: Chiesi Farmaceutici S.p.A.:Other: no profit support and speakers' honoraria;Bayer:Other: no profit support;ApoPharma Inc.:Other: no profit support.Pistoia:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.Meloni:Chiesi Farmaceutici S.p.A.:Other: speakers' honoraria.