bluuebunny/crossref_metadata_2025 huggingface dataset:
Editor's Introduction: Theorizing ICTs and Society
Authors: Hofkirchner Wolfgang
Published: May 2018

Given the short period of time internet research and related new fields had to establish themselves, it does not come as a surprise that their development is still a search for identity. Self-reflection is needed when it comes to recommendations for practice, and when it comes to empirical studies, and it is in the domain of theory where the glue can be found that integrates praxis with empirical research. The four collected papers published here date back to a panel I held on “Approaches towards ICTs and Society - Theories and Methodologies” at the IADIS ICT, Society and Human Beings 2009 (ICT 2009) Conference chaired by Gunilla Bradley.
Information – is it Subjective or Objective?
Authors: Zaliwski Andrzej Stanislaw
Published: May 2018

The article deals first with the problems of defining information. It is concluded that it is a misunderstanding to take a term and then to look for a definition. Rather a different way ought to be taken: to find the phenomenon first and then assign a name to it. The view that information is the same thing as a structure is considered. Then the processes by which information is created are analyzed. The definition that information is detected difference is closely scrutinized and it is found that information can also be detected sameness. It is argued that information is relative to the observer and for the very reason of the way it is created it is subjective. That extends only to information acquired. The existence of subjective information, however, does not prove information cannot exist objectively.
Book Review: Signs of Science - Linguistics meets Biology
Authors: Prinz Robert
Published: May 2018

„Biosemiotics“ is an integrative and interdisciplinary research effort that investigates living systems with concepts borrowed from linguistics and the communication sciences. Life is seen as an entanglement of communicative processes relating entities with each other by defined rules. Those “rules” are the very heart of (bio)semiotic analysis. A hallmark of life is the existence of rules that are very different from natural laws. We can find such rules embedded in the genetic code, for example, where a transfer RNA relates a codon in mRNA to an amino acid. Nevertheless, it could have evolved in another way as well as genetic code engineering shows. Apparently arbitrary relationships are inherent to all levels of biological organization: from cells to organisms. Parts are connected in ways that can hardly be inferred from physical (thermodynamic) principles and still await reconciliation in a reasonable manner.   Essential Readings in Biosemiotics Anthology and Commentary Series: Biosemiotics, Vol. 3 Favareau, Donald (editor) 1st Edition., 2010, 880 p., 219,94 €, Hardcover ISBN: 978-1-4020-9649-5
Neoliberalism in the Information Age, or Vice Versa? Global Citizenship, Technology, and Hegemonic Ideology
Authors: Neubauer Robert
Published: May 2018

Contingent as they are upon technological globalization, contemporary notions of global citizenship tend to run parallel to theories of ‘post-industrialism’ and ‘information society’. This paper problematizes this relationship by delineating the connections between ‘informationist’ theory and neoliberal ideology, which together have laid the ideational foundations for a reordering of the global political economy over the past 40 years in favor of global capital. Drawing on the work of Antonio Gramsci, this paper argues that information-age theories have served to facilitate the neoliberal project, obscuring behind a veil of teleological inevitability and technological determinism the political transformations which make global neoliberalism possible, even while prescribing the technological innovations which make such transformations technically feasible. Crucially, in eroding national sovereignty over trade and labour laws, capital flows, and fiscal and monetary policy, the ascent of ‘informational neoliberalism’ has served to undermine traditional citizenship in favor of market discipline and neoliberal hegemony.
Two New Critical Internet Studies-Books: Marcus Breen’s “Uprising” and Eran Fisher’s “Media and New Capitalism in the Digital Age”
Authors: Fuchs Christian
Published: May 2018

This article is a review essay of two books: * Breen, Marcus. 2011. Uprising. The Internet’s unintended consequences. Champaign, IL: Common Ground. ISBN 978-1-863-35866-8. * Fisher, Eran. 2010. Media and new capitalism in the digital age. The spirit of networks. New York: Palgrave Macmillan. ISBN 978-0-230-61607-3.
Critical Media and Communication Studies Today. A Conversation
Authors: Fuchs Christian , Winseck Dwayne
Published: May 2018

This article documents a conversation between us that was first published in parallel on our two blogs http://dwmw.wordpress.com and http://fuchs.uti.at/blog. The conversation deals with our assessments of the status of Critical Media and Communication Studies today. We discuss the work of Dallas Smythe, how to study and assess Google, research dimensions of Critical Political Economy of the Media, how important each of these dimensions should be, the role of ideology critique for Critical Political Economy of the Media, the commonalities and differences between Political Economies of the Media and Critical Political Economy of the Media/Critique of the Political Economy of the Media, the role of Karl Marx for Political Economies of the Media, Nicholas Garnham's recent comments on the field of Critical Political Economy of the Media, neoliberalism and capitalist crisis as contexts for Political Economies of the Media. Comments are very welcome on our blogs, URLs to the specific blog postings can be found in the article sections.
Introduction to the Special Issue ICTs and Society - A New Transdiscipline? What Kind of Academic Field Do We Need to Meet the Challenges of the Information Age?
Authors: Brenner Joseph E. , Raffl Celina
Published: May 2018

Introduction to the Special Issue ICTs and Society - A New Transdiscipline? What Kind of Academic Field Do We Need to Meet the Challenges of the Information Age?
Towards a New Science of Information
Authors: Doucette Dail Dewitt
Published: May 2018

This paper suggests a New Information Paradigm and recommends the establishment of a new academic and scientific discipline to be titled "Science of Information", built on a premise that information is also a major part of all the universes, elements, systems, and conditions. Therefore, it is also an integral part of all the other individual disciplines and sciences. It is essential to look beyond the limitations of how humans use and perceive information, or even how other living organisms use information. It is proposed that information is a continuous evolving process, that exists in some simple to complex form in every stage of development, across all scientific and academic domains, as well as being a significant part of everything that exists. Information is a trigger mechanism, emphasis and nutrient, not only for information activities itself but also all physical, and biological elements, systems and activities. Each existing discipline has within it a significant core Informational Element, which helps formulate and define that discipline. The Science of Information will bring together these core information elements in order to correlate, compare and assemble a combined theoretical base. This new discipline should be established as a meta-discipline. It should exist equally with traditional discipline categories such as physical, social science, arts, and humanities. It should not compete with or replace other disciplines. It should stand alongside them and assist them, as well as conduct comparisons and consolidations amongst multiple disciplines regarding information theories, methodologies, practices, by adding new perspectives, resources and developments.
Towards a Transdisciplinary Frame: Bridging Domains, a Multidimensional Approach to Information
Authors: Díaz Nafría José María , Salto Alemany Francisco
Published: May 2018

A trans-disciplinary frame is proposed, aimed at addressing the very understanding of information in all its variety. It aims at unifying perspectives and integrating techniques from different fields of knowledge and practice, searching for the most overarching account of information phenomena, a better formalization of real processes and a global stance towards problems concerning information. Such research frame might try to answer: Which are the basic distinct accounts of infor-mation to be applied in fields from telecommunication to philosophy, from biology to documentation, from logic to quantum physics? Which are the minimum primitive concepts that may cover all of them? Is a unified theory feasible? Could a better information measure be found? Could the societal and practical interest be better preserved in an integrated perspective of information? The methodological proposal aims at opening a space for the interweaving of different scientific frameworks (characterized by specific paradigms and methodologies) to delve into the very landscape of information, searching for a transdisciplinary treatment of theoretical, technical and practical problems concerning information. It is based on an already active interdisci-plinary International community and a critical mass of research groups at the global level. By means of bridging these com-munities, a new transdisciplinary science of information might emerge as an integrated framework in which information will be considered in all its formal, natural, cognitive, social, technical, ethical and philosophical aspects.
Kinds of Information in Scientific Use
Authors: Collier John
Published: May 2018

There are many different mathematical definitions of information that have their various uses, but I will be concerned with notions of information used in applications in various branches of science that are distinguished by their topic, i.e., what they apply to. I describe the major uses information, and show their relations to each other. I will argue that the various uses form a nested hierarchy, in which each is a restriction on the previous, inheriting the properties of its predecessor, but adding in new features that make it a special case. The lowest level is physical information determined by distinctions and the highest is explicit representation in linguistic social communication. Is there anything common to information at all these levels? I will argue that there is, and that information in each case is what Donald MacKay (1969) called a distinction that makes a difference. What distinguishes the use of information at each level is what distinctions make a causal difference at that level. At each successive level distinctions that make a difference at a previous level make no difference at that level. In order to create this sort of filter new levels have to be formed by cohesion peculiar to the identifying characteristics at that level. A consequence of this view is that information must have causal powers, and that there is a tight connection between information and causation
Information Philosophy in China: Professor Wu Kun’s 30 Years of Academic Thinking in Information Philosophy
Authors: Li Guowu
Published: May 2018

Professor Wu Kun, from Xi'an Jiaotong University of China, has been studying information philosophy for 30 years. He thinks information conception is one of the most fundamental areas in philosophy and has founded information philosophy. He has done original and pioneering research in information ontology, epistemology, social information theory, information production theory, information evolution theory, information value, and information thinking directions. He is the first scholar to develop a completely new view of theories, systems, and methods about information philosophy.
Information in Reality: Logic and Metaphysics
Authors: Brenner Joseph E.
Published: May 2018

The recent history of information theory and science shows a trend in emphasis from quantitative measures to qualitative characterizations. In parallel, aspects of information are being developed, for example by Pedro Marijuan, Wolfgang Hofkirchner and others that are extending the notion of qualitative, non-computational information in the biological and cognitive domain to include meaning and function. However, there is as yet no consensus on whether a single acceptable definition or theory of the concept of information is possible, leading to many attempts to view it as a complex, a notion with varied meanings or a group of different entities. In my opinion, the difficulties in developing a Unified Theory of Information (UTI) that would include its qualitative and quantita-tive aspects and their relation to meaning are a consequence of implicit or explicit reliance on the principles of standard, truth-functional bivalent or multivalent logics. In reality, information processes, like those of time, change and human con-sciousness, are contradictory: they are regular and irregular; consistent and inconsistent; continuous and discontinuous. Since the indicated logics cannot accept real contradictions, they have been incapable of describing the multiple but interre-lated characteristics of information. The framework for the discussion of information in this paper will be the new extension of logic to real complex processes that I have made, Logic in Reality (LIR), which is grounded in the dualities and self-dualities of quantum physics and cos-mology. LIR provides, among other things, new interpretations of the most fundamental metaphysical questions present in discussions of information at physical, biological and cognitive levels of reality including, especially, those of time, continuity vs. discontinuity, and change, both physical and epistemological. I show that LIR can constitute a novel and general ap-proach to the non-binary properties of information, including meaning and value. These properties subsume the notion of semantic information as well-formed, meaningful and truthful data as proposed most recently by Luciano Floridi. LIR sup-ports the concept of ‘biotic’ information of Stuart Kauffmann, Robert Logan and their colleagues and that of meaningful information developed by Christophe Menant. Logic in Reality does not pretend to the level of rigor of an experimental or mathematical theory. It is proposed as a meth-odology to assist in achieving a minimum scientific legitimacy for a qualitative theory of information. My hope is that by seeing information, meaning and knowledge as dynamic processes, evolving according to logical rules in my extended sense of logic, some of the on-going issues on the nature and function of information may be clarified.
Cognitive Sustainability in the Age of Digital Culture
Authors: Bruni Luis Emilio
Published: May 2018

The aim of this article is to contextualize the implications of the expansion of digital culture in the on-going dis- cussions about the relations between sustainability and information and communication technologies. In order to relate the development of a global digital communication web, its effects on cultural processes and the issues of ecosystem and hu- man sustainability that humanity is facing, I will relate and elaborate on three aspects: 1) A Batesonean perspective on sustainability 2) The recent evolution of the technosphere, and 3) Yuri Lotman’s notion of Semiosphere and his semiotic theory of culture. This path will lead me to delineate some of the eco-ethical dimensions implied in the development of pervasive digital-interactive-immersive-representational technologies.
The choices we make and the world they create: Métis conflicts with Treaty One peoples in MMF v Canada
Authors: Voth Daniel
Published: May 2018

This article explores the intense fight over land between the Métis Nation and the Treaty One peoples (interveners) as it played out in the landmark Manitoba Métis Federation v Canada and Manitoba hearing at the Supreme Court of Canada. The article argues that this battle demonstrates the way zero-sum understandings of land, as well as racialized derivative title logics, animate the Treaty One peoples’ court strategy. By examining the contexts and complexities of these logics, the author shows that Treaty One peoples’ arguments undermine their own interests while also serving to undermine the formation of a coordinated Métis/Treaty One court strategy. The work uses Vine Deloria Jr’s interventions on time and the choices that make future worlds to argue that Métis and Treaty One peoples are not well served by narrowly self-interested litigation strategies. The piece concludes that shifting to a coordinated strategy would help avoid the weaknesses of Treaty One’s position while also better addressing the shared struggles of Métis and Treaty One peoples.
Honour in sovereignty: Can Crown consultation with Indigenous peoples erase Canada’s sovereignty deficit?
Authors: Stacey Richar
Published: May 2018

It has been uncontroversial in Canada since the Supreme Court of Canada’s decision in Haida Nation v British Columbia (Minister of Forests) that the Crown bears a constitutional duty to consult Indigenous peoples before proceeding with any conduct that threatens potential or unproven Indigenous rights or title. This duty is rooted in the honour of the Crown and is important to the broader goal of reconciliation between Indigenous and non-Indigenous Canadians. But section 35 of the Constitution Act, 1982 mentions neither the honour of the Crown nor the duty to consult. The conceptual foundations of the duty are unclear and remain undertheorized, leaving courts, Indigenous peoples, the Crown, and private industry to wonder precisely what consultation should involve. This article attempts to fill this theoretical gap. First, it argues, as an analytical matter, that the duty to consult is most coherently understood to flow from a commitment to creating space within the existing structures of Canadian democracy for the exercise of political sovereignty by Indigenous peoples. Second, the article makes the normative argument that this is the correct way to understand the duty. Canada’s historical failure since contact to recognize Indigenous sovereignty in any politically meaningful way has perpetuated a sovereignty deficit in Canada. Reconciliation, in turn, requires erasing this sovereignty deficit. Crown consultation with Indigenous peoples is one way to restore some degree of political sovereignty to Indigenous peoples, by holding the Crown more directly accountable to Indigenous communities. If these procedural protections for unproven Indigenous rights and title are to promote reconciliation, it must be shaped and informed by the extent to which consultation increases Crown accountability to Indigenous peoples and allows Indigenous peoples to act as sovereign, politically autonomous nations. This proceduralized understanding of section 35, however, should not be allowed to undermine the substantive protections that section 35 entrenches for existing Indigenous rights and title.
The need to justify and limit procedural innovation in national security litigation
Authors: Roach Kent , Forcese Craig
Published: May 2018

Legal systems should not always assume the legitimacy of state demands for secrecy and accommodate them with procedural innovations. This is especially so in Canada, which has made problematic policy choices to stress secrecy even in counterterrorism investigations where secret intelligence often has evidential value. A fairer and more efficient transition from secret intelligence to public evidence could be achieved if Canadian criminal trial judges, like those in other democracies, could make and revise non-disclosure or public interest immunity orders to protect secrets. The government of Canada has not justified adopting the procedural innovation of closed material procedures that would allow it to defend itself in national security civil litigation on the basis of secret evidence not seen by plaintiffs claiming to have been abused, but only by special advocates. There is a danger that even justified procedural innovation such as the use of special advocates will create new baselines that can be used to support additional innovations that may undermine the legitimacy of the legal system and discount the value of procedural regularity.
Special advocates and amici curiae in national security proceedings in the United Kingdom
Authors: Chamberlain Martin
Published: May 2018

This article considers the use of special advocates (SAs) in the United Kingdom in ‘closed material proceedings’ (CMPs) – that is, proceedings where the court relies on evidence that is not shown to one or more of the parties (closed material) in reaching its decision on the substantive issues in the case. It charts the development of CMPs from 1997 to the present day and examines some of the criticisms made of them, including by SAs instructed in them. From the perspective of a barrister with experience of acting in CMPs, this article identifies three particular examples of the difficulties that have arisen in practice in understanding the proper role of SAs and their effect on the way proceedings are conducted by judges: first, the conflict that can arise between the function of acting in the interests of the excluded party (generally, the role of the SA) and that of assisting the court (the traditional role of an amicus curiae); second, whether and to what extent SAs can make CMPs fair; and, third, the extent to which CMPs and SAs should play a part in appellate proceedings.
Unruptured aneurysms in the elderly: perioperative outcomes and cost analysis of endovascular coiling and surgical clipping
Authors: Silva Nicole A. , Shao Belinda , Sylvester Michael J. , Eloy Jean Anderson , Gandhi Chirag D.
Published: May 2018

OBJECTIVE

Observation and neurosurgical intervention for unruptured intracranial aneurysms (UIAs) in the elderly population is rapidly increasing. Cerebral aneurysm coiling (CACo) is favored over cerebral aneurysm clipping (CAC) in elderly patients, yet some elderly individuals still undergo CAC. The cost-effectiveness of treating UIAs requires further exploration. Understanding the effect of intervention on hospital charges and length of stay (LOS) as well as perioperative mortality and complications can further shed light on its economic impact. The purpose of this study was to analyze the cost and perioperative outcomes of UIAs in elderly patients (≥ 65 years of age) after CACo or CAC intervention.

METHODS

Retrospective cohorts of CACo and CAC admissions were extracted from National (Nationwide) Inpatient Sample data obtained between 2002 and 2013, forming parallel intervention groups to compare the following outcomes between elderly and nonelderly patients: average LOS and mean hospital admission costs, in-hospital mortality, and complications. Covariates included sex, race or ethnicity, and comorbidities.

RESULTS

Elderly patients undergoing CAC experienced an average LOS of 8.0 days, whereas elderly patients undergoing CACo stayed an average of 3.2 days. The mean hospital charges incurred during admission totaled $95,960 in the elderly patients who underwent CAC versus $87,960 in the ones who underwent CACo. Elderly patients in whom CAC was performed had a 2.2% rate of in-hospital mortality, with a 2.6 greater adjusted odds of in-hospital mortality than nonelderly patients treated with CAC. In contrast, elderly patients who underwent CACo had a 1.36 greater adjusted odds of in-hospital mortality than their nonelderly counterparts. Compared to nonelderly patients receiving both interventions, elderly individuals had a significantly higher prevalence of various comorbidities and incidence of complications. Elderly patients who received CAC experienced a 10.3% incidence rate of perioperative stroke, whereas their CACo counterparts experienced this complication at a rate of 3.5%. Elderly patients treated with CAC had greater odds of perioperative acute renal failure, whereas their CACo counterparts had greater odds of perioperative deep venous thrombosis and pulmonary embolism.

CONCLUSIONS

Intervention with CAC and CACo in the elderly is resource intensive and is associated with higher risk than in the nonelderly. Those deciding between intervention and conservative management should consider these risks and costs, especially the 2.2% postoperative mortality rate associated with CAC in the elderly population. Further comparative cost-effectiveness research is needed to weigh these costs and outcomes against those of conservative management.
Assessment of cost drivers and cost variation for lumbar interbody fusion procedures using the Value Driven Outcomes database
Authors: Twitchell Spencer , Karsy Michael , Reese Jared , Guan Jian , Couldwell William T. , Dailey Andrew , Bisson Erica F.
Published: May 2018

OBJECTIVE

Efforts to examine the value of care—combining both costs and quality—are gaining importance in the current health care climate. This thrust is particularly evident in treating common spinal disease where both incidences and costs are generally high and practice patterns are variable. It is often challenging to obtain direct surgical costs for these analyses, which hinders the understanding of cost drivers and cost variation. Using a novel tool, the authors sought to understand the costs of posterior lumbar arthrodesis with interbody devices.

METHODS

The Value Driven Outcomes (VDO) database at the University of Utah was used to evaluate the care of patients who underwent open or minimally invasive surgery (MIS), 1- and 2-level lumbar spine fusion (Current Procedural Terminology code 22263). Patients treated from January 2012 through June 2017 were included.

RESULTS

A total of 276 patients (mean age 58.9 ± 12.4 years) were identified; 46.7% of patients were men. Most patients (82.2%) underwent 1-level fusion. Thirteen patients (4.7%) had major complications and 11 (4.1%) had minor complications. MIS (β = 0.16, p = 0.002), length of stay (β = 0.47, p = 0.0001), and number of operated levels (β = 0.37, p = 0.0001) predicted costs in a multivariable analysis. Supplies and implants (55%) and facility cost (36%) accounted for most of the expenditure. Other costs included pharmacy (7%), laboratory (1%), and imaging (1%).

CONCLUSIONS

These results provide direct cost accounting for lumbar fusion procedures using the VDO database. Efforts to improve the value of lumbar surgery should focus on high cost areas, i.e., facility and supplies/implant.
Patient out-of-pocket spending in cranial neurosurgery: single-institution analysis of 6569 consecutive cases and literature review
Authors: Yoon Seungwon , Mooney Michael A. , Bohl Michael A. , Sheehy John P. , Nakaji Peter , Little Andrew S. , Lawton Michael T.
Published: May 2018

OBJECTIVE

With drastic changes to the health insurance market, patient cost sharing has significantly increased in recent years. However, the patient financial burden, or out-of-pocket (OOP) costs, for surgical procedures is poorly understood. The goal of this study was to analyze patient OOP spending in cranial neurosurgery and identify drivers of OOP spending growth.

METHODS

For 6569 consecutive patients who underwent cranial neurosurgery from 2013 to 2016 at the authors’ institution, the authors created univariate and multivariate mixed-effects models to investigate the effect of patient demographic and clinical factors on patient OOP spending. The authors examined OOP payments stratified into 10 subsets of case categories and created a generalized linear model to study the growth of OOP spending over time.

RESULTS

In the multivariate model, case categories (craniotomy for pain, tumor, and vascular lesions), commercial insurance, and out-of-network plans were significant predictors of higher OOP payments for patients (all p < 0.05). Patient spending varied substantially across procedure types, with patients undergoing craniotomy for pain ($1151 ± $209) having the highest mean OOP payments. On average, commercially insured patients spent nearly twice as much in OOP payments as the overall population. From 2013 to 2016, the mean patient OOP spending increased 17%, from $598 to $698 per patient encounter. Commercially insured patients experienced more significant growth in OOP spending, with a cumulative rate of growth of 42% ($991 in 2013 to $1403 in 2016).

CONCLUSIONS

Even after controlling for inflation, case-mix differences, and partial fiscal periods, OOP spending for cranial neurosurgery patients significantly increased from 2013 to 2016. The mean OOP spending for commercially insured neurosurgical patients exceeded $1400 in 2016, with an average annual growth rate of 13%. As patient cost sharing in health insurance plans becomes more prevalent, patients and providers must consider the potential financial burden for patients receiving specialized neurosurgical care.
The estimated cost of surgically managed isolated traumatic head injury secondary to road traffic accidents
Authors: You Xinli , Liew Boon S. , Rosman Azmin K. , DCSN  , Musa Kamarul Imran , Idris Zamzuri
Published: May 2018

OBJECTIVE

Traumatic brain injury due to road traffic accidents occurs mainly in the younger age group in which injury-related disability leads to long-term impact on employment and economic and social consequences across the lifespan. This study was designed to assign a monetary cost (in Malaysian ringgits [RM]) to the treatment of patients with surgically treated isolated traumatic head injury as determined up to 1 year after injury.

METHODS

Relevant resource items used were identified and valued using the direct measurement of costs method, cost accounting methods, standard unit costs method, fees, charges and/or market prices method. These values were then tabulated to generate the total costs for each patient, via a combination of macro-costing and micro-costing methods. Malaysian currency values were converted to US dollars according to the average conversion rate for the period from January to May 2016: RM1 = US$0.2452.

RESULTS

This costing study analyzed data from 49 patients. The estimated cost for the 1st year of care for all patients was RM1,471,919.80 (US$360,914.735), with a mean (± SD) cost per case of RM30,039.18 ± 22,986.25 or $7365.61 ± $5636.23. The mean cost of care per case was RM11,041.35 ± 10,936.88 or $2707.34 ± $2681.72 for mild head injury, RM32,550.00 ± 20,998.76 or $7981.26 ± $5148.90 for moderate head injury, and RM36,917.86 ± 23,697.34 or $9052.26 ± $5810.59 for severe head injury. Severe head injury (p = 0.001), sustaining 2 or more intracranial pathologies (p = 0.01), having a poor Glasgow Outcome Scale (GOS) score (GOS score 1–3) (p = 0.02), requiring a tracheostomy (p < 0.001), and contracting pneumonia (p < 0.001) were significantly associated with higher cost. Logistic regression analysis revealed that cost of care increased by RM591.60 or $145.06 per year increment of age (β = RM591.60, p = 0.05).

CONCLUSIONS

The mean cost of treatment for traumatic head injury is high compared to the per capita income of RM37,900 in 2016. The cost values generated in this study provide baseline cost estimates that the authors hope will be used as a guide to determine where adequate funding should be allocated to provide timely and appropriate delivery of care.
Economic benefit of carpal tunnel release in the Medicare patient population
Authors: Hubbard Zachary S. , Law Tsun Yee , Rosas Samuel , Jernigan Sarah C. , Chim Harvey
Published: May 2018

OBJECTIVE

The epidemiology of carpal tunnel syndrome (CTS) has been extensively researched. However, data describing the economic burden of CTS is limited. The purpose of this study was to quantify the disease burden of CTS and determine the economic benefit of its surgical management.

METHODS

The authors utilized the PearlDiver database to identify the number of individuals with CTS in the Medicare patient population, and then utilized CPT codes to identify which individuals underwent surgical management. These data were used to calculate the total number of disability-adjusted life years (DALYs) associated with CTS. A human capital approach was employed and gross national income per capita was used to calculate the economic burden.

RESULTS

From 2005 to 2012 there were 1,500,603 individuals identified in the Medicare patient population with the diagnosis of CTS. Without conservative or surgical management, this results in 804,113 DALYs without age weighting and discounting, and 450,235 DALYs with age weighting and a discount rate of 3%. This amounts to between $21.8 and $39 billion in total economic burden, or $2.7–$4.8 billion per year. Surgical management of CTS has resulted in the aversion of 173,000–309,000 DALYs. This has yielded between $780 million and $1.6 billion in economic benefit per year. Endoscopic carpal tunnel release provided between $11,683 and $23,186 per patient at 100% success while open carpal tunnel release provided between $10,711 and $22,132 per patient at 100% success. The benefit-cost ratio at its most conservative is 2.7:1, yet could be as high as 6.9:1.

CONCLUSIONS

CTS is prevalent in the Medicare patient population, and is associated with a large amount of economic burden. The surgical management of CTS leads to a large reduction in this burden, yielding extraordinary economic benefit.
The unreimbursed costs of preventing revision surgery in adult spinal deformity: analysis of cost-effectiveness of proximal junctional failure prevention with ligament augmentation
Authors: Safaee Michael M. , Dalle Ore Cecilia L. , Zygourakis Corinna C. , Deviren Vedat , Ames Christopher P.
Published: May 2018

OBJECTIVE

Proximal junctional kyphosis (PJK) is a well-recognized complication of surgery for adult spinal deformity and is characterized by increased kyphosis at the upper instrumented vertebra (UIV). PJK prevention strategies have the potential to decrease morbidity and cost by reducing rates of proximal junctional failure (PJF), which the authors define as radiographic PJK plus clinical sequelae requiring revision surgery.

METHODS

The authors performed an analysis of 195 consecutive patients with adult spinal deformity. Age, sex, levels fused, upper instrumented vertebra (UIV), use of 3-column osteotomy, pelvic fixation, and mean time to follow-up were collected. The authors also reviewed operative reports to assess for the use of surgical adjuncts targeted toward PJK prevention, including ligament augmentation, hook fixation, and vertebroplasty. The cost of surgery, including direct and total costs, was also assessed at index surgery and revision surgery. Only revision surgery for PJF was included.

RESULTS

The mean age of the cohort was 64 years (range 25–84 years); 135 (69%) patients were female. The mean number of levels fused was 10 (range 2–18) with the UIV as follows: 2 cervical (1%), 73 upper thoracic (37%), 108 lower thoracic (55%), and 12 lumbar (6%). Ligament augmentation was used in 99 cases (51%), hook fixation in 60 cases (31%), and vertebroplasty in 71 cases (36%). PJF occurred in 18 cases (9%). Univariate analysis found that ligament augmentation and hook fixation were associated with decreased rates of PJF. However, in a multivariate model that also incorporated age, sex, and UIV, only ligament augmentation maintained a significant association with PJF reduction (OR 0.196, 95% CI 0.050–0.774; p = 0.020). Patients with ligament augmentation, compared with those without, had a higher cost of index surgery, but ligament augmentation was overall cost effective and produced significant cost savings. In sensitivity analyses in which we independently varied the reduction in PJF, cost of ligament augmentation, and cost of reoperation by ± 50%, ligament augmentation remained a cost-effective strategy for PJF prevention.

CONCLUSIONS

Prevention strategies for PJK/PJF are limited, and their cost-effectiveness has yet to be established. The authors present the results of 195 patients with adult spinal deformity and show that ligament augmentation is associated with significant reductions in PJF in both univariate and multivariate analyses, and that this intervention is cost-effective. Future studies will need to determine if these clinical results are reproducible, but for high-risk cases, these data suggest an important role of ligament augmentation for PJF prevention and cost savings.
Systematic review of health economic studies in cranial neurosurgery
Authors: Ryu Won Hyung A. , Yang Michael M. H. , Muram Sandeep , Jacobs W. Bradley , Casha Steven , Riva-Cambrin Jay
Published: May 2018

OBJECTIVE

As the cost of health care continues to increase, there is a growing emphasis on evaluating the relative economic value of treatment options to guide resource allocation. The objective of this systematic review was to evaluate the current evidence regarding the cost-effectiveness of cranial neurosurgery procedures.

METHODS

The authors performed a systematic review of the literature using PubMed, EMBASE, and the Cochrane Library, focusing on themes of economic evaluation and cranial neurosurgery following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Included studies were publications of cost-effectiveness analysis or cost-utility analysis between 1995 and 2017 in which health utility outcomes in life years (LYs), quality-adjusted life years (QALYs), or disability-adjusted life years (DALYs) were used. Three independent reviewers conducted the study appraisal, data abstraction, and quality assessment, with differences resolved by consensus discussion.

RESULTS

In total, 3485 citations were reviewed, with 53 studies meeting the inclusion criteria. Of those, 34 studies were published in the last 5 years. The most common subspecialty focus was cerebrovascular (32%), followed by neurooncology (26%) and functional neurosurgery (24%). Twenty-eight (53%) studies, using a willingness to pay threshold of US$50,000 per QALY or LY, found a specific surgical treatment to be cost-effective. In addition, there were 11 (21%) studies that found a specific surgical option to be economically dominant (both cost saving and having superior outcome), including endovascular thrombectomy for acute ischemic stroke, epilepsy surgery for drug-refractory epilepsy, and endoscopic pituitary tumor resection.

CONCLUSIONS

There is an increasing number of cost-effectiveness studies in cranial neurosurgery, especially within the last 5 years. Although there are numerous procedures, such as endovascular thrombectomy for acute ischemic stroke, that have been conclusively proven to be cost-effective, there remain promising interventions in current practice that have yet to meet cost-effectiveness thresholds.
Cost-effectiveness development for the postoperative care of craniotomy patients: a safe transitions pathway in neurological surgery
Authors: Osorio Joseph A. , Safaee Michael M. , Viner Jennifer , Sankaran Sujatha , Imershein Sarah , Adigun Ezekiel , Weigel Gabriela , Berger Mitchel S. , McDermott Michael W.
Published: May 2018

OBJECTIVE

The authors’ institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU. Implementation of the pilot will expand and utilize neurosurgery beds available on the NTCU and reduce the burden on NICU beds for critically ill patient admissions.

METHODS

Ten patients who underwent craniotomy to treat supratentorial brain tumors were included. Prior to implementation of the pilot, inclusion criteria were designed for patient selection. Patients included were less than 65 years of age, had no comorbid conditions requiring postoperative intensive care unit (ICU) care, had a supratentorial meningioma less than 3 cm in size, had no intraoperative events, had routine extubation, and underwent surgery lasting fewer than 5 hours and had blood loss less than 500 ml. The Safe Transitions Pathway (STP) was started in August 2016.

RESULTS

Ten tumor patients have utilized the STP (5 convexity meningiomas, 2 metastatic tumors, 3 gliomas). Patients’ ages ranged from 29 to 75 years (median 49 years; an exception to the age limit of 65 years was made for one 75-year-old patient). Discharge from the hospital averaged 2.2 days postoperative, with 1 discharged on postoperative day (POD) 1, 7 discharged on POD 2, 1 discharged on POD 3, and 1 discharged on POD 4. Preliminary data indicate that quality and safety for patients following the STP (moving from the operating room [OR] to the neuro transitional care unit [OR-NTCU]) are no different from those of patients following the traditional OR-NICU pathway. No patients required escalation in level of nursing care, and there were no readmissions. This group has been followed for greater than 1 month, and there were no morbidities.

CONCLUSIONS

The STP is a new and efficient pathway for the postoperative care of neurosurgery patients. The STP has reduced hospital cost by $22,560 for the first 10 patients, and there were no morbidities. Since this pilot, the authors have expanded the pathway to include other surgical cases and now routinely schedule craniotomy patients for the (OR-NTCU) pathway. The potential cost reduction in one year could reach $500,000 if we reach our potential of 20 patients per month.
Synthesis of Novel Benzochromenes Using Triarylphosphines, Alkyl X-Phenylpropiolates and 2-Hydroxy-1-Naphthaldehyde
Authors: Gholami Hamid Reza , Asghari Sakineh
Published: May 2018

The reactions of a series of alkyl X-phenylpropiolates with 2-hydroxy-1-naphthaldehyde and triphenylphosphine led to benzochromenes in moderate yields. When the reactions were performed in the presence of bis(4-methoxyphenyl)phenylphosphine instead of triphenylphosphine, the rate and yields of the reactions increased. Reaction yields were enhanced for alkyl X-phenylpropiolates when X was an electron-deficient substituent such as CF3 or Cl, thus showing that the electronic effect of substituents plays an important role in the reactions.
Estimation of Minimal Length Using Binding Energy of Deuteron
Authors: Moniruzzaman M. , Faruque S. B.
Published: May 2018

We find the shift of ground state energy of deuteron caused by generalized uncertainty principle (GUP) using Yukawa potential as the binding force between the proton and neutron. This leads to an upperbound on minimal length of about 10 -18 m which is close to the values frequently found in literature.
The Effects of Equivalence Ratio on Pressure Wave Development during Knocking Combustion
Authors: Deb D. , Uddin M. A. , Terashima H. , Oshima N.
Published: May 2018

A knocking combustion in a one-dimensional constant volume reactor has been simulated with a detailed chemical kinetic mechanism of n-heptane premixed gases by using the compressible Navier-Stokes equations. This study focuses on the impact of the various equivalence ratios (0.6–1.4) in the pressure wave development during knocking combustion in an account of different initial temperature (600–900K). The result demonstrates the autoignition process in the end-gas region and explains the knocking phenomenon on different equivalence ratio. In an adiabatic wall condition, the largest knocking intensity occurs in equivalence ratio 1.4 whereas the lowest knocking intensity found in equivalence ratio 0.6. Regarding to initial temperatures, a strong peak of knocking is generated around 650K in all the equivalence ratios (0.8–1.4). However, yet a small perceptivity of knocking is found in around 750K for each equivalence ratio. In case of smaller equivalence ratios, a weak knocking occurs, which can be identified by the behavior of the pressure wave generation in the end-gas region.
Cytotoxic Activity on Brine Shrimp, MCF-7 Cell Line and Thrombolytic Potential: Seven Different Medicinal Plant Leaves Extract
Authors: Azad A. K. , Jainul M. A. , Labu Z. K.
Published: May 2018

The aim of our study was to find out the preliminary cytotoxic and thrombolytic effect of the seven selected medicinal plant leaves extract. In cytotoxic activity, out of the seven leaves extract three of them exhibited stronger brine shrimp lethality with LC50 122.548 (Uncaria acida), 170.861 (Leea indica) and 175.469 (Piper porphyrophyllum) μg /mL respectively, and  on MCF-7 cell line, they also exhibited moderate cytotoxic activity with different concentration of the extract of the same plant leaves such as,Uncaria acida (72.31, 56.22, 38.12 and 9.24%), Leea indica (67.31, 58.22, 43.12 and 15.24%), Piper porphyrophyllum (65.88, 48.12, 40.12 and 21.34%).  In thrombolytic assessments, all the leaves extract showed moderate (considering > 20% moderate; **p < 0.01; *p < 0.05) clot lysis activity, but among the extracts, Uncaria cordata (27.36 ± 0.10%) showed the highest and Stachytarpheta indica the lowest (6.14 ± 0.20%) percent clot lysis as compared with the standard streptokinase (65.15 ± 0.16%). This study was conducted to legalize the folkloric use of seven medicinal plant leaves.
A Generalized Size-Biased Poisson-Lindley Distribution and Its Applications to Model Size Distribution of Freely-Forming Small Group
Authors: Shanker R. , Shukla K. K.
Published: May 2018

In this paper, generalized size-biased Poisson-Lindley distribution (GSBPLD) which includes size-biased Poisson-Lindley distribution (SBPLD) as particular case, has been proposed and studied. Its moments based measures including coefficients of variation, skewness, kurtosis, and index of dispersion have been derived and their nature and behavior have been discussed with varying values of the parameters. The estimation of its parameter has been discussed using maximum likelihood estimation. Some applications of the proposed distribution have been explained through datasets relating to size distribution of freely-forming and the goodness of fit has been found satisfactory over SBPLD and size-biased Poisson distribution (SBPD).