bluuebunny/crossref_metadata_2025 huggingface dataset:
Relative survival after diagnosis with a primary brain or other central nervous system tumor in the National Program of Cancer Registries, 2004 to 2014
Authors: Ostrom Quinn T , Truitt Gabrielle , Gittleman Haley , Brat Daniel J , Kruchko Carol , Wilson Reda , Barnholtz-Sloan Jill S
Published: December 2019

Background

The majority of reported cancer survival statistics in the United States are generated using the National Cancer Institute’s publicly available Surveillance, Epidemiology, and End Results (SEER) data, which prior to 2019 represented 28% of the US population (now 37%). In the case of rare cancers or special subpopulations, data sets based on a larger portion of the US population may contribute new insights into these low-incidence cancers. The purpose of this study is to characterize the histology-specific survival patterns for all primary malignant and nonmalignant primary brain tumors in the United States using the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR).

Methods

Survival data were obtained from the NPCR (includes data from 39 state cancer registries, representing 81% of the US population). Relative survival rates (RS) with 95% CI were generated using SEER*Stat 8.3.5 from 2004 to 2014 by behavior, histology, sex, race/ethnicity, and age at diagnosis.

Results

Overall, there were 488 314 cases from 2004 to 2014. Overall 5-year RS was 69.8% (95% CI = 69.6%-69.9%). Five-year RS was 35.9% (95% CI = 35.6%-36.1%) for malignant and 90.2% (95% CI = 90.1%-90.4%) for nonmalignant tumors. Pilocytic astrocytoma had the longest 5-year RS (94.2%, 95% CI = 93.6%-94.6%) of all glioma subtypes, whereas glioblastoma had the shortest 5-year RS (6.1%, 95% CI = 6.0%-6.3%). Nonmalignant nerve sheath tumors had the longest 5-year RS (99.3%, 95% CI = 99.1%-99.4%). Younger age and female sex were associated with increased survival for many histologies.

Conclusions

Survival after diagnosis with primary brain tumor varies by behavior, histology, and age. Using such a database that includes more than 80% of the US population may represent national survival patterns.
Return to work following meningioma surgery: a Swedish nationwide registry-based matched cohort study
Authors: Thurin Erik , Corell Alba , Gulati Sasha , Smits Anja , Henriksson Roger , Bartek J , Salvesen Øyvind , Jakola Asgeir Store
Published: December 2019

Background

Meningioma is the most common primary intracranial tumor. It is usually slow growing and benign, and surgery is the main treatment modality. There are limited data on return to work following meningioma surgery. The objective of this study was to determine the patterns of sick-leave rate prior to surgery, and up to 2 years after, in patients compared to matched controls.

Methods

Data on patients ages 18 to 60 years with histologically verified intracranial meningioma between 2009 and 2015 were identified in the Swedish Brain Tumor Registry (SBTR) and linked to 3 national registries after 5 matched controls were assigned to each patient.

Results

We analyzed 956 patients and 4765 controls. One year prior to surgery, 79% of meningioma patients and 86% of controls were working (P < .001). The proportion of patients at work 2 years after surgery was 57%, in contrast to 84% of controls (P < .001). Statistically significant negative predictors for return to work in patients 2 years after surgery were high (vs low) tumor grade, previous history of depression, amount of sick leave in the year preceding surgery, and surgically acquired neurological deficits.

Conclusion

There is a considerable risk for long term sick leave 2 years after meningioma surgery. Neurological impairment following surgery was a modifiable risk factor increasing the risk for long-term sick leave. More effective treatment of depression may facilitate return to work in this patient group.
Cost-effectiveness of a Medical Care Coordination Program for People With HIV in Los Angeles County
Authors: Flash Moses J E , Garland Wendy H , Martey Emily B , Schackman Bruce R , Oksuzyan Sona , Scott Justine A , Jeng Philip J , Rubio Marisol , Losina Elena , Freedberg Kenneth A , Kulkarni Sonali P , Hyle Emily P
Published: December 2019

Background

The Los Angeles County (LAC) Division of HIV and STD Programs implemented a medical care coordination (MCC) program to address the medical and psychosocial service needs of people with HIV (PWH) at risk for poor health outcomes.

Methods

Our objective was to evaluate the impact and cost-effectiveness of the MCC program. Using the CEPAC-US model populated with clinical characteristics and costs observed from the MCC program, we projected lifetime clinical and economic outcomes for a cohort of high-risk PWH under 2 strategies: (1) No MCC and (2) a 2-year MCC program. The cohort was stratified by acuity using social and clinical characteristics. Baseline viral suppression was 33% in both strategies; 2-year suppression was 33% with No MCC and 57% with MCC. The program cost $2700/person/year. Model outcomes included quality-adjusted life expectancy, lifetime medical costs, and cost-effectiveness. The cost-effectiveness threshold for the incremental cost-effectiveness ratio (ICER) was $100 000/quality-adjusted life-year (QALY).

Results

With MCC, life expectancy increased from 10.07 to 10.94 QALYs, and costs increased from $311 300 to $335 100 compared with No MCC (ICER, $27 400/QALY). ICERs for high/severe, moderate, and low acuity were $30 500/QALY, $25 200/QALY, and $77 400/QALY. In sensitivity analysis, MCC remained cost-effective if 2-year viral suppression was ≥39% even if MCC costs increased 3-fold.

Conclusions

The LAC MCC program improved survival and was cost-effective. Similar programs should be considered in other settings to improve outcomes for high-risk PWH.
Facial Nerve Preservation for Supraorbital Approaches: Anatomical Mapping Based on Consistent Landmarks
Authors: García-García Sergio , González-Sánchez José Juan , Kakaizada Sofia , Lawton Michael T , Benet Arnau
Published: December 2019

BACKGROUND

The supraorbital keyhole approach (SOKA) provides a safe and advantageous access to the anterior cranial fossa. The implemented skin incision varies depending on surgeon's preferences and requirements. Facial nerve (FN) injury might appear in up to 5.6% of patients. There is a lack of validated tenets for avoiding FN injury.

OBJECTIVE

To define a safety area for FN preservation during a SOKA.

METHODS

Ten dried skulls and 5 injected cadaveric heads (10 sides) were used. A Cartesian frame was created with its horizontal axis at the level of the supraorbital notch and the vertical axis just lateral to the frontozygomatic junction (FZj). FNs were dissected and points along their course were registered and transferred to the Cartesian frame.

RESULTS

Ten microscopic dissections of the FN were performed preserving all branches. A safety area could be defined 8 mm superior and 10 mm inferior to the FZj extending medially to the supraorbital notch and beyond. A 20 mm2 area superior and lateral to the FZj provided low probability (≤10%) of injuring the FN. Similarly, starting 4 mm inferior to the FZj, a lateral safety area was also found. A probabilistic colored heat map was built to represent the results.

CONCLUSION

We provide a “safety zone” for a SOKA incision in which the probability to encounter the FN is low. Clinical studies following our method may validate our findings and add evidence to the tenets for minimizing morbidity related to the SOKA incision.
Microsurgical Treatment of Ruptured Spetzler-Martin Grade 3 Right Hippocampal Arteriovenous Malformation: 3-Dimensional Operative Video
Authors: Echeverría Kléber González , da Costa Marcos Devanir Silva , Costa Bruno Lourenço , Ortiz Robert Zanabria , Paganelli Samantha Lorena , Granados Oliver Soto , Doria-Netto Hugo Leonardo , Centeno Ricardo Silva , Chaddad-Neto Feres
Published: December 2019

We present a 14-yr-old male with a history of traumatic brain injury in March 2016, secondary to clonic tonic generalized seizures. CT scan showed hemorrhage at mesial temporal region in the body of right hippocampus, intraventricular hemorrhage at the level of lateral ventricles (right and left side) and fourth ventricle. After this the patient presented with pulsating right temporal headache of high intensity (VAS 10/10) that improved with common analgesics, dizziness, and clonic tonic generalized seizures despite taking Phenobarbital 100 mg/24 h. Neuropsychological assessment reveal major deficits regarding executive functions: working memory, verbal fluency, and planning abilities. Brain MRI and angiography showed AVM at the right level of hippocampus body. An intranidal aneurysm was also observed. Venous drainage was through the basal vein of Rosenthal. We planned for surgery and resection of the hippocampal AVM through the trans-T2 approach. Postoperatively, the patient was without medical complications. We present a 3-dimensional video of the microsurgical treatment for right hippocampal AVM performed through a trans-T2 approach.

The patient signed the Institutional Consent Form, which allows the use of his/her images and videos for any type of medical publications in conferences and/or scientific articles.
Later school start times in a flexible system improve teenage sleep
Authors: Winnebeck Eva C , Vuori-Brodowski Maria T , Biller Anna M , Molenda Carmen , Fischer Dorothee , Zerbini Giulia , Roenneberg Till
Published: December 2019

Sleep deprivation in teenage students is pervasive and a public health concern, but evidence is accumulating that delaying school start times may be an effective countermeasure. Most studies so far assessed static changes in schools start time, using cross-sectional comparisons and one-off sleep measures. When a high school in Germany introduced flexible start times for their senior students—allowing them to choose daily between an 8 am or 9 am start (≥08:50)—we monitored students’ sleep longitudinally using subjective and objective measures. Students (10–12th grade, 14–19 y) were followed 3 weeks prior and 6 weeks into the flexible system via daily sleep diaries (n = 65) and a subcohort via continuous wrist-actimetry (n = 37). Satisfaction and perceived cognitive outcomes were surveyed at study end. Comparisons between 8 am and ≥9 am-starts within the flexible system demonstrated that students slept 1.1 h longer when starting school later—independent of gender, grade, chronotype, and frequency of later starts; sleep offsets were delayed but, importantly, onsets remained unchanged. Sleep quality was increased and alarm-driven waking reduced. However, overall sleep duration in the flexible system was not extended compared to baseline—likely because students did not start later frequently enough. Nonetheless, students were highly satisfied with the flexible system and reported cognitive and sleep improvements. Therefore, flexible systems may present a viable alternative for implementing later school starts to improve teenage sleep if students can be encouraged to use the late-option frequently enough. Flexibility may increase acceptance of school start changes and speculatively even prevent delays in sleep onsets through occasional early starts.
The Role of Radiotherapy in Resected R0/R+ Pancreatic Cancer
Authors: Lutsyk Myroslav , Ben-Yosef Rahamim
Published: December 2019

Purpose/Objective:

The purpose of this study was to evaluate the role of external radiation therapy following resection of pancreatic cancer.

Patients and Methods:

Patients who underwent either Whipple procedure or distal pancreatectomy and treated with either chemo-radiotherapy (chemo-rad) or chemotherapy alone (R0 chemo) were enrolled in this study. The chemotherapy (chemo) was based on cisplatin and either gemcitabine or 5 FU/leukovorin. The total radiation dose was 50.4 Gy given in 1.8 Gy 5 times a week. Overall survival, based on resection margin, nodal status, and treatment type, was estimated in all patients.

Results:

Of the 734 referred patients, 134 underwent either Whipple procedure or distal pancreatectomy during the years 2000 to 2018. In total, 93 had complete tumor resection (R0 group), and 41 had involved resection margins (R+ group). An overall 49 of the 93 were treated with R0 chemo, and 44 were treated with chemo-rad (R0 chemo-rad). The median overall survival for the R0 group was 28 months; for R0 chemo, it was 29 months, and, for R0 chemo-rad, it was 27 months (P-value, NS). For the 41 R+ group, it was 17 months and was significantly lower than that of R0 (P<0.001). The survival of R+ chemo-rad (26 patients) was 23 months, and, for R+ chemo (15 patients), it was 12 months (P=0.01). In total, 72 with positive nodes (N+) had shorter overall survival than those with N negative (22 and 27 mo, P=0.015). The survival of patients with N+/R0 chemo-rad and chemo was similar—31 and 27 months (P-value, NS), and, in the N+/R+ group, the survival was 22 and 16 months in the chemo-rad and chemo only groups, respectively (P=0.006).

Conclusions:

external radiation therapy increased significantly the overall survival of R+ resected pancreatic cancer but not N+ patients. Additional studies to delineate the role of chemo-rad in this setting are warranted.
Hip and Knee Weakness and Ankle Dorsiflexion Restriction in Individuals Following Lateral Patellar Dislocation: A Case-Control Study
Authors: Arrebola Lucas Simões , Smith Toby , Silva Fabrícia Ferreira , de Oliveira Vanessa Gonçalves Coutinho , de Oliveira Pedro Rizzi , Wun Paloma Yan Lam , Pinfildi Carlos Eduardo
Published: December 2019

Objective:

To explore the relationship between ankle dorsiflexion range of motion (ROM) and hip and knee muscle strength between patients with a history of patellar dislocation (PD) to healthy controls.

Design:

Case–control study.

Setting:

Orthopedical specialty outpatient clinic at a tertiary hospital.

Participants:

Eighty-eight individuals were recruited; 44 individuals aged 16 years or older, of both sexes, with a history of at least one episode of atraumatic unilateral or bilateral PD requiring emergency care (14 men; 30 women; mean age 20 years) and 44 healthy (control) individuals (11 men; 33 women; mean age 21 years) matched for age, weight, and height to PD cases.

Intervention:

Assessment of hip and knee strength and ankle dorsiflexion ROM.

Outcome Measures:

Ankle dorsiflexion ROM was assessed through the lunge test with a goniometer. Hip and knee muscle strength was evaluated through isometric hand-held dynamometry. Differences between healthy and control individuals were assessed using Student t Tests and Mann–Whitney U Test.

Results:

Patellar dislocation individuals presented with a reduced ankle dorsiflexion ROM [mean difference (MD): 9 degrees; effect size (ES): 1.39; P < 0.001] and generalized hip and knee weakness (MD range: 4.74 kgf to 31.4 kgf; ES range: 0.52-2.35; P < 0.05) compared with healthy subjects.

Conclusion:

Individuals with a history of PD have reduced ankle dorsiflexion ROM and hip and knee muscle strength compared with healthy controls.
Validity and inter-observers reliability of blood pressure measurements using mercury sphygmomanometer in the PERSIAN Guilan cohort study
Authors: Joukar Farahnaz , Naghipour Mohammad Reza , Yeganeh Sara , Sepehrimanesh Masood , Keshtkar Abbasali , Ashoobi Mohammad Taghi , Hassanipour Soheil , Mansour-Ghanaei Fariborz
Published: December 2019

Objective:

Accurate measuring of blood pressure is a vital step in both clinical and para-clinical settings. The aims of the present study were to evaluate the validity and inter-observer reliability of measured blood pressures by two trained observers and one expert supervisor in the PERSIAN Guilan cohort study (PGCS).

Participants and methods:

In a quasi-experimental study, two trained observers and one expert supervisor measured systolic and diastolic blood pressures (SBP and DBP) in 85 included participants. All measurements were done using Riester mercury sphygmomanometer as duplicate for each people.

Results:

Lack of validity in the total SBP (P = 0.017), DBP in age <50 years (P = 0.039), and DBP in BMI >25 (P=0.019) of first observer and total SBP (P = 0.045), SBP of male (P = 0.019), both SBP and DBP in age >50 years (P = 0.034, P = 0.012) and DBP in BMI <25 (P = 0.001) of second observer were seen. In addition, total inter-rater reliability was found as 12.2% and 27.2% in SBP and DBP, respectively. Age, sex and BMI categorized inter-observer reliability were not more than 15% in SBP of BMI <25 kg/m2 and 31.6% in DBP of female. The final inter-observer agreement after educational course was higher than 0.7 totally and in all categorical evaluations.

Conclusion:

Based on lack of validity in some conditions and low level of reliability, education of all observers to measure both SBP and DBP accurately is needed. This is more necessary to done before performing the high population surveys.
County-Level Social Capital and Bacterial Sexually Transmitted Infections in the United States
Authors: Owusu-Edusei Kwame , McClendon-Weary Bryttany , Bull Lara , Gift Thomas L. , Aral Sevgi O.
Published: December 2019

Background

The association between county-level social capital indices (SCIs) and the 3 most commonly reported sexually transmitted infections (STIs) in the United States is lacking. In this study, we determined and examined the association between 2 recently developed county-level SCIs (ie, Penn State Social Capital Index [PSSCI] vs United States Congress Social Capital Index [USCSCI]) and the 3 most commonly reported bacterial STIs (chlamydia, gonorrhea, and syphilis) using spatial and nonspatial regression techniques.

Methods

We assembled and analyzed multiyear (2012–2016) cross-sectional data on STIs and 2 SCIs (PSSCI vs USCSCI) on counties in all 48 contiguous states. We explored 2 nonspatial regression models (univariate and multiple generalized linear models) and 3 spatial regression models (spatial lag model, spatial error model, and the spatial autoregressive moving average model) for comparison.

Results

Without exception, all the SCIs were negatively associated with all 3 STI morbidities. A 1-unit increase in the SCIs was associated with at least 9% (P < 0.001) decrease in each STI. Our test of the magnitude of the estimated associations indicated that the USCSCI was at least 2 times higher than the estimates for the PSSCI for all STIs (highest P value = 0.01).

Conclusions

Overall, our results highlight the potential benefits of applying/incorporating social capital concepts to STI control and prevention efforts. In addition, our results suggest that for the purpose of planning, designing, and implementing effective STI control and prevention interventions/programs, understanding the communities' associational life (as indicated by the factors/data used to develop the USCSCI) may be important.
Pediatric Trauma
Authors: Svantner Julianna , Dolci Mirko , Heim Catherine , Schoettker Patrick
Published: December 2019

Objectives

The purpose of this study was to provide an internationally comparable overview of pediatric trauma of the University Hospital of Lausanne to improve the care of children.

Methods

We analyzed the data from all injured children (<16 years of age) listed in our trauma registry from 2011 to 2016. These children were admitted to the resuscitation room after prehospital triage. Our data were analyzed using descriptive statistics.

Results

We included 327 children. Sixty-three percent were male, and the median age was 8 years. Severe trauma (Injury Severity Score (ISS), >15) occurred in 97 children. The principal mechanisms of injury were falls (45%), traffic accidents (29%), and burns (14%). The most frequently affected areas were the head and external body regions. Intensive care admissions amounted to 27%. Twenty percent of patients underwent immediate surgery (wound care, neurosurgery, and orthopedic surgery). The overall mortality rate was 5.5%, with a median ISS of 9. The mortality of severe trauma was 17.5%, with a median ISS of 22. Half of the children died within 6 hours. The main causes of death were falls from greater than 5 m and traffic accidents as pedestrians.

Conclusions

The demographics and patterns of injury in the pediatric trauma population are similar to other European pediatric trauma centers, but the mortality and the severity of injuries can vary (United Kingdom, 3.7%, median ISS of 9; Denmark, 7.3%, median ISS of 9; and Germany, 13.4%, median ISS of 25). The elevated early mortality rate suggests that improvements in prehospital care and early resuscitation could decrease mortality.
Differentiating Between Idiopathic Toe Walking and Cerebral Palsy: A Systematic Review
Authors: Schlough Kathleen , Andre Kerryn , Owen Marley , Adelstein Lindsey , Hartford Mary Claire , Javier Bernadette , Kern Rachel
Published: December 2019

Purpose:

The purpose of this systematic review is to identify evidence-based examination components that enable a clinician to distinguish between participants with idiopathic toe walking (ITW) and cerebral palsy (CP) to accurately categorize them into their respective movement system diagnosis.

Summary of Key Points:

Five articles were used that compared key clinical findings, walking characteristics, and muscle firing patterns of participants with CP and ITW. Differences in these components allow participants with CP and ITW to be classified into different movement system diagnoses to better target plan of care.

Conclusions and Recommendations for Clinical Practice:

The authors recommend that clinicians perform specific evidence-based tests and measures in accordance with the International Classification of Functioning, Disability and Health model.
Therapy Workloads in Pediatric Health: Preliminary Findings and Relevance for Defining Practice
Authors: Long Jason T. , Neogi Smriti , Vidonish William , Badylak Julie , Reder Rebecca D.
Published: December 2019

Purpose:

To measure time spent by pediatric physical and occupational therapists in performing daily work activities.

Methods:

Physical and occupational therapists at an urban pediatric academic hospital were observed during a standard workday. Time studies recorded total time spent performing patient care and other workplace-specific tasks. Data were analyzed to identify trends.

Results:

Broad similarities existed in average amounts of time spent in direct patient care, indirect patient care, and nonpatient care tasks. Indirect patient care tasks demonstrated the lowest variability in time spent.

Conclusions:

This is the first report of pediatric physical and occupational therapists' time in performing daily tasks. The metric and tools derived from these findings support managerial decision-making, provide a comparison of actual versus targeted workload, assist with determining appropriate and safe staffing caseloads, and contribute to measurements of a patient's therapy acuity level.

Video Abstract: For more insights from the authors, access Supplemental Digital Content 1, available at: http://links.lww.com/PPT/A280.
Educational Research Priorities for Pediatric Physical Therapy: A Consensus Study
Authors: Moerchen Victoria A. , Lundeen Heather , Dole Robin L.
Published: December 2019

Purpose:

This study engaged stakeholders internal and external to pediatric physical therapy education in a consensus exercise toward determining and refining priorities and considerations for educational research for pediatric physical therapy.

Methods:

The Delphi method was used to survey 54 physical therapists from 5 stakeholder groups drawn from experts in the field of physical therapy education and from Academy of Pediatric Physical Therapy members invested in educational leadership, research, and/or pediatric physical therapy clinical and residency education.

Results:

A 4-round survey process revealed 12 educational research priorities and 13 educational research considerations that reached 80% consensus, with clear and consistent top ranking of 4 of these priorities and 4 considerations across all stakeholder groups.

Discussion:

As the Academy of Pediatric Physical Therapy continues to develop and advance its capacity and support for educational research, knowledge of these priorities and considerations might be used to guide an educational research agenda.
Timely Access to Mental Health Services for Patients with Pain
Authors: Butz Catherine , Castillo Anthony , Gallup James , Valleru Jahnavi , Butter Eric
Published: December 2019

Introduction:

Efficient access to pediatric mental health services is a growing concern as the number of patients increases and outpaces efforts to expand services. This study outlines interventions implemented using quality improvement (QI) science and methodology to demonstrate how a clinic embedded in a large children’s hospital can improve access to the first appointment for a population seeking pain management services.

Methods:

A process improvement project started with a QI team, whose members designed interventions to change scheduling practices. Initial changes involved decreased time between calls to families, and efforts to streamline notifications among clinicians. Additional interventions included a close examination of waitlist assignment based on appropriateness and assessing patient interest in treatment.

Results:

Within 3 months of implementation, a significant decline in wait time occurred for patients seeking services for pain management, from 106 to 48 days. This change remained stable for 6 months. In light of a sharp increase in referrals and wait time during the study period, efforts to engage additional clinicians in managing referrals resulted in wait time to stabilize at an average of 63 days to the first appointment. This change remained for 10 months. Scheduling changes did not negatively affect other providers.

Conclusions:

This study demonstrates the application of QI science to improve patient access to mental health care. Future directions will focus on enhancing the use of the electronic health record, along with previsit family engagement.
The Risk of Complications after Carpal Tunnel Release in Patients Taking Acetylsalicylic Acid as Platelet Inhibition: A Multicenter Propensity Score–Matched Study
Authors: Kaltenborn Alexander , Frey-Wille Stefanie , Hoffmann Sebastian , Wille Jörn , Schulze Christoph , Settje Andreas , Vogt Peter M. , Gutcke André , Ruettermann Mike
Published: December 2019

Background:

Carpal tunnel release is one of the most common procedures in hand surgery. There is only scarce evidence regarding whether platelet inhibitors increase the risk of developing postoperative hemorrhage in carpal tunnel release.

Methods:

This is a multicenter, propensity score–matched study including 635 carpal tunnel releases in 497 patients. Multivariate regression models were adjusted with the propensity score, which was developed to mitigate differences in patients with and without platelet inhibition with acetylsalicylic acid. Propensity score matching provides results close to the statistical quality of randomized controlled trials. The primary study endpoint was postoperative bleeding complication, defined as acute bleeding leading to reoperation or hematoma leading to physician visit. Patient satisfaction, functional outcome measured with the Boston Carpal Tunnel Questionnaire, and onset of surgical-site infection were also analyzed.

Results:

Bleeding complications were observed in 56 procedures (8.8 percent). After propensity score matching, there was no significant difference between the patients with and without acetylsalicylic acid treatment (p = 0.997). History of thyroid disease (p = 0.035) and of rheumatoid arthritis (p = 0.026) were independent risk factors, whereas higher body mass index might have a beneficial effect (p = 0.006). Patients with postoperative bleeding had significantly impaired functional outcome as measured with the Boston Carpal Tunnel Questionnaire (p = 0.026). Median satisfaction in the investigated study population was 10 of 10 points and did not differ significantly between the antiplatelet and the non-antiplatelet cohorts (p = 0.072)

Conclusion:

Carpal tunnel release under platelet inhibition with acetylsalicylic acid is safe and can be performed without interruption of such medication.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Evidence-Based Performance Measures for Autologous Breast Reconstruction: An American Society of Plastic Surgeons Quality Performance Measure Set
Authors: Siddiqui Aamir , Ueno Cristiane , Agarwal Jayant , Chang Edward I. , Chrysopoulo Minas , Davidson Caryn , Khuthaila Dana , Manahan Michele A. , Matros Evan , Newman Lisa A. , Newman Michael , Sowden Michelle , Tessler Oren , Whitacre Eric , Lee Bernard T.
Published: December 2019

The American Society of Plastic Surgeons commissioned the Autologous Breast Reconstruction Performance Measure Development Work Group to identify and draft quality measures for the care of patients undergoing autologous breast reconstruction and other breast reconstruction surgery. Four outcome measures and one process measure were identified. Outcomes include patient satisfaction with information for all breast reconstruction, a subscale of the BREAST-Q, and the length of stay, operative time, and rate of blood transfusion for autologous blood transfusion. The process measure looks at coordination of care around managing the breast reconstruction patient’s care, with the physician coordinating the ongoing care, be it an oncologist, radiologist, other specialist, or primary care physician. All measures in this report were approved by the American Society of Plastic Surgeons Quality and Performance Measures Work Group and the American Society of Plastic Surgeons Executive Committee. The Work Group recommends the use of these measures for quality initiatives, continuing medical education, maintenance of certification, American Society of Plastic Surgeons’ Qualified Clinical Data Registry reporting, and national quality-reporting programs.
Utility of Preoperative Multidetector-Row Computed Tomographic Angiography after Sublingual Nitroglycerin with Three-Dimensional Reconstruction in Planning of the Anterolateral Thigh Flap
Authors: Watanabe Masako , Murakami Ryuichi , Miyauchi Ritsuko , Amano Nobuyuki , Moriuchi Yuki , Imachi Kenzo
Published: December 2019

The utility of nitroglycerin is well established in coronary angiography but less so in other surgical fields. In this study, the authors investigated the utility of preoperative computed tomographic angiography after sublingual nitroglycerin followed by three-dimensional visualization for selecting suitable perforators in planning the free anterolateral thigh flap. The authors performed preoperative computed tomographic angiography following sublingual nitroglycerin (after screening for contraindications) in patients for whom reconstructive surgery with the free anterolateral thigh flap was planned. Data were reconstructed three-dimensionally, mapping location and course of source arteries and perforators. Suitable perforators were selected, and flap design was planned. The characteristics of perforators were analyzed statistically. Of 14 patients for whom surgery was planned, two had contraindications to nitroglycerin and underwent computed tomographic angiography alone. Nitroglycerin allowed for the visualization of more peripheral branches. The Hounsfield units at the deep fascia of perforators selected for surgery were significantly higher than for those not selected (p = 0.003). The distance from the intermuscular septum to the selected perforators was significantly shorter than the distance to nonselected perforators (p = 0.017). There were no adverse events, and all flaps survived. Sublingual nitroglycerin before computed tomographic angiography was safe and increased the visibility of perforators, enabling preoperative planning of flap design based on the three-dimensionally–reconstructed image. The authors highly recommend this procedure.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Diagnostic, IV.
Self-Reported Weight and Height Among Idiopathic Intracranial Hypertension Patients
Authors: Parish Deborah C. , Bidot Samuel , Bruce Beau B. , Micieli Jonathan A. , Blanch Richard J. , Newman Anna B. , Newman Nancy J. , Biousse Valérie
Published: December 2019

Background:

Idiopathic intracranial hypertension (IIH) mostly affects overweight and obese women. Severe obesity is associated with poorer visual outcomes in IIH, and weight gain can precipitate IIH and increase the risk of recurrence. Conversely, weight loss can decrease intracranial pressure and is an effective IIH treatment. Therefore, accurate monitoring of weight and body mass index (BMI) is important to help guide the management of IIH patients. Our goal was to compare estimated and measured BMI among patients with presumed IIH and non-IIH controls to determine whether these vital signs should be systematically measured when evaluating patients for IIH.

Methods:

A retrospective chart review was performed of consecutive patients with reported and measured weight and height seen in one ophthalmology-based neuro-ophthalmology clinic for IIH between January 2, 2018 and September 10, 2018. Patients with IIH or presumed IIH were compared to non-IIH controls, matched according to age (±5 years), BMI (±5 kg/m2 unless ≥40 kg/m2), sex, and race. Patients with confirmed IIH were asked to self-report their weight when seen in follow-up and they were weighed to compare their self-reported vs measured percent weight change.

Results:

We included 379 subjects (140 patients; 239 controls) among whom 75 of the IIH patients were matched to non-IIH controls. Patients with presumed or definite IIH accurately estimated their height and generally underestimated their weight by a median of 1.8 kg (4 lb), resulting in a median BMI underestimate of 0.9 kg/m2. There was no difference in BMI underestimation when comparing presumed or definite IIH patients to matched non-IIH controls while controlling for insurance status, smoking, diabetes, and vascular disease (P = 0.66). As BMI increased, all subjects underestimated their BMI more (by 0.9% per 10 measured BMI unit increase), when controlling for age, sex, and race (P < 0.003). Sixteen confirmed IIH patients were seen in follow-up. At initial neuro-ophthalmology consultation, these subjects underestimated their weight by a mean of 3.2%. At last follow-up they underestimated their weight by only 1.2% (P = 0.03).

Conclusions:

There was no evidence that IIH or presumed IIH patients had a different perception of their weight than non-IIH controls at initial neuro-ophthalmology consultation. Both patients and matched controls tended to underestimate their weight by the same amount, resulting in an overall BMI underestimation of approximately 1% per 10 measured BMI unit increase. Heavier subjects tended to underestimate their body weight and resultant BMI more, and IIH patients tended to estimate their weight more accurately at follow-up. Our results emphasize the need to systematically objectively measure the weight of presumed IIH patients seen in an ophthalmology clinic.
Applying minimal RNA-seq of peripheral blood platelet mRNA to reveal novel biomarkers in male patients with cerebral stroke
Authors: Pan Xiaofan , Hu Zhaoyang , Qin Lin , Han Yang , Zhu Xiaohua , Zhou Yan , Dong Wanli
Published: December 2019

Cerebral stroke is caused by the reduction or disruption of the blood supply to the brain, which results in cell death. Currently, the diagnosis of stroke is troublesome and expensive. In this study, samples of peripheral blood from eight male stroke patients and four male healthy controls were collected. RNA-seq of platelets was performed to detect the differential expression of mRNA in platelets isolated from the samples. Totally, 1091 (429 up-regulated and 662 down-regulated) differentially expressed genes were identified in patients with stroke compared with healthy controls. Analyses based on Gene Ontology and the KEGG pathway revealed that most annotated genes were involved in graft-versus-host disease, cell adhesion molecules signaling pathways, inflammation-related pathways, and so on. RNA expression levels of 15 inflammation-related genes were analyzed using qRT-PCR, especially egr2, which acts as a protector against stroke. In brief, RNA-seq analysis of platelets from all the samples indicated novel candidate genes and pathways that had the potential to be applied to clinical molecular diagnosis of stroke. Besides, this study provided insights into the function and underlying mechanism of stroke.
Profiles of mothers who seek treatment for substance use disorders in a clinical centre
Authors: Fernandez-Montalvo Javier , López-Goñi José J.
Published: December 2019

Purpose

The purpose of this paper is to explore the prevalence and profile of mothers among women who sought treatment for drug addiction, as well as the therapeutic progression of these patients.

Design/methodology/approach

A sample of 180 Spanish women with addiction problems was assessed. Information was collected on the patients’ socio-demographic characteristics, consumption variables and psychological symptoms.

Findings

Of the total sample, 22.2 per cent (n= 40) of the women seeking treatment for substance use disorder were mothers. Compared with women without children, mothers scored significantly higher on several EuropASI and psychological variables. Specifically, mothers presented with more medical problems, worse employment/financial situations, and more severity in alcohol use. Moreover, having a history of lifetime physical and/or sexual abuse was related to belonging to the group of mothers. Regarding therapeutic progression, no statistically significant differences in the retention rate were found between mothers and non-mothers.

Originality/value

The results of this study show that mothers generally have more severe problems than non-mothers. Therefore, comprehensive, continuum-based, and client-centred care for mothers is paramount for effective treatment in mothers. The implications of these results for further research and clinical practice are discussed.
The two best ways to derive the Black–Scholes PDE
Authors: Wilmott Paul
Published: December 2019

Purpose

The purpose of this paper is to explain the Black–Scholes model with minimal technical requirements and to illustrate its impact from a business perspective.

Design/methodology/approach

The paper employs simple accounting concepts and an argument part based on business need.

Findings

The Black–Scholes partial differential equation can be derived in many ways, some easy to understand, some hard, some useful and others not. The two methods in this paper are extremely insightful.

Originality/value

The paper takes a big-picture view of derivatives valuation. As such, it is a simple accompaniment to more complex methods and aims to keep modelling grounded in reality.
The impact of biased technology on employment distribution and labor status in income distribution
Authors: Wang Linhui , Zhao Jing , Sun Jia , Dong Zhiqing
Published: December 2019

Purpose

The purpose of this paper is to examine the effect of biased technology on employment distribution and labor status in income distribution of China. It also testifies a threshold effect of the capital per labor and employment distribution on labor status from biased technology.

Design/methodology/approach

This paper presents a normalized supply-side system of three equations to measure the bias of technology in China. Linear and threshold regressions approaches are applied over cross-province panel data to investigate the influence which biased technology has on labor status under different capital per labor and employment distribution regimes.

Findings

This paper empirically shows that technology has been mostly capital-biased in China. The regression results indicate that capital-biased technology impairs labor income status and tend to modify employment distribution and labor income between industries. Furthermore, it reveals the threshold effect of capital per labor and employment distribution on the relationship between biased technology and labor status.

Originality/value

This paper extends the literature by explaining labor status from the perspective of biased technology and the effect of inter-industry employment distribution in China. It further explores the asymmetric effect of biased technology on labor productivity and income, which promotes inter-industry labor mobility and modifies employment distribution. This paper highlights the implications of this explanation for labor relations and human resource management.
Level of education and knowledge, foresight competency and international entrepreneurship
Authors: Jafari-Sadeghi Vahid , Kimiagari Salman , Biancone Paolo Pietro
Published: December 2019

Purpose

Global economies are involved with enormous activities of internationalization that provide pure and untapped opportunities for entrepreneurs and businesses to place and promote their products.

Design/methodology/approach

The authors applied structural equation modeling (SEM) analysis with the partial least squares (PLS), conducting an empirical analysis of data from 28 European countries.

Findings

The results reveal that the higher level of education/knowledge in a country enhances the foresight competencies of entrepreneurs and that they both have a positive influence on the effective business creation. The findings of this paper also stress on the positive relationship between the effect of business creation and international intensity in economy level.

Research limitations/implications

The limitation of this study lies in the impossibility of obtaining a larger and more complete data. Consequently, this study uses national-level data from 28 European countries, which makes the sample too small. In addition, although innovation is one of the driving factors in both internationalization and entrepreneurship, because of the limitation, it has not been considered in this study.

Practical implications

The authors assert that countries, specifically European nations studied in this research, can improve their employment rate and value creation (through their products in international markets) by giving a special attention to the entrepreneurial-oriented human capitals.

Social implications

This research warns policymakers that they can have a serious contribution in promoting (international) entrepreneurship. They should draw a rigorous plan for formal and informal educational systems that effectively develops essential knowledge for launching new businesses and fosters the innovation and entrepreneurship.

Originality/value

This study set out to improve the understanding of the role of level of education/knowledge and foresight competencies, as the elements of human capitals, on international entrepreneurship.
Differences among women in response to workplace incivility
Authors: Oyet Mercy C. , Arnold Kara A. , Dupré Kathryne E.
Published: December 2019

Purpose

The purpose of this paper is to explore the consequences of experienced workplace incivility when female employees perceive that they are different from their workgroup. The authors examine how women’s perceptions of demographic dissimilarity from their workgroup moderate the relationships between incivility and psychological wellbeing, and between incivility and turnover intentions.

Design/methodology/approach

A total of 125 female employees of a post-secondary institution participated in this study. Participants were recruited through an electronic mailing list over the course of one month and completed an online survey.

Findings

Experienced workplace incivility among females is related to poorer psychological wellbeing and higher turnover intentions. Controlling for actual age and gender dissimilarity at the department level, perceived gender dissimilarity from one’s workgroup moderated the workplace incivility-turnover intentions relationship, whereby the relationship was strengthened at low, but not high levels of experienced incivility. Perceived gender dissimilarity did not moderate the incivility–psychological wellbeing relationship. Perceived age dissimilarity was not a significant moderator.

Research limitations/implications

The role of perceived dissimilarity and other personal contextual variables should be considered in future work on selective incivility. Perceived dissimilarity can influence some of the negative outcomes associated with incivility, particularly at low levels.

Originality/value

This research extends the selective incivility literature by incorporating a relational demography perspective to the study of female targets’ experience of workplace incivility. Findings suggest that perceptions of difference may affect the interpretation and outcomes associated with females’ experience of incivility.
KnoDues – a start-up with a solution to India’s split-expenses problem
Authors: Murthy Venkatesh , Subramaniam Ram
Published: December 2019

Learning outcomes

Using the case, students will learn about the following topics: identification of the right shareholder for a start-up. Need for a tech co-founder for an app-based start-up. Delay in building the right team at the right time. Lack of preparedness; a start-up’s challenges in identifying the business model. What was the real pain point (problem identification)? Did the solution meet market expectations (solution quality)?; consumers’ usual social habits. How do people’s habits hinder a product’s survival in the market? Why do consumers continue to behave the same way they have? Technology-related constraints.

Case overview/synopsis

KnoDues was a mobile application (app)-based start-up in the domain of split expenses. The business idea germinated in early 2015 and became a reality toward the end of 2015. In a developing country context, the case provides rich insights into lean vs traditional start-up formation, founders’ knowledge, opportunity identification, product development and investment. India is a growing economy with ever-increasing smartphone users and internet consumers. Despite its deep-rooted rural-urban divide in the usage of modern technologies, India possesses a vast market opportunity in big cities. Rightly so, KnoDues intended to target the urban youth (between 15 and 35 years of age) population. Although KnoDues was not a unique product or the first of its kind, the founders perceived it to be the “first mover” in the Indian market. In its initial days, the product received an overwhelming response from accelerators and business-plan judges. Although KnoDues achieved more than 20,000 downloads by the end of 2016, customer retention and attracting investors became a difficult task. Founders felt that the difficulty was because of people’s “usual social habits,” and inadequate revenue model. Toward the end of 2017, KnoDues’s founders contemplated on ceasing their business.

Complexity academic level

Undergraduate, postgraduate and executive.

Supplementary materials

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 3: Entrepreneurship.