bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimizing Vulnerability to Malpractice Claims
Authors: Berry William R , Lagoo Janaka
Published: January 2021

This review provides strategies for avoiding lawsuits and advice for dealing with a lawsuit if one is ever filed. Medical malpractice is explained, as are the personal issues for the defendant physician. Strategies for preventing malpractice suits are presented, including those relative to communication and interpersonal skills, the informed consent process, and documentation. Advice is provided for what surgeons should do if sued or threatened with a lawsuit, including measures for assisting in the defense and settling claims versus trying a case. Preparing for a deposition is discussed. How a surgeon should act when serving as a defendant or witness in a courtroom trial is presented.
This review contains 5 tables, and 23 references.
Key words: claim, communication, defendant, informed consent, lawsuit, malpractice, medical records, negligence, suit
Surgical Treatment of Obesity and the Metabolic Syndrome
Authors: Ghaderi Iman , Dhanabalsamy Nisha , Galvani Carlos A
Published: January 2021

Obesity and obesity-related comorbid conditions have been steadily increasing in the United States over the past few decades. Despite the availability of several anti-obesity measures such as diet, exercise, pharmacotherapy and behavioral modifications, bariatric surgery is the only effective modality that can provide a sustainable long-term weight loss and improve obesity-associated comorbidities. In this chapter, we discuss perioperative assessment and work-up of morbidly obese patients, minimally invasive approaches to various bariatric surgery procedures including laparoscopic adjustable gastric band, sleeve gastrectomy, gastric bypass and biliopancreatic diversion with duodenal switch, and their short and long term outcomes. We also address revisional bariatric surgery and use of robotic platform and other new procedures and their role in metabolic and bariatric surgery.
This review contains 7 figures, 2 videos, 2 tables, and 110 references.
Keywords: Obesity, comorbidities, metabolic surgery, bariatric surgery, gastric bypass, adjustable gastric band, sleeve gastrectomy, Biliopancreatic Diversion with Duodenal Switch, revisional surgery
Periampullary and Pancreatic Adenocarcinoma
Authors: Cho Clifford S. , Lee Jay S
Published: January 2021

Appropriate surgical management of periampullary adenocarcinoma (ampullary adenocarcinoma, duodenal adenocarcinoma, distal cholangiocarcinoma, and pancreatic head adenocarcinoma) requires a familiarity with both anatomy and cancer biology. This review describes the clinical behavior of the various subtypes of periampullary adenocarcinoma, the appropriate diagnostic evaluation of the patient afflicted with these malignancies, the surgical anatom­y of the pancreas and peripancreatic region, and the nature and outcome of contemporary therapeutic interventions.
This review contains 9 figures, 7 tables, and 30 references.
Key words: American Joint Committee on Cancer staging system, ampullary adenocarcinoma, borderline resectable, distal cholangiocarcinoma, duodenal adenocarcinoma, locally advanced, pancreatic adenocarcinoma, superior mesenteric artery first dissection
Injuries to the Stomach, Small Bowel, Colon, and Rectum
Authors: Weinberg Jordan A , Fabian Timothy C.
Published: January 2021

Hollow viscus injury is most often the consequence of penetrating abdominal trauma. As a result of blunt force trauma, bowel injury occurs with relative infrequency: in one multi-institutional analysis, only 1.2% of blunt trauma admissions had an associated hollow viscus injury. The diagnosis of hollow viscus injury remains a challenge in abdominal trauma patients, and subsequent evaluation is determined by the mechanism of injury. Regardless of the specific injury mechanism, however, the principles and techniques of operative management are largely the same. This review covers determination of need for operation, and operative management. Figures show algorithms outlining the evaluation of blunt hollow organ injury in a hemodynamically stable patient with an unreliable physical examination, the treatment of truncal stab wounds, the treatment of blunt bowel and mesenteric injury, the treatment of gastric injury, the treatment of small bowel injury, the treatment of colon injury, the treatment of rectosigmoid or rectal injury, and a demonstration of presacral drainage through a curved incision midway between the anus and the tip of the coccyx. Tables list the incidence of findings suggestive of blunt mesenteric and bowel injury in true positive and false positive computed tomography  scans, and the American Association for the Surgery of Trauma organ injury scales for gastrointestinal tract and pancreas.
 
This review contains 8 figures, 3 tables, and 58 references
Keywords: Injury, blunt, primary rectal repair, colostomy, laparotomy, trauma
Cardiac Resuscitation
Authors: Tisherman Samuel A
Published: January 2021

Sudden cardiac death, whether in the hospital or out of the hospital, is a leading cause of death. Early recognition and activation of an emergency response, following the “chain of survival”, is critical. High quality Cardiopulmonary Resuscitation (CPR) should be initiated as soon as possible. Rescue breaths can be added when a qualified medical professional is available. Once emergency medical services personnel arrive for an out of hospital cardiac arrest or the “code team” arrives for an in hospital cardiac arrest, the Advanced Cardiovascular Life Support (ACLS) algorithm should be followed. For patients with pulseless ventricular tachycardia or ventricular fibrillation, early defibrillation improves the chances for restoration of spontaneous circulation and survival. The use of vasopressors and anti-arrhythmics are part of the protocol, though the benefits are unclear. Once trained airway providers are available, placement of an advanced airway, either supraglottic or endotracheal, can be considered after several minutes of CPR-ACLS, though optimal timing and clear benefit have not been established. For patients who remain comatose after resuscitation, initiation of Targeted Temperature Management can improve outcomes. Neuroprognostication is complex and should be delayed for at least 3-5 days after resuscitation and should be based upon multiple sources of information.

This review contains 1 figure, 5 tables, and 44 references.
Keywords: Cardiac arrest, cardiopulmonary resuscitation, anti-arrhythmics, airway management, targeted temperature management, prognostication
Multiple Organ Dysfunction Syndrome
Authors: Bansal Vishal , Doucet Jay
Published: January 2021

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS.
This review contains 1 figure, 7 tables, and 159 references.
The Immunocompromised Surgical Patient
Authors: Reed Rhiannon Deierhoi , Shelton Brittany , Locke Jayme E.
Published: January 2021

General surgeons are encountering an increasing number of cases involving immunosuppressed patients due to a number of factors, including the improvement in treatment for HIV, increased survival following solid-organ transplantation, and more aggressive chemotherapy. These groups of patients present unique challenges for the surgeon and often require more comprehensive preoperative assessment and perioperative monitoring. This review addresses the surgical management of these immunocompromised populations, with specific recommendations for each type of patient. Tables outline opportunistic infections and antibiotic prophylaxis; common immunosuppressive medications, posttransplantation drug levels, and side effects for renal transplant recipients; components of preoperative workup involving suspected infection in immunocompromised patients; and anesthetics and demonstrated impact on immune response and cancer recurrence. Graphs display the number of AIDS diagnoses and deaths and people living with AIDS and HIV in the United States over time, and compare percentages of death certificates reporting opportunistic infection versus chronic disease in the HIV-infected population. Management algorithms outline approaches to patients with defects in host defenses and candidates for transplantation to be deliberately immunosuppressed.
This review contains 2 graphs, 2 management algorithms, 4 tables, 157 references, and 5 annotated key references.
Thoracic Diagnostic and Staging Procedures
Authors: Banki Farzaneh , Kaiser Larry R.
Published: January 2021

This chapter reviews the diagnostic and staging procedures that relate to the most common thoracic malignancies in the thoracic cavity that are relevant to the general surgeon. Thoracic diagnostic and staging procedures involve the lungs, pleural space, and mediastinum, and include bronchoscopy (transbronchial needle aspiration, endobronchial ultrasound-guided needle aspiration, and rigid bronchoscopy), mediastinosocopy, parasternal mediastinotomy, video-assisted thoracic surgery, and mediastinal lymph node dissection. Diagnostic and staging procedures for the esophagus include esophagoscopy. The evaluation of a patient who presents with a question of intrathoracic pathology should begin with appropriate imaging studies, usually beginning with plain chest radiography followed by CT scanning of the chest done with intravenous contrast. Figures show various anatomic views, including a video-assisted thoracoscopic view. This chapter contains 26 references.
Evolving Molecular Therapeutics and Their Applications to Surgical Oncology
Authors: Dunn Kelli Bullard , Francescutti Valerie
Published: January 2021

Despite major advances in the diagnosis and treatment of cancer, chemotherapy, the mainstay of therapy for systemic disease, is rarely curative and toxicity is common. Research efforts are focusing on the development of agents that target molecules that are specific to tumor cells with few effects on normal healthy cells. The ultimate goal of molecular therapeutics is to develop agents that are lethal only to tumor cells, that maintain efficacy without developing resistance, and that possess acceptable toxicities that make them well tolerated by patients. This review covers tyrosine kinase inhibitors, angiogenesis inhibitors, cell cycle inhibitors, inducers of apoptosis, phosphatidylinositol 3-kinase/Akt/mammalian target of rapamycin inhibitors, and focal adhesion kinase inhibitors. Figures show activation of a receptor tyrosine kinase, the interaction of cyclin-dependent kinases and cyclins during regulation of the cell cycle, cyclin-cyclin-dependent kinase-regulated progression through each phase of the cell cycle, and the role of focal adhesion kinase in a signaling cascade that can lead to the tumorigenic properties of cancer cells. Tables list tyrosine kinase inhibitors, cell cycle inhibitors, and inducers of apoptosis.
 
This review contains 4 highly rendered figures, 3 tables, and 242 references
The Liver and Portal System
Authors: White Jared A
Published: January 2021

Understanding of the anatomy and physiology of the liver and techniques for safe anatomic and nonanatomic liver resections has evolved over the past several decades. The liver is composed of a complex arterial and portal venous inflow, which has several important variants that are crucial for the surgeon to understand when planning hepatic resections, both anatomic and nonanatomic. In addition, intra- and extrahepatic biliary configurations may be encountered, and variants must be recognized to prevent complications during common surgical procedures, such as cholecystectomy and liver resection. The liver is responsible for numerous metabolic, homeostatic, and immunologic processes throughout the body. It is crucial for the practicing physician and surgeon to have a fundamental understanding of hepatic anatomy and physiology when treating patients with derangements in liver structure and function. 
Key words: bile duct, bilirubin, bilirubin metabolism, hepatic artery, hepatic blood flow, hepatic parenchyma microstructure, liver anatomy, portal hypertension, portal vein
Computed Tomographic Screening for Lung Cancer
Authors: Jarrar Doraid , Song Grace Y. , Swanson Scott
Published: January 2021

Lung cancer is the leading cause of cancer deaths worldwide. Although lung cancer screening has been advocated, for a long time level 1 evidence has been absent, leaving physicians with the challenge of treating patients with mostly incurable disease. Even in 2014, the 5-year survival for lung cancer will only be around 16% despite sophisticated imaging and diagnostic tools. Physicians are thus taking a more proactive route, including early screening for lung cancer and efforts to curb tobacco use. This review discusses lung cancer screening in the context of the National Lung Screening Trial, risk of overdiagnosis, cost-effectiveness, U.S. Preventive Services Task Force recommendations, lung cancer screening in the community, improving the specificity of lung cancer screening, and treatment options for early-stage lung cancer. Tables review key principles of computed tomographic screening, cost-effectiveness of computer tomographic screening, predictors of malignancy in the Pan-Canadian screening study model, and follow-up and management of newly detected indeterminate nodules. Figures show common causes of cancer death in the United States, estimated new cancer cases and cancer deaths in men and women, a four-stage system used in clinical and surgical evaluation of lung cancer, secondary prevention lung cancer screening goals, and a low-dose computer tomographic scan.
This review contains 5 figures, 5 tables, and 31 references.
The Parathyroids
Authors: Balentine Courtney J. , Geraldson C Taylor
Published: January 2021

Successful surgery of the parathyroid glands depends on a thorough knowledge of their anatomic and developmental relations. This knowledge is crucial for locating ectopic parathyroids or preventing injury to the recurrent laryngeal nerve. In addition, the surgeon should understand the physiology and function of these glands. Unlike other conditions a surgeon might treat, physiology, and not anatomy alone, often dictates the timing and course of parathyroid procedures. This surgeon-oriented, focused review covers the development, histology, anatomy, physiology, and pathophysiology of the parathyroid. Figures show the location and frequencies of ectopic upper and lower parathyroid glands, and regulation of calcium homeostasis.

This review contains 2 highly rendered figures, and 16 references
Key words: calcitonin; hypercalcemia; hyperparathyroidism; multiple endocrine neoplasia; parathyroid; parathyroid hormone; primary hyperparathyroidism; secondary hyperparathyroidism; tertiary hyperparathyroidism
The Endocrine System: Pituitary Gland
Authors: Doron Omer , Cohen Jose E , Paldor Iddo
Published: January 2021

The pituitary gland is the main point where the neural and endocrine systems function in continuity, maintaining homeostasis of many functional elements of the human body. Located inside the sella turcica, it is separated from the rest of the central nervous system (CNS); however, it plays a crucial part in the regulation of the fundamental endocrine profile, inhibiting or promoting CNS signaling to the rest of the human body. Made up of two distinct tissue subtypes, this gland is fed by a complex vascular network, which enables communication beyond the blood-brain barrier. Lying in close proximity to both important neural and vascular structure, changes in gland size and function result in significant clinical impact. The pituitary gland controls many processes, among which are thermoregulation; metabolism and metabolic rate; glucose, solute, and water balance; growth and development; blood pressure; and sexual drive, pregnancy, childbearing, birth, and breast-feeding. The devastating effects of pituitary dysfunction underscore the importance of the pituitary gland in maintenance of the various functions that underlie normal everyday human activity. This review covers the basic aspects of pituitary gland development, anatomy, and physiologic function.
This review contains 3 figures, and 38 references,
Key words: adenohypophysis, neurohypophysis, pituitary-hypothalamic axis, pituitary portal system, sella turcica
The Skin and the Physiology of Normal Wound Healing
Authors: King Timothy W. , Kapur Sahil K.
Published: January 2021

This review presents normal wound healing as a complex process that is generally carried out in three overlapping stages: an inflammatory phase, a proliferative phrase (made up of fibroplasia, contraction, neovascularization, and granulation), and a remodeling phase. In addition, wound healing occurs under the influence of multiple cytokines, growth factors, and extracellular matrix signals. Figures show the layers of the skin and the cycles of wound healing. 
This review contains 6 highly rendered figures, 8 tables, and 47 references
Keywords: wound, wound care, healing, epithelialization, migration, granulation
Transplantation for the General Surgeon: History of Transplantation, End-organ Disease, Organ Donation and Allocation, and Transplantation Regulation and Ethics
Authors: Nazarian Susanna M , Hwang Jasmine , Gupta Meera , Goldshore Matthew
Published: January 2021

This chapter provides a glimpse of the complex regulatory, financial, ethical, and procedural aspects of transplantation. The general surgeon should appreciate the evolution of the field as seen through a brief review of its history as well as its evolving self-governance as manifested through national policies. Knowledge of the process of organ donation is important for any practitioner as is an understanding of the burden of end-organ disease.

This review contains 2 figures, 1 table and references.
Key Words: brain death, donation after cardiac death, epidemiology and costs of end-organ disease, history of immunosuppression, history of transplantation, living donation, organ allocation, organ donation, transplantation ethics, transplantation regulation
Bedside Procedures for General Surgeons: Part 1
Authors: Cogbill Thomas H. , Marcos Basem S
Published: January 2021

This review focuses on six procedures that are commonly performed by general surgeons in the emergency department, critical care unit, and operating room. Although considered basic procedures, all have their own set of key steps that must be learned, practiced, and mastered. Included in the description for each procedure are technical points that are intended to facilitate successful performance of the procedures and pitfalls to avoid. The most frequent complications for each procedure are briefly discussed in an effort to raise awareness so that they can be recognized and managed expeditiously. Common to all of these procedures is a need to understand the indications based on a careful history, physical examination, and review of pertinent objective data. Whenever possible, informed consent should be obtained from the patient or family prior to the procedure and a complete surgical timeout performed. Sterile technique and personal protective gear/universal precautions should be employed whenever feasible. Finally, these patients should be followed postoperatively and appropriate follow-up studies and/or treatments arranged.
This review contains 19 figures, 7 tables, and 33 references.
Key words: central venous catheter, intraosseous vascular access, needle chest decompression, percutaneous arterial catheter, percutaneous tracheostomy, tracheostomy, venous cutdown
Minimally Invasive Approaches in Liver Surgery
Authors: Lutfi Waseem , Hogg Melissa E
Published: January 2021

Minimally invasive approaches for liver surgery are being increasingly used at highly specialized centers. Both laparoscopic and robotic techniques appear to be associated with improved short-term outcomes such as decreased morbidity and shorter hospital stay. However, there are still concerns with regard to cost-effectiveness and technical training that have prevented widespread dissemination of these techniques. Within the realm of liver surgery, laparoscopic approaches have gained acceptance; however, robotic surgery still remains a relatively new technique. This chapter discusses the preoperative considerations and operative techniques of minimally invasive liver surgery, while also reviewing the current literature detailing short-term and long-term outcomes.

This review contains 6 figures, 5 tables and 33 references
Key Words: clinical trials, laparoscopic, liver cancer, minimally invasive, morbidity, mortality, oncologic outcomes, open, robot-assisted,
Minimally Invasive Approaches in Pancreatic Surgery
Authors: Lutfi Waseem , Hogg Melissa E
Published: January 2021

Minimally invasive approaches for pancreatic resections are being increasingly utilized at highly specialized centers. Both laparoscopic and robotic techniques appear to be associated with improved short-term outcomes such as decreased morbidity and shorter hospital stay. However, there are still concerns with regards to cost-effectiveness and technical training, which have prevented widespread dissemination of these techniques. For pancreatic surgery, both laparoscopic and robotic techniques have gained acceptance for all pancreatic resections, most notably in distal pancreatectomy where minimally invasive approaches have become the standard of care at high-volume centers. This chapter discusses the preoperative considerations and operative techniques of minimally invasive pancreatic surgery while also reviewing the current literature detailing short-term and long-term outcomes.
This review contains 46 references, 6 figures, 5 tables, and 2 videos.
Key Words: clinical trials, laparoscopic, minimally invasive, morbidity, mortality, oncologic outcomes, open, pancreatic cancer, robot-assisted
Principles of Wound Management and Soft Tissue Repair II
Authors: Friedstat Jonathan S. , Coriddi Michelle R , Halvorson Eric G , Disa Joseph J
Published: January 2021

Wound management and soft-tissue repair can vary depending on the location. The head and neck, chest and back, arm and forearm, hand, abdomen, gluteal area and perineum, thigh, knee, lower leg, and foot all have different local options and preferred free flaps to use for reconstruction. Secondary reconstruction requires a detailed analysis of all aspects of the wound including any scars, soft tissue and/or skin deficits, functional defects, contour defects, complex or composite defects, and/or unstable previous wound coverage. Careful monitoring of both the patient and reconstruction is necessary in the postoperative period to ensure long-term success.
 
This review contains 2 figures and 17 references.
Key Words: free tissue transfer, pedicle flaps, soft-tissue coverage, wound closure, wound healing, wound management, wound reconstruction, tissue flaps
Management of Nonthrombotic May-Thurner Syndrome
Authors: Mousa Albeir Y
Published: January 2021

Venous outflow pathology of the lower extremity may be categorized into thrombotic or nonthrombotic etiology. This chapter focuses on the nonthrombotic etiology that results from the compression of the left iliac vein or May-Thurner syndrome (MTS). MTS is an anatomic variant condition associated with venous outflow stenosis due to extrinsic compression of the iliocaval venous segment. The most common cause of the partial obstruction is left iliac vein compression by the overlying right common iliac artery, although other anatomic varieties of MTS do exist. Partial or complete impedance to the venous outflow in the iliocaval venous segment may lead to extensive deep vein thrombosis of the ipsilateral extremity. Clinical presentations may include, but are not limited to, pain, extensive lower-extremity swelling, venous stasis ulcers, and skin discolorations. Treatment is based entirely on the clinical presentation; normally for nonthrombotic MTS, angioplasty and stenting of the diseased iliac vein segment are usually sufficient after defining the location and extent of stenosis. In this review, we (1) describe and define MTS, (2) highlight variable presentations of MTS, and (3) outline the possible management strategies within the current Society for Vascular Surgery updated consensus guidelines.
This review contains 3 Figures, 2 Videos, 3 Tables and 66 references

Key Words: angioplasty, artery compression, deep venous thrombosis, iliac vein, iliofemoral stenosis, May-Thurner syndrome, spur, stent, venogram, venous hypertension
Management of Acute Iliofemoral Deep Vein Thrombosis
Authors: Mousa Albeir Y
Published: January 2021

Acute deep venous thrombosis (DVT) of iliofemoral segment is one of the most dreaded presentations of venous thromboembolism, as it can not only compromise the function of the extremity but may also result in pulmonary embolism and even death. There are many causes for acute iliofemoral DVT, including underdiagnosed May-Thurner syndrome, hypercoagulable syndrome, and external compression on iliocaval segment. The available treatment depends on the acuity of the symptoms. Acute iliofemoral DVT can be treated with medical anticoagulation, pharmacomechanical therapy, including thrombolysis or surgical thrombectomy. Chronic iliofemoral occlusion may be treated with recanalization of the occluded segments with angioplasty stenting.

This review contains 4 Figures, 4 Tables and 63 references

Key Words: acute, angioplasty, deep venous thrombosis, iliofemoral, inferior vena cava, pharmacomechanical therapy, occlusion, stent
New Endoscopic Techniques
Authors: Ge Phillip S , Thompson Christopher C
Published: January 2021

Major advancements in endoscopic techniques have allowed for the minimally invasive endoscopic management of many diseases that previously required surgical intervention. This review briefly describes major advances in endoscopic resection, including endoscopic mucosal resection and endoscopic submucosal dissection; endoscopic ablation, including radiofrequency ablation and cryotherapy; submucosal endoscopy, including peroral endoscopic myotomy and submucosal tunneling endoscopic resection; endoscopic access, including biliary access, pseudocyst drainage and direct endoscopic necrosectomy, and endoscopic gastrojejunostomy; endoscopic management of gastroesophageal reflux disease; and endoscopic management of obesity. Owing to the broad range of topics covered, extensive primary literature is provided for further reference for the interested reader.

This review contains 8 figures and 55 references
Key words: bariatric endoscopy, direct biliary access, endoscopic mucosal resection, endoscopic submucosal dissection, gastroesophageal reflux disease, gastrojejunostomy, peroral endoscopic myotomy, pseudocyst drainage, radiofrequency ablation, submucosal tumors
Efficacy and Safety of Dulaglutide 3.0 mg and 4.5 mg Versus Dulaglutide 1.5 mg in Metformin-Treated Patients With Type 2 Diabetes in a Randomized Controlled Trial (AWARD-11)
Authors: Frias Juan P. , Bonora Enzo , Nevarez Ruiz Luis , Li Ying G. , Yu Zhuoxin , Milicevic Zvonko , Malik Raleigh , Bethel M. Angelyn , Cox David A.
Published: January 2021

OBJECTIVE

To compare efficacy and safety of dulaglutide at doses of 3.0 and 4.5 mg versus 1.5 mg in patients with type 2 diabetes inadequately controlled with metformin.

RESEARCH DESIGN AND METHODS

Patients were randomly assigned to once-weekly dulaglutide 1.5 mg, 3.0 mg, or 4.5 mg for 52 weeks. The primary objective was determining superiority of dulaglutide 3.0 mg and/or 4.5 mg over 1.5 mg in HbA1c reduction at 36 weeks. Secondary superiority objectives included change in body weight. Two estimands addressed efficacy objectives: treatment regimen (regardless of treatment discontinuation or rescue medication) and efficacy (on treatment without rescue medication) in all randomly assigned patients.

RESULTS

Mean baseline HbA1c and BMI in randomly assigned patients (N = 1,842) was 8.6% (70 mmol/mol) and 34.2 kg/m2, respectively. At 36 weeks, dulaglutide 4.5 mg provided superior HbA1c reductions compared with 1.5 mg (treatment-regimen estimand: −1.77 vs. −1.54% [−19.4 vs. −16.8 mmol/mol], estimated treatment difference [ETD] −0.24% (−2.6 mmol/mol), P < 0.001; efficacy estimand: −1.87 vs. −1.53% [−20.4 vs. −16.7 mmol/mol], ETD −0.34% (−3.7 mmol/mol), P < 0.001). Dulaglutide 3.0 mg was superior to 1.5 mg for reducing HbA1c, using the efficacy estimand (ETD −0.17% [−1.9 mmol/mol]; P = 0.003) but not the treatment-regimen estimand (ETD −0.10% [−1.1 mmol/mol]; P = 0.096). Dulaglutide 4.5 mg was superior to 1.5 mg for weight loss at 36 weeks for both estimands (treatment regimen: −4.6 vs. −3.0 kg, ETD −1.6 kg, P < 0.001; efficacy: −4.7 vs. −3.1 kg, ETD −1.6 kg, P < 0.001). Common adverse events through 36 weeks included nausea (1.5 mg, 13.4%; 3 mg, 15.6%; 4.5 mg, 16.4%) and vomiting (1.5 mg, 5.6%; 3 mg, 8.3%; 4.5 mg, 9.3%).

CONCLUSIONS

In patients with type 2 diabetes inadequately controlled by metformin, escalation from dulaglutide 1.5 mg to 3.0 mg or 4.5 mg provided clinically relevant, dose-related reductions in HbA1c and body weight with a similar safety profile.
Local Anesthetics: A Century of Progress
Authors: Yagiela John A.
Published: January 2021

One century after the clinical introduction of cocaine, local anesthesia remains the most important method of pain control in dentistry. Many local anesthetics have been marketed since 1884, and it is likely that attempts to produce drugs that enhance anesthetic efficacy, reduce systemic and local toxicity, and increase nociceptive selectivity, will continue. In addition, new methods of drug administration have been and will be developed to achieve these goals. Of fundamental importance to such improvements are investigations into the pharmacology of drugs with local anesthetic activity and anatomical and physiologic studies pertaining to the reasons why local anesthetics sometimes fail to achieve desired results. This paper reviews recent advances in our understanding of these drugs and their clinical use.
E SE O AIRBNB FOSSE UMA PESSOA: um estudo sobre personalidade de marca na economia compartilhada.
Authors: De Castro Seabra Anderson Leonardo
Published: January 2021

Este estudo verifica a percepção da personalidade da marca Airbnb na perspectiva dos usuários (anfitriões) brasileiros da plataforma por meio da Escala de Personalidade de Marca (BPS) de Aaker (1997). Em paralelo, examina a aplicabilidade das variáveis e dimensões da referida escala para medições generalizáveis de marcas da Economia Compartilhada. Consiste em abordagem quantitativa por meio de aplicação de survey à 82 usuários brasileiros, análise descritiva e análise fatorial exploratória. Resultados indicam a presença das cinco dimensões de personalidade de marca na percepção dos participantes relativa ao Airbnb em corroboração com o modelo de Aaker. Foi verificada predominância das dimensões Competência, Sinceridade e Entusiasmo na percepção dos anfitriões. Também foi indicada pouca significância da dimensão Robustez para o caso. Do ponto de vista gerencial, evidencia as percepções dos usuários a respeito da marca, permitindo ajustes estratégicos, e, na comunicação. Do ponto de vista teórico estende o conhecimento sobre personalidade de marcas no campo do turismo e no contexto da Economia Compartilhada.
ELA OU ELE? REFLEXÕES SOBRE AS QUESTÕES DE GÊNERO EM EMPRESAS FAMILIARES
Authors: Radons Daiane Lindner
Published: January 2021

Este ensaio teórico busca aprofundar a discussão sobre questões de gênero em empresas familiares, verificando elementos de dominação masculina, desafios e perspectivas acerca do assunto na esfera organizacional. Com o decorrer dos anos, mudanças foram percebidas em relação a estrutura familiar, especialmente, com o crescente declínio da família patriarcal. Dessa forma, realiza-se o seguinte questionamento: como as questões de gênero permeiam a dinâmica das empresas familiares? Visando buscar subsídios para elucidar tal indagação, discute-se sobre questões de gênero e dominação masculina, considerando concepções e perspectivas relacionadas às empresas familiares. Demonstra-se que a superação da dominação masculina só é possível através do sentimento do amor, que, com uma concepção valorativa das relações, podem reprimir a produção de desigualdades entre gêneros.
Modelos mentais na pesquisa em aprendizagem organizacional: Uma revisão integrativa
Authors: Adriano Bruna Manuela , Steil Andrea Valéria
Published: January 2021

O trabalho visa revisar pesquisas sobre modelos mentais (MM) e aprendizagem organizacional (AO), sumarizando o estado do conhecimento acumulado da literatura. Para tanto, elaborou-se uma revisão integrativa das publicações indexadas em quatro bases, disponíveis até o ano de 2018. De um total de 137 artigos recuperados 14 foram selecionados e integraram a presente revisão, tratando-se de 8 trabalhos empíricos e 6 teóricos. A literatura aponta que MM são um constructo que permite explicar a passagem da aprendizagem individual para a aprendizagem organizacional (AO), pois a aprendizagem é um processo de explicitação dos MM individuais, assim como de construção e de reconstrução dos MM compartilhados (MME). Ao final, apresenta-se possíveis rumos para as pesquisas no campo.
AWARENESS ABOUT MEDIATION AS AN ALTERNATIVE FORM OF DISPUTE RESOLUTION: PRACTICES IN THE REPUBLIC OF MACEDONIA
Authors: Stoilkovska Aleksandra , Mucunska Palevski Valentina , Ilieva Jana
Published: January 2021

Disputes resolved with the use of mediation as a form of dispute resolution are rare (or at striking level) in the practice in our country. In order to increase the number of disputes that were successfully completed based on mediation, it is necessary for the people to know about the alternative forms of resolving litigation. The lack of information contributes to the lack of trust in any resolution of the dispute except in the court. There is also the positive practice of resolving disputes through mediation macular placed in public. This Paper treats the action research which aims to connect the people awareness of mediation as a form of negotiation through which can quickly and easily, without major financial implications, to resolve any dispute. This paper is based on a survey with the members of Chamber of Mediators of the Republic of Macedonia. These results clearly confirm the lack of information among the local population about the forms of dispute resolution that are available and the benefits they offer.
EEG BASED COGNITIVE WORKLOAD CLASSIFICATION DURING NASA MATB-II MULTITASKING
Authors: Chandra Sushil , Lal Verma Kundan , Sharma Greeshma , Mittal Alok , Jha Devendra
Published: January 2021

The objective of this experiment was to determine the best possible input EEG feature for classification of the workload while designing load balancing logic for an automated operator. The input features compared in this study consisted of spectral features of Electroencephalography, objective scoring and subjective scoring. Method utilizes to identify best EEG feature as an input in Neural Network Classifiers for workload classification, to identify channels which could provide classification with the highest accuracy and for identification of EEG feature which could give discrimination among workload level without adding any classifiers. The result had shown Engagement Index is the best feature for neural network classification.
CASE REPORT: THE USE OF WISC-IV IN ASSESSING INTELLECTUAL FUNCTIONING
Authors: K. Nkyi Anthony
Published: January 2021

The purpose of this paper is to provide detailed description of clinical assessment of the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) that can be used by clinicians to assess the level of intelligence of children and adolescents. The WISC-IV is a standardized intelligence test provides essential information and critical clinical insights into a child’s cognitive functioning. Literature review and analysis of how to interpret the WISC-IV are described. A psychological report of a 15 year African girl with the use of WISC-IV is reported and clinical impression is given. Information from several sources including interviews with parents, test scores and behavioral observations were used to develop a hypothesis about the child’s skills. Her Full Scale IQ of 125 is classified in the superior or higher range of intelligence. Recommendations about how to address problem areas are discussed.
AUGMENTED REALITY AS A TEACHING TOOL IN HIGHER EDUCATION
Authors: Rizov Tashko , Rizova Elena
Published: January 2021

Rapid development of the technology has influenced its inevitable entrance in the learning processes. Teachers are often challenged to use the appropriate educational technology in the process of teaching in order to ease the learning process of students. Introducing new technology in the teaching process should utilize the new technology in any possible way in order to assist the teacher in transferring the knowledge and assist the students in grasping that knowledge. This paper should emphasize the benefits of using augmented reality in higher education, by measuring outcomes of the students which used augmented reality as a teaching tool in the courses. Results from the survey imply that students show significantly improved results in increasing the interest, understanding and interiorizing the learning material. University teachers found that using augmented reality is significantly improving the learning process of students and their teaching process in a pedagogical and technical sense.
QUESTIONING CONVENTIONS: ARE PRODUCT CONVENTIONS TRADING OFF THE USABILITY OF PRODUCTS FOR SHORT TERM USER SATISFACTION
Authors: Gough Young Bryan , Wodehouse Andrew , Sheridan Marion
Published: January 2021

Mapping conventions are a key aspect of user centered design as they present users with familiar interactions in unfamiliar products. Conventions evolve over time and are slow to be adopted, requiring a high percentage of acceptance within a society, ensuring that conventions exhibit a sufficient level of usability. However this paper argues that while usability is a necessary condition for good interactions it is not a sufficient one. Therefore user centered design which accents individuals bias towards conventions my in fact be hindering the innovation of product interactions. This paper argues that a cognitive approach should be adopted in order understand and reassess product interactions. An experiment was carried out that demonstrates the influence that simple mappings can have on cognitive load. The results showed that basic mappings of the types that are found throughout product conventions can have a substantial impact on mental load and subsequently product interaction.
KNOWLEDGE SHARING IN AN ORGANIZATION FROM THE PERSPECTIVE OF THE INDIVIDUAL
Authors: Mesner Andolšek Dana , Andolšek Stanislav
Published: January 2021

Authors introduce a theoretical model of knowledge sharing in an organization through individual perspective. The social exchange theory offers a clarification of fundamental assumptions regarding individual action and is therefore appropriate for explaining why and when an individual is ready to share her/his knowledge in an organization. The article aims to reveal what shapes employees’ decisions to share knowledge in a work situation and what is needed in an organization to facilitate individuals to share and not to hoard their knowledge. These assumptions have never been included in the literature of knowledge management up until now.
An Automated Approach of Detection of Memory Leaks for Remote Server Controllers
Authors: Bhavana D  , Veena M B  , Santosh Kumar Sahu
Published: January 2021

Memory leaks are a major concern to the long running applications like servers which make the working set to grow with the program. This eventually leads to system crashing. This paper discusses a staged approach to detect leaks in firmware of remote server controller. Remote server controller monitors the server remotely with many processes running in the background. Any memory leak in the long running applications pose a threat to the performance of the system. The approach adopted here filters the processes running in the system with leaks based on time threshold in the first stage. These processes with leaks are passed to the next stage where precise memory leak detection is done using the open source dynamic instrumentation tool Valgrind. The system leverages an automated leak detection approach that invokes the leak detection process on encountering any severity in the system and generates a consolidated leak report. The proposed approach has less impact on the performance of the system and is faster compared to many available systems as there is no need to modify or re-compile the program. In addition, the automated approach offers an effective technique for detecting possible leakages in early software development phases.
Resistensi Warga di Bantaran Ciliwung terhadap Rencana Penggusuran oleh Pemerintah
Authors: Pramudita Pramudita , Gunawan Budhi , Riawanty Selly
Published: January 2021

This paper focuses on the topic of normalization which apparently is not always acceptable to the community, it raises resistance to the community. In this study entitled "Citizens Resistance in Ciliwung River Against Plans for Eviction by the Government ", the researcher looked at how the resistance patterns carried out by the people in the Low Land area. The method used in this research is in-depth interviews. This research is descriptive-qualitative in nature. The results of this study indicate that resistance by residents in the region is closed and categorized as closed resistance. In hidden transcripts it appears that citizens obey the government by reporting the area of land and buildings and agreeing on the area of land and buildings that have been measured by officials from the National Land Agency, but in public transcripts the citizens clandestinely continue to show disapproval of the normalization program from the government
Peningkatan Kemampuan Berpikir Kritis Mahasiswa pada Media melalui Film dan Model Discovery Learning
Authors: Bahruddin Muh.
Published: January 2021

This study aims to determine the increase in critical thinking skills of Visual Communication Design studens at Universitas Dinamika in the mass media. This research focuses on the ability to identify, discover, and solve problems. Researcher used a film medium called "Green Hornet" (2011) by Michel Gondry combined with the discovery learning model. This film tells the story of the production process of the media (newspapers) in the hands of readers. There are interference from media owners, journalists, and other conditions on an issue that will be published by the media. The "discovery learning" model provides an opportunity for students to actively search for, gather, and compile information in order to describe a knowledge. While a lecturer provide data or instructions (models) to find out what students must learn. The lecturer must also review and provide a review of the student's independent learning outcomes. Researcher ask questions that fit the indicators of critical thinking using newspapers and television media. The results of this study were the students' critical thinking skills improved. In cycle 1, students are able to increase their critical power when identifying titles, subtitles, words, phrases, sentences, paragraphs, and captions. While in cycle 2, improvement occurs when students identify images or visuals, tables, charts, and problem solving.
Women Empowerment in Talent Group Interest Activities at Satya Wacana Christian University
Authors: Nababan Kristina Roseven , Kurniawati Kurniawati , Shamsahara Rigma Vellanika
Published: January 2021

This research aims to obtain an overview of gender equality in the Talent Group Interest (KBM) activities at Satya Wacana Christian University. This research used a qualitative method, where each data is taken from the observation and interviews with the research subject consisting of the Chairman and members of the KBM existing in the University and the validity technique of data using the triangulation of the source and method. The results found in this study were that gender equality and the opportunities that women had in occupying certain positions existed in each KBM were the same and there was no distinction between women and men, especially in terms of leadership. It is explained that anyone can occupy a specific position with conditions and criteria that have been determined and must be able to be accountable to the KBM. It proves that men and women have the same rights to continue to arise and strive for the sake of the KBM. Besides some of the advantages of the KBM if led by women have the opportunity to be more advanced, because women are seen more thoroughly and more attention to detail matters. The weakness that can arise when it is not possible to decline when women are difficult in determining decisions and need support from other members of both men and women to find the solutions.
Pelaksanaan Keterbukaan Informasi Publik di Universitas Jambi: Suatu Telaah Normatif
Authors: Putra Akbar Kurnia , Kadir Sulhi Muhammad Daud Abdul
Published: January 2021

Openness of public information is one of the pillars of freedom of expression and the pillars of democracy, transparency and good governance. To encourage public participation, Law Number 14 of 2008 concerning Openness of Public Information was born. The provision regulates social norms to obtain data access and guarantees that each individual fulfills his basic rights. This research is focused on the implications of these regulations at the University of Jambi. As a public body, the University of Jambi is required to apply all the provisions that have been set. Aside from being a controlling system, this policy must be addressed as part of bureaucratic reform, especially regarding good governance so that the fundamental changes that occur are directly proportional to the area of change desired. The research methodology uses the normative type of jurisprudence, namely by examining the legal literature through the study of documents with the nature of analytic description so as to produce systematic factual basis.