bluuebunny/crossref_metadata_2025 huggingface dataset:
Suture and Fixation of the Transversalis Fascia during Robotic-Assisted Transabdominal Preperitoneal Hernia Repair to Prevent Seroma Formation after Direct Inguinal Hernia Repair
Authors: Pini Ramon , Mongelli Francesco , Proietti Francesco , Cianfarani Agnese , Garofalo Fabio , Di Giuseppe Matteo , La Regina Davide
Published: September 2020

Background. Seroma formation after videoendoscopic repair of inguinal hernias, known as “pseudorecurrence”, may vary from an asymptomatic, self-limiting occurrence to a painful, chronic problem. The aim of this study was to investigate the incidence of postoperative seroma in robotic-assisted transabdominal preperitoneal hernia repair (R-TAPP), modified by suturing and fixating the transversalis fascia to the Cooper ligament. Methods. The study was approved by the local ethics committee (2019-01132 CE-3495). Patients undergoing R-TAPP for direct inguinal hernia from October 2017 to December 2019 were included. In all patients, a barbed running suture of the transversalis fascia was performed to close the cavity resulting from the direct hernia reduction and to fix it to the Cooper ligament, then a lightweight mesh was placed. Demographic and clinical data were collected and analysed. Results. Over the study period, 67 R-TAPP in 51 patients were identified. All patients were male, with a mean age of 63.1 ± 12.7  years. There was 1 case of conversion to open surgery due to adhesions of the caecum to the groin as a result of perforated appendicitis. The mean length of the hospital stay was 1.8 ± .6  days. After discharge, no cases of seroma or recurrence at 30  days nor chronic pain at a mean follow-up of 10.3 ± 6.8  months was detected. Conclusions. In the treatment of direct inguinal hernia with R-TAPP, suturing and anchoring the transversalis fascia to the Cooper ligament are safe, feasible and recommendable in order to prevent postoperative seromas.
Men and COVID-19: A Pathophysiologic Review
Authors: Lipsky Martin S. , Hung Man
Published: September 2020

Coronaviruses are single-stranded ribonucleic acid viruses that can cause illnesses in humans ranging from the common cold to severe respiratory disease and even death.In March 2020, the World Health Organization declared the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the first pandemic. Compared to women, most countries with available data report that men with COVID-19 have greater disease severity and higher mortality. Lab and animal data indicate that men respond differently to the SARS-CoV-2 infection, offering possible explanations for the epidemiologic observations. The plausible theories underlying these observations include sex-related differences in angiotensin-converting enzyme 2 receptors, immune function, hormones, habits, and coinfection rates.In this review we examine these factors and explore the rationale as to how each may impact COVID-19. Understanding why men are more likely to experience severe disease can help in developing effective treatments, public health policies, and targeted strategies such as early recognition and aggressive testing in subgroups.
Study on the scouring-bleaching technology of Xinjiang scutched flax
Authors: Li Zhijiang , Yu Tianru , Yu Lichao
Published: September 2020

This study explored and improved the optimal scouring-bleaching process of Xinjiang scutched flax, based on its characteristics and the scouring-bleaching process of existing mature flax. The physical properties, such as length, strength, split degree and fineness, and the chemical composition of Xinjiang scutched flax, such as the content of cellulose, lipowax, pectin, hemicellulose, water-soluble matter, lignin, etc., were measured and analyzed. The approximate range of bleaching process parameters was determined referring to the existing general flax scouring-bleaching process. Thirdly, the orthogonal experiment of three factors and three levels interaction is designed, and the optimal scouring-bleaching process scheme is obtained after analysis and verification.
The Association of AUSCAN and PRWHE Patient-reported Outcome Measures With Radiographic Progression of Early Thumb Carpometacarpal Arthritis at 36-Month Follow-up Is Limited to Subtle Changes in the Pain Subscale
Authors: Gil Joseph A. , Kleiner Justin , McQuillan Thomas J. , Kenney Deborah , Ladd Amy L. , Weiss Arnold-Peter C. , Crisco Joseph J.
Published: September 2020

Background

There is a paucity of literature that examines how patient-reported outcomes correspond to early radiographic progression of thumb carpometacarpal (CMC) osteoarthritis (OA). This study examines how Australian/Canadian Osteoarthritis Hand Index (AUSCAN) and Patient-Rated Hand and Wrist Evaluation (PRWHE) scores change over 36 months in subjects with early CMC OA.

Methods

Ninety-one subjects with symptomatic early thumb CMC OA were enrolled. Differences in AUSCAN and PRWHE scores were measured between subjects at baseline and at 18-month follow-up, and between the subjects at baseline and at 36-month follow-up. Radiographic progression was defined as an increase in modified Eaton Stage. Differences in AUSCAN and PRWHE scores were compared between these 2 groups in order to determine if radiographic progression was associated with a greater change in AUSCAN and PRWHE at 18- and 36-month follow-up.

Results

At 18- and 36-month follow-up visits, there were no significant differences in AUSCAN or PRWHE compared to baseline. Multivariable logistic regression analysis did not reveal any significant differences between subjects with radiographic progression to subjects without radiographic progression at 18-month follow-up. At 36-month follow-up, this analysis did demonstrate that subjects with evidence of radiographic progression had a significant increase in the PRWHE pain subscale.

Conclusion

AUSCAN and PRWHE scores were not found to significantly progress at 18-month and 36-month follow-up. However, when comparing the subset of subjects with and without radiographic OA, subjects with early CMC OA who had 1 stage of radiographic progression were found to have a significantly higher intensity of pain on the PRWHE pain subscale at 36-month follow-up.
An Anatomical Evaluation of the Trapezium and Its Relationship to Basilar Joint Osteophytic Change
Authors: Flanagan Christopher D. , Tamer Pierre , Cooperman Daniel R. , Crisco Joseph J. , Ladd Amy L. , Liu Raymond W.
Published: September 2020

Background

To perform a comprehensive osteologic investigation into trapezium anatomy and investigate the relationship between anatomical factors and osteophyte formation, focusing on sex-specific differences.

Methods

This was a cadaveric study involving 1233 trapezia and first metacarpals. Two subgroups (“Control” and “Main Study”) were established. The “Control” cohort was used to identify features of the trapezium in specimens devoid of osteophytic change. The prevalence and severity of osteophytic change were investigated in the “Main Study” cohort. Sex differences were specifically assessed. Regression analyses were used to identify factors associated with osteophyte formation.

Results

Three discrete surface morphologies exist at the trapezium trapeziometacarpal (TM) facet: heart, quadrilateral, and bean. Controlling for height, men have a larger trapezium TM facet surface area. However, the trapezium assumes the same off-center saddle shape in both sexes. The presence of osteophytes at the basilar joint is a common finding; no differences in osteologic prevalence exist between sexes. The progression of osteophytic change complements the radiographic Eaton-Littler classification system. The trapezium TM facet increases the surface area with incremental osteophyte involvement, with the degree of surface area expansion correlated with increases in the severity of osteophytic change. Increased age, increased surface area, bean morphology, and decreased volar joint depth are associated with more severe osteophyte formation.

Conclusions

Anatomical features of the trapezium may contribute to osteophyte development. Although the prevalence of osteophytic disease appears equal between sexes, sex differences exist in some anatomical parameters. These differences may help explain the increased prevalence of symptomatic basilar joint disease in women.
Adaptive output feedback control for a class of uncertain non-strict feedback systems with asymmetric time-varying output constraints
Authors: Wan Min , Huang Shanshan
Published: September 2020

This study investigated a novel adaptive output feedback control scheme for non-strict feedback nonlinear systems with uncertainties, disturbances, and asymmetric time-varying output constraints. Because that the states of the system are unmeasurable, we used an adaptive fuzzy state observer to obtain the estimated values of the states. To make the output and tracking error satisfy their asymmetric time-varying constraints, an asymmetric time-varying barrier Lyapunov function was adopted. To overcome the “explosion of complexity” problem, we also adopted the dynamic surface control technology. The stability of the closed-loop system was proved by the Lyapunov method, and we give two simulation examples to show the effectiveness of the proposed control method.
Nonlocal spatial attention module for image classification
Authors: Chen Bingling , Huang Yan , Xia Qiaoqiao , Zhang Qinglin
Published: September 2020

To enhance the capability of neural networks, research on attention mechanism have been deepened. In this area, attention modules make forward inference along channel dimension and spatial dimension sequentially, parallelly, or simultaneously. However, we have found that spatial attention modules mainly apply convolution layers to generate attention maps, which aggregate feature responses only based on local receptive fields. In this article, we take advantage of this finding to create a nonlocal spatial attention module (NL-SAM), which collects context information from all pixels to adaptively recalibrate spatial responses in a convolutional feature map. NL-SAM overcomes the limitations of repeating local operations and exports a 2D spatial attention map to emphasize or suppress responses in different locations. Experiments on three benchmark datasets show at least 0.58% improvements on variant ResNets. Furthermore, this module is simple and can be easily integrated with existing channel attention modules, such as squeeze-and-excitation and gather-excite, to exceed these significant models at a minimal additional computational cost (0.196%).
What impact do specialist and advanced-level nurses have on people living with heart failure compared to physician-led care? A literature review
Authors: Anderson Dean A , Clemett Victoria
Published: September 2020

Background

The inclusion of specialist nurses in multi-disciplinary teams is the current gold standard for care of people with heart failure (HF) in the UK; however, they remain underutilised in practice. Though existing systematic reviews favourably compare advanced nursing roles to physician-led care, none has focused solely on HF.

Aim

To investigate the impact of specialist and advanced nurse-led care on the clinical outcomes, quality of life and satisfaction of people with HF compared to physician-led care.

Methods

Literature review and narrative synthesis.

Results

This review included 12 studies and categorised their measured outcomes into five domains: mortality; hospital admissions and length of stay; HF diagnosis and management; quality of life and patient satisfaction; and finally, self-assessment and self-care. Five studies appraised as medium or low risk of bias suggest the impact of specialist and advanced-level nurses on people with HF to be broadly equivalent to physicians regarding mortality, hospital admissions and length of stay, while superior in terms of self-assessment and self-care behaviours.

Conclusions

There were too few studies of sufficient methodological quality to draw definitive conclusions. However, no evidence was found to suggest that nurse-led services are any less effective or safe than physician-led services.
FOLFIRINOX in borderline resectable and locally advanced unresectable pancreatic adenocarcinoma
Authors: Yoo Changhoon , Hwang Inhwan , Song Tae Jun , Lee Sang Soo , Jeong Jae Ho , Park Do Hyun , Seo Dong Wan , Lee Sung Koo , Kim Myung-Hwan , Byun Jae Ho , Park Jin-hong , Hwang Dae Wook , Song Ki Byung , Lee Jae Hoon , Lee Woohyung , Chang Heung-Moon , Kim Kyu-pyo , Kim Song Cheol , Ryoo Baek-Yeol
Published: September 2020

Background:

Despite the scarcity of data based on randomized trials, FOLFIRINOX is widely used in the management of borderline resectable pancreatic cancer (BRPC) and locally advanced unresectable pancreatic cancer (LAPC). We investigated the clinical outcomes of neoadjuvant FOLFIRINOX in patients with BRPC and LAPC.

Methods:

This single-center retrospective analysis included a total of 199 consecutive patients with BRPC or LAPC who received conventional or modified FOLFIRINOX between February 2013 and January 2017. An independent radiologist reviewed all baseline computed tomography or magnetic resonance imaging scans were reviewed for vascular invasion status.

Results:

With median follow-up duration of 40.3 months [95% confidence interval (CI), 36.7–43.8] in surviving patients, median progression-free survival (PFS) and overall survival (OS) were 10.6 (95% CI, 9.5–11.7) and 18.1 (95% CI, 16.0–20.3) months, respectively. The 1-year PFS rate was 66.0% (95% CI, 65.3–66.7%), and the 2-year OS rate was 37.2% (95% CI, 36.5–37.9%). PFS and OS did not differ between BRPC and LAPC groups [median PFS, 11.1 months (95% CI, 8.8–13.5) versus 10.1 months (95% CI, 8.4–11.8), p = 0.47; median OS, 18.4 months (95% CI, 16.1–20.8) versus 17.1 months (95% CI, 13.2–20.9), p = 0.50]. Curative-intent conversion surgery (R0/R1) was performed in 63 patients (31.7%). C•A 19-9 response, objective tumor response to FOLFIRINOX, and conversion surgery were independent prognostic factors for OS.

Conclusion:

FOLFIRINOX was effective for management of BRPC and LAPC. Given the potential for cure, a significant proportion of patients can undergo conversion curative-intent surgery following FOLFIRINOX.
Can publicly reported data be used to understand performance in an Australian rural hospital?
Authors: Lloyd Sheree , Cliff Cynthia , FitzGerald Gerard , Collie Jean
Published: September 2020

Background:

Despite agreement among policymakers, funders, consumers and researchers about the value of public reporting of health information, limited attention has been paid to how it can be used to understand the performance of rural hospitals.

Objective:

To determine whether publicly available information can be used to measure health service performance in a rural hospital.

Method:

The study used performance data routinely reported for public consumption in Australia. Data across four domains, multiple measures and time periods were collected to examine access and equity; efficiency and sustainability; quality, safety and patient orientation; and employee engagement. Performance of the rural hospital was examined using a visualisation tool.

Results:

Visualisation of multiple measures of performance over time was achievable but required a high degree of health information management skills.

Conclusion and implications:

Publicly reported data can be used to represent performance for a rural hospital. Timeliness, level of detail available and peer groupings of data limits optimal utility. Consumers, clinicians and health service managers wanting to understand the performance of rural hospitals will need to use significant health information management skills to gain a picture of performance. Further research in the applied use of publicly available performance data and relevant dashboards for rural hospitals is suggested.
Demonstrating the Clinical Impact of Continuous Glucose Monitoring Within an Integrated Healthcare Delivery System
Authors: Isaacson Brad , Kaufusi Stephanie , Sorensen Jeff , Joy Elizabeth , Jones Christopher , Ingram Valerie , Mark Nickolas , Phillips Mike , Briesacher Mark
Published: September 2020

Background:

Approximately 30 million Americans currently suffer from diabetes, and nearly 55 million people will be impacted by 2030. Continuous glucose monitoring (CGM) systems help patients manage their care with real-time data. Although approximately 95% of those with diabetes suffer from type 2, few studies have measured CGM’s clinical impact for this segment within an integrated healthcare system.

Methods:

A parallel randomized, multisite prospective trial was conducted using a new CGM device (Dexcom G6) compared to a standard of care finger stick glucometer (FSG) (Contour Next One). All participants received usual care in primary care clinics for six consecutive months while using these devices. Data were collected via electronic medical records, device outputs, exit surveys, and insurance company (SelectHealth) claims in accordance with institutional review board approval.

Results:

Ninety-nine patients were randomized for analysis ( n = 50 CGM and n = 49 FSG). CGM patients significantly decreased hemoglobin A1c ( p = .001), total visits ( p = .009), emergency department encounters ( p = .018), and labs ordered ( p = .001). Among SelectHealth non-Medicare Advantage patients, per member per month savings were $417 for CGM compared to FSG, but $9 more for Medicare Advantage. Seventy percent of CGM users reported that the technology helped them better understand daily activity and diet compared to only 16% for FSG.

Discussion:

Participants using CGM devices had meaningful improvements in clinical outcomes, costs, and self-reported measures compared to the FSG group. Although a larger study is necessary to confirm these results, CGM devices appear to improve patient outcomes while making treatment more affordable.
Stability and Change: The Dark Factor of Personality Shapes Dark Traits
Authors: Zettler Ingo , Moshagen Morten , Hilbig Benjamin E.
Published: September 2020

The Dark Factor of Personality (D) is conceptualized as the basic disposition out of which “dark” traits arise as specific manifestations. We herein critically test this conceptualization across nine dark traits in a 4-year longitudinal study with N = 1,261 ( n = 470 at the second measurement occasion, employing full information maximum likelihood estimation) adults from the general population. Results strongly support the conceptualization of D. Specifically, D (1) showed high rank-order stability (higher than any of the dark traits), substantiating that it represents a basic disposition; (2) longitudinally predicted individual differences in all dark traits; and (3) accounted for personality changes in dark traits. Additionally, we investigated the pattern of mean-level change of D and the dark traits. In line with the maturity principle of personality development, D (and most dark traits) decreased with age.
Peace of mind: A community-industry-academic partnership to adapt dementia technology for Anishinaabe communities on Manitoulin Island
Authors: Jacklin Kristen , Pitawanakwat Karen , Blind Melissa , Lemieux Andrine M , Sobol Adam , Warry Wayne
Published: September 2020

Introduction

Aging Technologies for Indigenous Communities in Ontario (ATICON) explores the technology needs of Anishinaabe older adults in the Manitoulin region of Northern Ontario. Our program of research addresses inequitable access to supportive technologies that may allow Indigenous older adults to successfully age in place.

Methods

Using Indigenous research methodologies (IRM) and community-based participatory research (CBPR) we explored the acceptability of CareBand - a wearable location and activity monitoring device for people living with dementia using a LoRaWAN, a low-power wide-area network technology. We conducted key informant consultations and focus groups with Anishinaabe Elders, formal and informal caregivers, and health care providers (n = 29) in four geographically distinct regions.

Results

Overall, participants agreed that CareBand would improve caregivers’ peace of mind. Our results suggest refinement of the technology is necessary to address the challenges of the rural geography and winter weather; to reconsider aesthetics; address privacy and access; and to consider the unique characteristics of Anishinaabe culture and reserve life.

Conclusion

All three partners in this research, including the Indigenous communities, industry partner, and academic researchers, benefited from the use of CBPR and IRM. As CareBand is further developed, community input will be crucial for shaping a useful and valued device.
Is Endoscopic Discectomy the Next Gold Standard in the Management of Lumbar Disc Disease? Systematic Review and Superiority Analysis
Authors: Muthu Sathish , Ramakrishnan Eswar , Chellamuthu Girinivasan
Published: September 2020

Study Design:

Systematic review and meta-analysis.

Objectives:

We performed this meta-analysis to evaluate whether endoscopic discectomy (ED) shows superiority compared with the current gold standard of microdiscectomy (MD) in management of lumbar disc disease.

Materials and Methods:

We conducted independent and duplicate electronic database search including PubMed, Embase, and Cochrane Library from 1990 till April 2020 for studies comparing ED and MD in the management of lumbar disc disease. Analysis was performed in R platform using OpenMeta[Analyst] software.

Results:

We included 27 studies, including 11 randomized controlled trials (RCTs), 7 nonrandomized prospective, and 9 retrospective studies involving 4018 patients in the meta-analysis. We stratified the results based on the study design. Considering the heterogeneity in some results between study designs, we weighed our conclusion essentially based on results of RCTs. On analyzing the RCTs, superiority was established at 95% confidence interval for ED compared with MD in terms of functional outcomes like Oswestry Disability Index (ODI) score ( P = .008), duration of surgery ( P = .023), and length of hospital stay ( P < .001) although significant heterogeneity was noted. Similarly, noninferiority to MD was established by ED in other outcomes like visual analogue scale score for back pain ( P = .860) and leg pain ( P = .495), MacNab classification ( P = .097), recurrences ( P = .993), reoperations ( P = .740), and return-to-work period ( P = .748).

Conclusion:

Our meta-analysis established the superiority of endoscopic discectomy in outcome measures like ODI score, duration of surgery, overall complications, length of hospital stay and noninferiority in other measures analyzed. With recent advances in the field of ED, the procedure has the potential to take over the place of MD as the gold standard of care in management of lumbar disc disease.
A Rare Case of Cryptococcus gattii Meningitis in Advanced HIV Disease, Sagittal Thrombosis, and Immune Reconstitution Syndrome, Resolved With Isavuconazonium
Authors: Okudo Jerome , Civelli Valerie F. , Narang Vishal K. , Johnson Royce H. , Khan Nadir , Andruszko Brittany , Heidari Arash
Published: September 2020

Cryptococcus gattii is a species that has received more recognition in the recent past as distinct from Cryptococcus neoformans. C gattii is known to cause meningeal disease in both immunocompetent and immunosuppressed hosts. Patients may be clinically asymptomatic until immunosuppressive conditions occur such as corticosteroid treatment or an HIV infection. HIV-associated cryptococcal infections are most often due to C neoformans. C gattii is found in a minority. Speciation and subtyping of Cryptococcus are not always accomplished. In many parts of the world, there is no availability for speciation of Cryptococcus. Travel history may provide a clue to the most probable species. This case demonstrates a case of C gattii meningitis with a multiplicity of complications. These include advanced HIV disease secondary to nonadherence, immune reconstitution inflammatory syndrome, and superior sagittal sinus thrombosis. The patient represented diagnostic and therapeutic dilemmas over time. Headache was the primary symptom in cryptococcal meningitis, immune reconstitution inflammatory syndrome, and superior sagittal sinus thrombosis. All are discussed in detail as potential etiologies for the primary disease. Isavuconazonium is a relatively new broad-spectrum antifungal azole that was used as salvage therapy.
Return to Play and Performance in the Women’s National Basketball Association After Anterior Cruciate Ligament Reconstruction
Authors: Tramer Joseph S. , Khalil Lafi S. , Ziedas Alexander , Mehran Nima , Okoroha Kelechi R.
Published: September 2020

Background:

The incidence of anterior cruciate ligament (ACL) injuries in Women’s National Basketball Association (WNBA) athletes continues to increase. There is a paucity of data regarding return-to-play (RTP) rates and performance after ACL reconstruction in these athletes.

Purpose:

To quantify RTP rates and performance after ACL reconstruction in WNBA athletes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All ACL tears sustained in the WNBA from 1997 through 2018 were identified. Body mass index (BMI), age, and position at the time of injury were collected for each player. RTP rates were calculated, and performance data were collected for each player before and after injury to determine changes in playing time and statistical performance. Players who successfully returned to play after ACL reconstruction were compared with a group of healthy controls who were matched by age, years of experience, position, height, and BMI. Statistics at 1 and 3 years after injury were compared to assess acute and longitudinal changes in performance relative to preinjury baseline.

Results:

A total of 59 WNBA players sustained ACL tears during the study period, and 41 (69.5%) were able to successfully RTP. Players played a mean of 7.5 ± 12.8 fewer games, played 5.0 ± 9.2 fewer minutes per game, and scored 3.7 ± 5.0 fewer points per game in their first year after RTP compared with the year before injury. Athletes with ACL reconstruction demonstrated significantly decreased performance measures regarding games played, games started, minutes, rebounds, assists, and blocks per game in their first season after RTP compared with control athletes in the same indexed year; however, these differences resolved by year 3 after surgery.

Conclusion:

WNBA athletes have a high RTP rate after ACL reconstruction. Players may experience an initial decrease in playing time and performance when returning to play; however, these variables were found to return to baseline over time.
How Do Surgeon Preferences and Technique Variances Affect Outcome?
Authors: Axiopoulou Anastasia , Lin Katherine , Watson Keith , Cao Caroline G.L.
Published: September 2020

Surgeons’ training can greatly influence their surgical approach and tool selection. A hierarchical task analysis and time analysis were conducted to compare differences in the use of two different surgical tools in robot-assisted hysterotomy. Hysterectomy is a common surgery performed to remove the uterus, requiring complete visualization of the anatomy field and movement control of the uterus. This manipulation of the uterus can be accomplished by either a uterine manipulator or a myoma screw. Results revealed that even though the surgical tasks and subtasks were similar, the visual presentation of critical anatomy was vastly different. The uterine manipulator with a colpotomizer cup provided clear delineation of the cervicovaginal canal, while allowing easier manipulation of the uterus. The myoma screw provided minimal visual aid, limited manipulation of the uterus, and possibly more bleeding from penetrating the uterus. The uterine manipulator may be a better choice for less experienced surgeons.
Understanding Work-Related Injury Risk Among Montana Rehabilitation Clinicians
Authors: Ma Jiahui , Smith Tamera , Fitzgerald Macy , McCrory Bernadette
Published: September 2020

Background: Rehabilitation clinicians face a high risk of occupational injury. Work-related musculoskeletal disorders (WMSDs) are one of the most frequent injuries for these rehabilitation clinicians due to repeated heavy lifting and other forceful tasks. The objective of this study was to identify factors which caused or contributed to WMSDs for clinicians specifically working in rehabilitation settings (e.g., acute care, inpatient rehabilitation, long-term care, skilled nursing, outpatient therapy). Methods: A multifaceted pilot survey was conducted of Montana physical and occupational therapists working at a rural, Montana community hospital. Information on general workload, work-related pain or discomfort, patient handling and clinical experience were gathered using both a scripted interview questionnaire and a semi-scripted post-interview discussion. The survey contained five different categories and took approximately 20 minutes to complete. Six therapists from a local community hospital participated in the pilot survey. Results: Subjects (n=6) were all female and had an average age of 43 with standard deviation of 10. On average, these acute care rehabilitation therapists spent five to eight hours per day delivering “hands on” care to patients. During a typical workday, therapists spent 32% of the time heavy lifting, 37% kneeling/squatting, and 39% bending/twisting. Around half suffered musculoskeletal pain or discomfort but continued to work during the past year. Most pain was caused by transferring and repositioning patients. The clinicians’ necks, middle backs and wrists/hands suffered the most severe pain or discomfort. Adequate mobile floor and overhead lifting equipment as well as a shortage of therapeutic lifting device were reported from the survey. Non-mechanical lifting aids like sit-to-stand aids, friction reducing device and multi-handled gait belts was reflected inadequate for clinicians. Discussion: Physical therapists and occupational therapists are at higher risk for WMSDs due to patient handling tasks. There is limited inpatient therapy resources throughout Montana. More user-friendly and therapeutic patient handling equipment and therapeutic training are required. Application: This study highly followed the principle of core competencies for public health professionals to provide evidence-based results and systematic design to assess the risk of patient handling. Future Research: To study causal factors of WMSDs related to patient handling, additional interviews will be collected across Southwest Montana’s health system.
Moderation is the Key to Successful Human Factors Studies
Authors: Haggerty Laura
Published: September 2020

Human factors usability studies play an important role in the product development process. To yield valid and useful data from these formative and validation studies there must be effective moderation. In study sessions with participants, moderators must play the role of unbiased facilitator, perceptive observer, and curious researcher. In all studies, positive interactions and effective communication between moderator and participant can establish the rapport necessary to spark meaningful and honest discussions. From the conversational focus group to the passive moderation of a validation study, involvement and interactions with participants can vary greatly. Furthermore, consideration must be given to the stage of device development and the goals of the study. Strong moderation is the cornerstone of any successful usability study, opening the doors to valuable insights and thorough evaluations.
Recurrence Quantification Analysis of Postural Stability with Pendant-Based IMU under Varying Balance Conditions
Authors: Lyu Shubo , Yang Hui , Piazza Stephen J. , Downs Danielle Symons , Freivalds Andris
Published: September 2020

Recurrence quantification analysis (RQA) has been widely implemented as a nonlinear data analysis method in multiple research areas and has shown good potential for the study of human postural stability. Dynamic features identified by RQA may be useful for characterizing balance disorders using inertial measurement units (IMUs) placed on the lower back near the body’s center of mass. However, wearing IMU sensors may be challenging for some specific populations at risk for falling such as pregnant women due to discomfort and lack of fit. A novel pendant-based IMU sensor was proposed and shown to have good sensitivity to postural instability in different standing tasks, when compared with the sensor worn on the lower back with a waist belt. This study’s objective is to evaluate the sensitivity of the pendant sensor to balance perturbations using RQA-the nonstationary method. Six RQA measurements (%recurrence, %deterministic, linemax, entropy, %laminarity, trapping time) were extracted for data analysis. The objective of this research is to validate whether the pendant-based sensor can distinguish different balance conditions as well as or better than a sensor on a waist belt using RQA measurements.
Exploring the Use of Multimedia Resources in Online Medical Education: A Targeted Literature Review
Authors: Mansour Lauren A. , Amin Sabrina A. , Chirumamilla Varshita , Sushereba Christen E. , Militello Laura , Wolf Steve , San Miguel Christopher E , Barrie Michael , Ramachandran Sowmya , Patterson Emily S.
Published: September 2020

Immersive technologies, which include augmented, virtual, and mixed reality are increasingly accessible to educators. For this literature review, we assessed the gaps that exist in current literature that have the potential to be filled by immersive technology. Five key websites were used to identify resources specific to pneumothorax anatomy. The relevant results are reported. Our findings revealed that there are many gaps in medical education resources for anatomy training, diagnosing, and treatment complications of tension pneumothorax. These gaps emphasize that other medical training media could be utilized to give medical students a more holistic experience when learning how to treat patients with tension pneumothorax. Augmented reality could be used to incorporate additional learning objectives, filling many of the gaps exposed in our literature review.
Integrating Cognitive Task Analysis in a PhD-Level Applied Health Sciences Qualitative Methods Course
Authors: Papautsky Elizabeth Lerner , Kaelin Vera C. , Vatani Haleh
Published: September 2020

We discuss the integration of naturalistic decision making theoretical perspective and cognitive task analysis methods (CTA) in a PhD level qualitative methods courses offered to applied health sciences students. Students planned and executed a mini CTA project that included identification of a research question, development of a proposal with an interview guide, recruitment of participants, data collection and analysis, and documentation. We share a reading list and discuss the benefits and challenges of offering this course project.
Valuable, but not useful: Barriers to use in implementation of patient reported outcomes
Authors: Pruitt Zoe , Schubel Laura C. , Dixit Ram , Littlejohn Robin , Hsiao Chun-Ju , Wesley Deliya
Published: September 2020

Patient-reported outcome (PRO) measures can capture a patient’s perspective on their health. In an effort to increase use of PROs in ambulatory practice, an app-based survey tool was tested in nine diverse ambulatory settings. The Office of the National Coordinator for Health Information Technology’s (ONC) PRO FHIR Implementation Guide was used to modify an existing app. The app was utilized in nine diverse ambulatory settings with ninety patients. Nine interviews with patients and nine interviews with providers were completed during the data collection process to better understand the facilitators and barriers to implementation. The interviews revealed that human computer interaction, survey relevance, and clinical context could all have a significant impact on the success of a PRO app implementation.
Portable Gait Analysis System with an Integration of Kinect sensor and Inertial Measurement Units
Authors: Saravanan Pratima , Yao Jiyun , Menold Jessica
Published: September 2020

Clinical gait analysis is used for diagnosing, assessing, and for monitoring a patient by analyzing their kinetics, kinematics and electromyography while walking. Traditionally, gait analysis is performed in a formal laboratory environment making use of several high-resolution cameras, either video or infrared. The subject is asked to walk on a force platform or a treadmill with several markers attached to their body, allowing cameras to capture the joint coordinates across time. The space required for such a laboratory is non-trivial and often the associated costs of such an experimental setup is prohibitively expensive. The current work aims to investigate the coupled use of a Microsoft Kinect and Inertial Measurement Units as a portable and cost-efficient gait analysis system. Past studies on assessing gait using either Kinect or Inertial Measurement Units concluded that they achieve medium reliability individually due to some drawbacks related to each sensor. In this study, we propose that a combined system is efficient in detecting different phases of human gait, and the combination of sensors complement each other by overcoming the individual sensor drawbacks. Preliminary findings indicate that the IMU sensors are efficient in providing gait kinematics such as step length, stride length, velocity, cadence, etc., whereas the Kinect sensor helps in studying the gait asymmetries by comparing the right and left joint, such as hips, knees, and ankle.
The Effects of Telehealth Interventions on Oncological Disease and Treatment Outcomes: A Systematic Literature Review
Authors: Sinatra Christopher , Asan Onur
Published: September 2020

Tele-oncology research has been primarily feasibility-focused. Treatment-based telegenetic counseling, remote therapy delivery, and palliative care are the major applications of available technology, keeping patients out of the clinic and bringing the interventions home. The efficacy of these technologies will entirely determine patient outcomes and the overall patient work system. The purpose of this study was to report on current tele-oncological outcome studies, evaluation of their outcomes, and implications for future research. We used PubMed, IEEE Xplore, and Web of Science to identify eligible papers that met the defined inclusion criteria ( n=36). The final selected papers included telegenetic counseling (n=4), remote chemotherapy delivery (n=2), and palliative care (n=30). Results showed positive changes in the outcome measures such clinical outcomes for treatment, information exchanges, and therapeutic regimens. There is an evident lack of outcomes research conducted for remote chemotherapy delivery and telegenetic counseling. Future research should stray from feasibility studies and focus more heavily on outcomes, especially for the relatively unexplored fields of remote chemotherapy delivery and telegenetic counseling. Research should also aim to be more quantifiable and explore additional outcomes aside from the general “quality of life", such as adverse events reduction and fatigue severity.
Developing Technology-Enabled Solutions for College Students to Cope with Factors Leading to Health Problems
Authors: Ishak Timaf , Torres Angelica , Asan Onur
Published: September 2020

The purpose of this paper is to identify the leading causes of mental health issues among college students and determine a possible solution to mitigate these problems. The data presented was gathered through interviews and analyzed using thematic analysis. The study concluded that college students typically use various technologies to alleviate their stress.
Corporate Art Collections in Australia: The Influence of Aboriginal Art on Corporate Identity
Authors: Williams Martin , Biggemann Sergio
Published: September 2020

This study is the first to investigate the use of Aboriginal art for marketing purposes. Over 2000 major enterprises in Europe and North America collect art, but in Australia relatively few do. Research has established that art collections contribute to corporate identity, but this has not been studied in Australia. Using a qualitative case study approach, this exploratory study investigates how art collections are used to support the work of three Australian banking and law firms whose collections include Aboriginal art. We asked respondents from each firm how and why they collected Aboriginal art and their perception of the role of art in symbolizing their firm’s values and culture. Aboriginal art was found to contribute to a firm’s identity and corporate social responsibility, especially when collections included the work of emerging artists and more challenging political content. It also presented a friendly face to Aboriginal clients. For firms in overseas markets, Aboriginal art served to signal a firm’s Australianness.
Seeing and Being Seen: The Impact of Art Making on the Experience of Isolation and Fear in Patient Care
Authors: Byrne Libby
Published: September 2020

A positive diagnosis for COVID-19 is a threat not only to the health of an individual but also to the community where the disease manifests. Rather than being the discreet experience of a few or some, many people now appreciate our shared vulnerability with the threat of uncontained and incurable illness in our midst. “In this era of unspecified isolation, contagious disease, and with no sign of returning to normal life soon, coronavirus is putting an adverse effect on people’s mental health” (1). While managing the spread of COVID-19 has necessitated the use of social distancing and isolation a means of expressing care, equating care with the experience of fear and isolation can place unseen mental health burdens on inner resources for supporting the well-being of patients and those who care for them. Art can offer a remedy for this experience, lending the quality of durability to our fragile human experience and inviting us to extend the ways in which we see, think, and make sense of the world.
“Won’t You Be My Doctor?”: Four Keys to a Satisfying Relationship in an Increasingly Virtual World
Authors: Frankel Richard M , Beckman Howard
Published: September 2020

Despite rapid technological advances in healthcare, medicine is still largely practiced in a doctor’s office one conversation at a time. This reality is changing rapidly during the COVID-19 pandemic as face-to-face conversations with primary care practitioners are being replaced by virtual visits conducted by phone or video conferencing. Communication challenges in patient-practitioner relationships exist in face-to-face visits and they are accentuated in virtual ones. Absent a physical examination and other sensory data, conversation is the primary means by which safe, satisfying care depends. We present 4 steps to help patients and practitioners work together to obtain optimal results from virtual or face-to-face visits, summarized by the acronym PREP: Prepare, Rehearse, Engage, and Persist. Based on 80 years of combined clinical practice and research, we recommend strategies to help bridge the gap between what patients want and deserve in their medical visits and practitioners’ understanding of their patients’ concerns.
Primary human herpesvirus 8–negative effusion-based lymphoma: a large B-cell lymphoma with favorable prognosis
Authors: Kaji Daisuke , Ota Yasunori , Sato Yasuharu , Nagafuji Koji , Ueda Yasunori , Okamoto Masataka , Terasaki Yasushi , Tsuyama Naoko , Matsue Kosei , Kinoshita Tomohiro , Yamamoto Go , Taniguchi Shuichi , Chiba Shigeru , Ohshima Koichi , Izutsu Koji
Published: September 2020

Primary effusion-based lymphoma (EBL) presents as a malignant effusion in a body cavity. The clinicopathologic features and prognosis of primary human herpesvirus 8 (HHV8)–negative EBL remain unclear. We therefore conducted a retrospective study of 95 patients with EBL, regardless of HHV8 status, in Japan. Of 69 patients with EBL tested for HHV8, a total of 64 were negative. The median age of patients with primary HHV8-negative EBL at diagnosis was 77 years (range, 57-98 years); all 58 tested patients were negative for HIV. Primary HHV8-negative EBL was most commonly diagnosed in pleural effusion (77%). Expression of at least 1 pan B-cell antigen (CD19, CD20, or CD79a) was observed in all cases. According to the Hans algorithm, 30 of the 38 evaluated patients had nongerminal center B-cell (non-GCB) tumors. Epstein-Barr virus–encoded small RNA was positive in 6 of 45 patients. In 56 of 64 HHV8-negative patients, systemic therapy was initiated within 3 months after diagnosis. Cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) or CHOP-like regimens with or without rituximab (n = 48) were the most common primary treatments. The overall response and complete response rates were 95% and 73%, respectively. Three patients did not progress without systemic treatment for a median of 24 months. With a median 25-month follow-up, the 2-year overall survival and progression-free survival rates were 84.7% and 73.8%. Sixteen patients died; 12 were lymphoma-related deaths. Thus, most EBL cases in Japan are HHV8-negative and affect elderly patients. The non-GCB subtype is predominant. Overall, primary HHV8-negative EBL exhibits a favorable prognosis after anthracycline-based chemotherapy.
Preparing Ambient-Processed Perovskite Solar Cells with Better Electronic Properties via Preheating Assisted One-Step Deposition Method
Authors: Zhang Xi , Yang Wenyao , Qi Jingjing , Hu Yinggang
Published: September 2020

Although the power conversion efficiency (PCE) of perovskite solar cells (PSCs) increases rapidly, there are still some issues that limit their commercialization. The perovskite is sensitive to the water molecules, increasing the difficulty in the preparation of perovskite films in ambient condition. Most high-performance PSCs based on conventional method are required to be prepared in inert atmosphere condition, which increase the fabrication cost. To fabricate the high-quality perovskite in ambient condition, we preheated the substrates and selected the proper anti-solvent. As a result, the target perovskite films show a better crystallinity compared with perovskite film prepared via the conventional one-step deposition method in ambient condition. The PSCs prepared in ambient condition yield the improved PCE of 16.89% from a PCE of 11.59%. Compared with the reference devices, the performance stability of target PSCs is much better than that of reference PSCs.