bluuebunny/crossref_metadata_2025 huggingface dataset:
Time course of lymphocyte repopulation after dimethyl fumarate-induced grade 3 lymphopenia: contribution of patient age
Authors: Briner Myriam , Bagnoud Maud , Miclea Andrei , Friedli Christoph , Diem Lara , Chan Andrew , Hoepner Robert , Salmen Anke
Published: May 2019

Background:

Dimethyl fumarate (DMF) is licensed for treatment of relapsing–remitting multiple sclerosis (RRMS). DMF can induce lymphopenia, which is assumed to increase the risk for opportunistic infections like progressive multifocal leukoencephalopathy. Our goal for this work was to estimate the frequency of grade 3 lymphopenia in DMF-treated patients with RRMS and to characterize patient-sided factors influencing the time course of lymphocyte repopulation after DMF withdrawal.

Material and methods:

A single-center retrospective data analysis was performed at University Hospital Bern, Switzerland. Patients with DMF treatment were analyzed for lymphocyte counts. Demographic factors were statistically analyzed in grade 3 lymphopenic patients.

Results:

We estimated a grade 3 lymphopenia frequency of 11/246 (4.5%), corroborating previous studies. In all patients, lymphocytes recovered to values ⩾800/µl within 0.5 years. Multivariate linear regression analysis unmasked older age as being associated with a longer duration of repopulation.

Conclusion:

Considering the aging population, our findings warrant further investigations of DMF-induced lymphopenia.
Apparent diffusion coefficient and tumor volume measurements help stratify progression-free survival of bevacizumab-treated patients with recurrent glioblastoma multiforme
Authors: Buemi Francesco , Guzzardi Giuseppe , Del Sette Bruno , Sponghini Andrea P , Matheoud Roberta , Soligo Eleonora , Trisoglio Alessandra , Carriero Alessandro , Stecco Alessandro
Published: May 2019

Background

The aim of this study was to determine whether apparent diffusion coefficient (ADC) bi-component curve-fitting histogram analysis and volume percentage change (VPC) prior to bevacizumab treatment can stratify progression-free survival (PFS) and overall survival (OS) in patients with glioblastoma multiforme (GBM) on first recurrence.

Methods

We retrospectively evaluated 17 patients with recurrent GBM who received bevacizumab and fotemustine ( n = 13) or only bevacizumab ( n = 4) on first recurrence at our institution between December 2009 and July 2015. Both T2/FLAIR abnormalities and enhancing tumor on T1 images were mapped to the ADC images. ADC-L and ADC-M values were obtained trough bi-Gaussian curve fitting histogram analysis. Furthermore, the study population was dichotomized into two subgroups: patients displaying a reduction in enhancing tumor volume of either >55% or <55% between the mean value calculated at baseline and first follow-up. Subsequently, a second dichotomization was performed according to a reduction in the T2 / FLAIR volume >41% or <41% at first check after treatment. OS and PFS were assessed using volume parameters in a Cox regression model adjusted for significant clinical parameters.

Results

In univariate analysis, contrast-enhanced (CE)-ADC-L was significantly predictive of PFS ( p = 0.01) and OS ( p = 0.03). When we dichotomized our sample using the 55% cut-off for enhancing tumor volume, CE-VPC was able to predict PFS ( p = 0.01) but not OS ( p = 0.08). In multivariate analysis, only the CE-ADC-L was predictive of PFS ( p = 0.01), albeit not predictive of OS ( p = 0.14). CE-ADC-M, T2/FLAIR-ADC-L, T2/FLAIR-ADC, and T2/FLAIR VPC were not significantly predictive of PFS and OS ( p > 0.05) in both univariate and multivariate analysis.

Conclusions

CE-ADC and CE-VPC can stratify PFS for patients with recurrent glioblastoma prior to bevacizumab treatment.
Pulmonary hypertension and severe right heart failure following lumbar spinal surgery
Authors: Jayasekera Geeshath , Johnson Martin , Hussey Keith , Church Colin
Published: May 2019

Pulmonary hypertension is a disease process affecting the pulmonary circulation and is defined by an increase in pulmonary artery pressure subsequently causing right ventricular failure. Vascular complications, including arteriovenous fistulae, are recognised, but are uncommon complications of spinal surgery. Arteriovenous fistulae increase venous return to the right heart and can induce a high-output cardiac state, mimicking pulmonary arterial hypertension and right heart failure. We present a 47-year-old man with a 1 year history of worsening dyspnoea, exertional pre-syncope and leg swelling presenting with severe right heart failure. The previous year, he had complex spinal surgery, which included discectomy, laminectomy and bilateral nerve reconstruction at L5-S1 level. Initial non-invasive investigations including echocardiography and chest imaging raised the possibility of right heart failure presumed secondary to pulmonary vascular disease. Clinical examination and right heart catheterisation were in keeping with a high cardiac output state, and invasive saturation monitoring was suggestive of a sub-diaphragmatic shunt. Subsequent imaging confirmed the presence of an iatrogenic ilio-iliac arteriovenous fistula. The patient underwent urgent endovascular repair, which resulted in resolution of his symptoms and haemodynamics. We describe the case and present a review of the relevant literature.
A human tragedy? The pace of negative global change exceeds human progress
Authors: Morris Douglas W
Published: May 2019

I analyze changes in the demographic profiles and urbanization rates of 201 countries, and assess 69 global indicators of the human condition, in order to evaluate whether the human population is endangering its persistence and future quality of human life (tragedy of the commons). Encouraging changes in age profiles signal a slowing down in human population growth during the Anthropocene while exponential increases in several economic, education, and health indicators support an optimistic outlook for the future of humanity. But rapid growth by a larger number of negative indicators foretell a global human tragedy plagued by long-term increases in pollution, global warming, waning food production and unparalleled declines in biodiversity. Urgent action is required to avoid further collapse of the Earth System.
Lung adenocarcinoma metastasis to pancreas after the absence of primary tumour for almost two years
Authors: Shadhu Kamleshsingh , Xi Chunhua , Wei Jishu , Miao Yi
Published: May 2019

Lesson

This case report can argue in favour of optimal surgical management for isolated metastases to the pancreas, especially in patients with low surgical risk.
The Evaluation of a 19-Year-Old With Hypertension and Proteinuria: A Case Report
Authors: Edison Mara , Meunier Matthew , Miller Nathaniel
Published: May 2019

A 19-year-old male presented to the clinic and was found to be prehypertensive and have proteinuria on urine testing. He was subsequently diagnosed with focal segmental glomerulosclerosis (FSGS). Initial workup for pediatric hypertension includes urinalysis, chemistry panel, lipid panel, and renal ultrasound. Abnormalities on urinalysis, including proteinuria, hypercholesterolemia, and low serum albumin in children are characteristic of nephrotic disease. FSGS is a type of kidney pathology that often contributes to nephrotic disease and results from a variety of causes. For the primary care provider, being aware of the guidelines for pediatric hypertension screening and evaluation is important as 20% of children with hypertensive disease are due to kidney disease. FSGS is the third leading cause of end-stage renal disease in children aged 12 to 19 years, and its incidence was found to be rising in a study of Olmsted County, MN residents. Treatment to complete or partial remission of the proteinuria can slow the progression of renal disease. In this case report, we will discuss the evaluation of pediatric hypertension workup with proteinuria, specifically due to FSGS, and review current management strategies.
Social Support Outside the Workplace, Coping Styles, and Burnout in a Cohort of EMS Providers From Minnesota
Authors: Boland Lori L. , Mink Pamela J. , Kamrud Jonathan W. , Jeruzal Jessica N. , Stevens Andrew C.
Published: May 2019

Occupational burnout has been linked to the delivery of lower quality of care in some health care professions, including with turnover intentions and absenteeism in emergency medical services (EMS) workers. Thus, studies that identify factors associated with burnout may be integral to optimizing quality and workforce engagement among EMS professionals. A survey was conducted to assess social support outside the workplace, coping styles, and occupational burnout in a cohort of EMS providers from Minnesota. Surveys were returned by 217 providers (54% response), of which 167 had provided data on burnout, social support, and coping styles and were included in the analysis. The mean age was 41 years, 62% were male, and the prevalence of burnout was 17%. After adjustment for age and EMS tenure, the odds of burnout was higher among those characterized as socially isolated as compared with providers who were integrated socially or moderately integrated (odds ratio = 3.52; 95% confidence interval = [1.13, 10.98]). Common coping responses included planning, positive reframing, and active coping, while behavioral disengagement and denial were rarely used. Lack of social networks outside the workplace and frequent use of self-blame, food, or substance use as coping strategies were associated with burnout. Conversely, social integration and use of religion and instrumental support to cope with stressors were associated with reduced burnout.
Rural Parent Support of Child Health Behavior in the Home Environment: A Qualitative Study on an American Indian Reservation
Authors: Pedersen Maja , Brown Blakely , Harris Kari , France Sonja , Tryon Mike , Cooksley Aric
Published: May 2019

Background. Obesity rates are disproportionately high among rural and American Indian (AI) children. Health behaviors contributing to child obesity are influenced by parents at home. Engaging parents remains a challenge, particularly among low-income and ethnic minority families. Aims. The aim of this study was to learn how AI parents living on a rural AI reservation support and engage with their children’s nutrition and physical activity behaviors at home. Methods. Parents with children ages 6 to 12 years living on one, rural AI reservation participated. Focus groups and interviews were conducted, using a 14-question moderator’s guide. A systematic, iterative content analysis was applied to the transcripts. Results. Twenty-five parents (52% AI or Alaska Native) participated in 3 focus groups (n = 17) and interviews (n = 8). Themes related to enhancers included role modeling and whole family and child-initiated activities. Barriers included resources, child safety concerns, driving distances, and competing family priorities. Themes related to strategies for change included opportunities for peer learning from other local families, creating fun, program support for all supplies and incentives, and incorporation of storytelling and multicultural activities. Discussion. This study advances knowledge to promote parental engagement with child health behavior in the home, including unique themes of inclusiveness, culture-focused, and intergenerational activities. Conclusion. Results may inform interventions seeking to engage parents living in rural and AI reservation communities in home-based child behavior change efforts.
Social Media Research Strategy to Understand Clinician and Public Perception of Health Care Messages
Authors: Huber J. , Woods T. , Fushi A. , Duong M.T. , Eidelman A.S. , Zalal A.R. , Urquhart O. , Colangelo E. , Quinn S. , Carrasco-Labra A.
Published: May 2019

Introduction:

Despite the potential of social media to influence public health and generate insights, the process of monitoring and analyzing the dissemination of health care messages on social media has been described as difficult and in need of improvement.

Objectives:

The objective of this study was to describe and demonstrate a reproducible methodology for cataloging and analyzing health care–related social media comments and provide insight into how clinicians and members of the general public respond to health care messaging on social media.

Methods:

We collected social media comments related to the American Dental Association’s 2016 “Evidence-Based Clinical Practice Guideline for the Use of Pit-and-Fissure Sealants” between April 10, 2017, and October 31, 2017, from Facebook, Twitter, LinkedIn, Reddit, and online message boards for the New York Times, FiveThirtyEight, and Dentaltown. Using data provided in the comments, we conducted engagement analysis as well as content, network, and sentiment analysis across 8 categories.

Results:

We collected 671 comments. Among our findings, Facebook (472 of 671) was the most popular platform among commentators; almost half of all comments (335 of 671) aligned with the recommendations of the 2016 American Dental Association sealants guideline; clinicians were more likely than the general public to like a comment that suggested an improvement to the guideline; and >75% of comments (521 of 671) were supported by anecdotal evidence.

Conclusion:

As the prevalence of anecdotes on social media suggests, the likelihood of falsehoods spreading on social media is high. Insights gleaned from the methodology described in this research could help combat the spread of such misinformation by providing disseminators of health care messaging with insight into their target audiences. Armed with this knowledge, disseminators can craft health care messages that more effectively engage clinicians and the general public.

Knowledge Transfer Statement:

The methodology used in this research provides a reproducible strategy for tracking social media engagement with health care messages. Engagement results can assist future delivery of health care messages to key stakeholders and ensure better implementation and adoption of these communications.
The discursive construction of adaptation subjects via the Ada Sea Defense System in the Volta River Delta of Ghana
Authors: Owusu-Daaku Kwame N , Rosko Helen
Published: May 2019

As climate adaptation gains international prominence as one means for addressing climate change, it remains critical that just and equitable outcomes are maintained as adaptation technologies are deployed across various target populations. In this vein, subjectivity has been problematized by climate change adaptation scholars as a concept that needs further attention to understand the political nature of climate change adaptation. Extending frameworks of environmentality to cases of climate change adaptation, we engage the term adaptation subjects to distinguish individuals whose interests and desires align with broader understandings and goals of climate change adaptation. In this research, we situate the co-production of livelihoods and climate change adaptation interventions as projects of rule to understand subject-formation. Such an analysis allows for a move beyond econocentric framings of livelihoods that privilege material outcomes to also engage with the socio-political realities of these livelihoods and climate change adaptation more broadly. We apply the Livelihoods as Intimate Government approach to a case study of the Ada Sea Defense System in the Ada East District of the Volta River Delta of Ghana as a climate change adaptation project of rule, in order to illustrate the ways this adaptation technology discursively constructs (or not) different residents as adaptation subjects. Understanding the Ada Sea Defense System as a technology of adaptation constituted through socio-political practices has the potential to promote justice and equity when designing, implementing and evaluating such technologies in the future.
The evolution of the materials used in the yun technique for the decoration of Burmese objects: lacquer, binding media and pigments
Authors: Tamburini Diego , Kotonski Verena , Lluveras-Tenorio Anna , Colombini Maria Perla , Green Alexandra
Published: May 2019

A series of Burmese lacquered objects decorated with the yun (incised) technique and belonging to the British Museum’s collection was analysed with the aim to investigate the decorative materials—lacquer, binding media, additives and pigments—used in the production of these objects, which span chronologically from the eighteenth century to the late twentieth century. As the manufacturing process is supposed to have remained very similar over this time period, especially regarding the use of materials, we were interested in scientifically assessing for the first time the nature of these materials and the correspondence to the written sources in the relation to their specific use. Gas chromatography mass spectrometry (GC–MS) and analytical pyrolysis with in situ silylation coupled with GC–MS (Py(HMDS)GC–MS) were used for the identification of the organic components in several samples taken from the coloured areas of the objects. Fibre optic reflectance (FORS) and Raman spectroscopies were used to identify the pigments after a visual investigation of the samples by digital microscopy. Burmese lacquer was detected in all objects and trends in its degradation were highlighted. Lipids, proteins and saccharide material were found to be mixed with lacquer, and they appeared to be applied with specific pigments, in good agreement with the written records, apart from proteins, which are not mentioned. The use of synthetic pigments, such as phthalocyanines blue and green and chrome yellow, was assessed in the most recent objects, showing an evolution in the use of pigments. Indigo, although expected, was not identified in any of the green samples and Prussian blue appeared to be the main source of blue colour. All this information is of fundamental importance for conservation practices and corrects the general opinion about the production materials of these objects. These results also open the way to future research dedicated to exploring the chemical interaction between Burmese lacquer, proteins, lipids, gums and pigments, with the aim to predict possible differences in degradation pathways.
Frequency- and incident-angle-dependent P-wave properties influenced by dynamic stress interactions in fractured porous media
Authors: Cao Chenghao , Fu Li-Yun , Ba Jing , Zhang Yan
Published: May 2019

The effect of stress interactions on the effective poroelastic properties in saturated porous media has not been well-understood, especially for rocks with a fracture density larger than the dilute limit assumption. Frequency- and angle-dependent characteristics of stress interactions are analyzed by finite-element numerical tests with a least-squares procedure. We have investigated two types of fractured media: a stacked fractured model with stress shielding and a coplanar fractured model with stress amplification. We evaluate the effect of stress interactions from different spatial distributions of fractures on seismic attenuation and dispersion, with a specific focus on their frequency- and angle-dependent characteristics. We determine with numerical examples that a greater shielding effect corresponds to a larger frequency corresponding to maximum attenuation but a smaller peak attenuation. In contrast, a larger amplification effect leads to a higher attenuation. Due to the excluded diffusion energy outside the representative volume element, increasing the incidence angle ([Formula: see text]) leads to decreasing attenuation, whereas stress amplification is enhanced as the incidence angle increases continuously ([Formula: see text]), corresponding to increasing attenuation. This suggests that different incidence angles reshape the spatial distribution of stress interactions, in turn contributing to different frequency-dependent behaviors.
Case study: Phase-component amplitude variation with angle
Authors: De Abreu Elita Selmara , Castagna John Patrick , Gil Gabriel
Published: May 2019

In detectable and isolated thin layers below seismic resolution, phase decomposition can theoretically be used to discriminate relatively high-impedance thin-layer responses from low-impedance reservoir responses. Phase decomposition can be used to isolate seismic amplitudes with a particular phase response or to decompose the seismic trace into symmetrical and antisymmetrical phase components. These components sum to form the original trace. Assuming zero-phase seismic data and normal American polarity, seismically thin layers that are high impedance relative to overlying and underlying half-spaces are seen on the [Formula: see text] phase component, whereas a relatively low-impedance thin layer will appear on the [Formula: see text] phase component. When such phase decomposition is applied to prestack attributes on a 2D line across a thin, 8 m thick, gas-saturated reservoir in the Western Canadian Sedimentary Basin of Alberta, Canada, amplitude-variation-with-angle is magnified on the [Formula: see text] phase component. The [Formula: see text] far-offset component allows the lateral extent of the reservoir to be better delineated. This amplification is also seen on the [Formula: see text] phase component of the gradient attribute. These results are corroborated by seismic modeling that indicates the same phase-component relationships for near- and far-angle stacks as are observed on the real data. Fluid substitution and seismic modeling indicate that, relative to full-phase data, the mixed-phase response observed in this study exhibits variations in fluid effects that are magnified and better observed at far angles on the [Formula: see text] phase component.
Effects of case-load size on the process of care of patients with severe psychotic illness
Authors: Burns Tom , Fiander Matthew , Kent Andy , Ukoumunne Obioha C. , Byford Sarah , Fahy Tom , Kumar Kay Raj
Published: May 2019

Background

Studies of intensive case management (ICM) for patients with psychotic illnesses have produced conflicting results in terms of outcome. Negative results have sometimes been attributed to a failure to deliver differing patterns of care.

Aims

To test whether the actual care delivered in a randomised clinical trial of ICM v. standard case management (the UK700 trial) differed significantly.

Method

Data on 545 patients' care were collected over 2 years. All patient contacts and all other patient-centred interventions (e.g. telephone calls, carer contacts) of over 15 minutes were prospectively recorded. Rates and distributions of these interventions were compared.

Results

Contact frequency was more than doubled in the ICM group. There were proportionately more failed contacts and carer contacts but there was no difference in the average length of individual contacts or the proportion of contacts in the patients' homes.

Conclusions

The failure to demonstrate outcome differences in the UK700 study is not due to a failure to vary the treatment process. UK standard care contains many of the characteristics of assertive outreach services and differences in outcome may require that greater attention be paid to delivering evidence-based interventions.
Proton therapy for brain tumours in the area of evidence-based medicine
Authors: Weber Damien C , Lim Pei S , Tran Sebastien , Walser Marc , Bolsi Alessandra , Kliebsch Ulrike , Beer Jürgen , Bachtiary Barbara , Lomax Tony , Pica Alessia
Published: May 2019

Proton therapy (PT) has been administered for many years to a number of cancers, including brain tumours. Due to their remarkable physical properties, delivering their radiation to a very precise brain volume with no exit dose, protons are particularly appropriate for these tumours. The decrease of the brain integral dose may translate with a diminution of neuro-cognitive toxicity and increase of quality of life, particularly so in children. The brain tumour patient’s access to PT will be substantially increased in the future, with many new facilities being planned or currently constructed in Europe, Asia and the United States. Although approximately 150’000 patients have been treated with PT, no level I evidence has been demonstrated for this treatment. As such, it is this necessary to generate high-quality data and some new prospective trials will include protons or will be activated to compare photons to protons in a randomized design. PT comes however with an additional cost factor that may contribute to the ever-growing health’s expenditure allocated to cancer management. These additional costs and financial toxicity will have to be analysed in the light of a more conformal radiation delivery, non-target brain irradiation and lack of potential for dose escalation when compared to photons. The latter is due to the radiosensitivity of organs at risk in vicinity of the brain tumour, that photons cannot spare optimally. Consequentially, radiation-induced toxicities and tumour recurrences, which are cost-intensive, may decrease with PT resulting in an optimized photon/proton financial ratio in the end.

Advances in knowledge:

This review details the indication of brain tumors for proton therapy and give a list of the open prospective trials for these challenging tumors.
Real-Time Radiation Treatment Planning with Optimality Guarantees via Cluster and Bound Methods
Authors: Ungun Baris , Xing Lei , Boyd Stephen
Published: May 2019

Radiation therapy is widely used in cancer treatment; however, plans necessarily involve tradeoffs between tumor coverage and mitigating damage to healthy tissue. Although current hardware can deliver custom-shaped beams from any angle around the patient, choosing (from all possible beams) an optimal set of beams that maximizes tumor coverage while minimizing collateral damage and treatment time is intractable. Furthermore, even though planning algorithms used in practice consider highly restricted sets of candidate beams, the time per run combined with the number of runs required to explore clinical tradeoffs results in planning times of hours to days. We propose a suite of cluster and bound methods that we hypothesize will (1) yield higher-quality plans by optimizing over much (i.e., 100-fold) larger sets of candidate beams, and/or (2) reduce planning time by allowing clinicians to search through candidate plans in real time. Our methods hinge on phrasing the treatment-planning problem as a convex problem. To handle large-scale optimizations, we form and solve compressed approximations to the full problem by clustering beams (i.e., columns of the dose deposition matrix used in the optimization) or voxels (rows of the matrix). Duality theory allows us to bound the error incurred when applying an approximate problem’s solution to the full problem. We observe that beam clustering and voxel clustering both yield excellent solutions while enabling a 10- to 200-fold speedup.
Learning Preferences with Side Information
Authors: Farias Vivek F. , Li Andrew A.
Published: May 2019

Product and content personalization is now ubiquitous in e-commerce. There are typically not enough available transactional data for this task. As such, companies today seek to use a variety of information on the interactions between a product and a customer to drive personalization decisions. We formalize this problem as one of recovering a large-scale matrix with side information in the form of additional matrices of conforming dimension. Viewing the matrix we seek to recover and the side information we have as slices of a tensor, we consider the problem of slice recovery, which is to recover specific slices of “simple” tensors from noisy observations of the entire tensor. We propose a definition of simplicity that on the one hand elegantly generalizes a standard generative model for our motivating problem and on the other hand subsumes low-rank tensors for a variety of existing definitions of tensor rank. We provide an efficient algorithm for slice recovery that is practical for massive data sets and provides a significant performance improvement over state-of-the-art incumbent approaches to tensor recovery. Furthermore, we establish near-optimal recovery guarantees that, in an important regime, represent an order improvement over the best available results for this problem. Experiments on data from a music streaming service demonstrate the performance and scalability of our algorithm.

The e-companion is available at https://doi.org/10.1287/mnsc.2018.3092 .

This paper was accepted by Noah Gans, stochastic models and simulation.
Group Affiliation and Default Prediction
Authors: Beaver William H. , Cascino Stefano , Correia Maria , McNichols Maureen F.
Published: May 2019

Using a large sample of business groups from more than 100 countries around the world, we show that group information matters for parent and subsidiary default prediction. Group firms may support each other when in financial distress. Potential group support represents an off-balance sheet asset for the receiving firm and an off-balance sheet liability for the firm offering support. We find that subsidiary information improves parent default prediction over and above group-level consolidated information possibly because intragroup exposures are netted out upon consolidation. Moreover, we document that improvements in parent default prediction decrease in the extent of parent-country financial reporting transparency, a finding that suggests that within-group information matters most when consolidated financial statements are expected to be of lower quality. We also show that parent and other group-firms’ default risk exhibits predictive power for subsidiary default. Lastly, we find that within-group information explains cross-sectional variation in CDS spreads. Taken together, our findings contribute to the prior literature on default prediction and have direct relevance to investors, credit-rating agencies, and accounting regulators.

This paper was accepted by Suraj Srinivasan, accounting.
Methodological approaches for assessing the cost of diabetic foot ulcers: a systematic literature review
Authors: Mairghani Maisoon , Jassim Ghufran , Elmusharaf Khalifa , Patton Declan , Eltahir Omer , Moore Zena , Sorensen Jan
Published: May 2019

Objective:

To evaluate the methodological approaches used to assess the cost consequences of diabetic foot ulcers (DFUs) in published scientific papers.

Method:

A systematic literature search was conducted in PubMed, Embase, Scopus, Web of Science and CINAHL. English language papers reporting on the cost of DFUs were identified. Additionally, bibliographies were inspected to identify other relevant cost studies. Following the PRISMA guidance, the review identified the study design, epidemiological approach, analytical perspective and data collection approach in each of the included studies.

Results:

Relatively few studies of the cost consequences of DFUs were found (n=27). Most studies were conducted in Western countries with only five studies from countries in Asia and Africa. The identified studies used different study designs, epidemiological approaches, data collection strategies, and data sources, which in turn made a systematic comparison of cost estimates difficult. Detailed descriptions of the applied costing method and other methodological aspects were often limited or absent. Many studies only reported costs from a health-care payer's perspective and disregarded the costs to patients, their families and wider society.

Conclusion:

The costs of DFUs have been assessed using a wide range of different methodological approaches often restricted to the healthcare payer's perspective. Therefore, the cost analyses may fail to consider the true societal costs of DFUs.
Simultaneous repair of cutaneous and subcutaneous wounds using a single suture technique
Authors: Aksam Ersin , Karatan Berrak , Tuzuner Murat , Dervis Alper , Ceran Candemir
Published: May 2019

Objective:

To describe a single suture technique for the simultaneous repair of cutaneous and subcutaneous wounds.

Method:

Skin and subcutaneous wounds of >3cm in size were repaired using a single suture technique. Different suture sizes were chosen for different wounds. Timing of suture removal was decided according to body area and wound healing status.

Results:

A total of 78 patients were treated (41 women and 37 men). Mean age was 31.7 years (range: 14–72 years). At one month postoperatively, 56 patients attended a follow-up visit and 27 patients attended at six months postoperatively. Local infection was observed in one patient and wound dehiscence observed in two patients after suture removal. Resulting scars were similar to those of other types of suture techniques.

Conclusion:

This study describes a single suture technique for the simultaneous repair of cutaneous and subcutaneous wounds. It is easy to learn and perform. This technique reduces the risk of infection, cost and procedure time.
Porcine bladder extracellular matrix in paediatric pilonidal wound care: healing and patient experience evaluation
Authors: Cairo Sarah B. , Zhao Jane , Ha Minje , Bass Kathryn D.
Published: May 2019

Objective:

Pilonidal disease (PD) with inflammation and abscess formation occurs frequently in adolescents. The management of pilonidal disease, time to wound healing, and patient satisfaction, however remains variable despite advances in wound care methods. Porcine bladder extracellular matrix (PBEM) facilitates site-specific tissue deposition/re-growth for the management of a variety of wounds. The aim was to describe the use and outcomes of PBEM in PD at a single centre.

Method:

A retrospective chart review of adolescent patients who underwent treatment of pilonidal disease with PBEM between 2012 and 2016 at a single institution, was undertaken. Patient demographics and clinical characteristics were collected and compared with historical controls and literature regarding traditional wound therapies.

Results:

We reviewed 52 pilonidal disease wounds on 41 patients. Of these 36 were treated with PBEM. The average age was 16 years old at the time of operation with 39% male. Furthermore, 85% were being treated for recurrent pilonidal disease. Follow-up was available by chart review for 89% of patients with documented complete wound healing in 78% of patients treated with PBEM at an average of two months. Subjective reports included majority positive experience with PBEM dressing, minimal pain and overall high levels of patient satisfaction. There were three patients in which pilonidal disease recurred within two years of initial treatment and underwent repeat treatment with PBEM. There was one patient who transitioned to wet-to-dry saline dressings because of difficulty keeping the PBEM dressing intact.

Conclusion:

Advances in wound care technology include materials such as PBEM to promote site-specific tissue deposition. Follow-up phone calls and a prospective study to compare alternative wound care with porcine PBEM in the management of pilonidal disease is underway to better quantify time to wound healing and patient satisfaction.
Surgical intervention and customised dressings in an extremity wound caused by necrotising fasciitis: a case study
Authors: Collins Jessica
Published: May 2019

Necrotising fasciitis can result in extensive loss of soft tissue and limb function. Therefore, surgical intervention requires a balance between extensive tissue removal and saving the limb. A 56-year-old male presented with necrotising fasciitis of the upper extremity. Debridement resulted in a full-thickness wound of the forearm and upper arm, an exposed olecranon and two proximally-based skin flaps. Reconstruction required multiple debridements to optimise the wound for skin grafting and to obtain flap adherence to underlying tissues of the upper arm. Conventional dressings over the flaps proved unsuccessful. Therefore, a customised versatile dressing to address each area of the wound was developed. Negative pressure wound therapy (NPWT) was applied over the exposed muscle (no exposed bone or tendon) of the lower arm and anterior upper arm; a hydropolymer foam dressing covered the elbow region. Closed incision negative pressure wound therapy (ciNPT) was applied over the incision on the posterior upper arm. Ultimately, complete wound closure was achieved, with normal/near-normal range of motion for all joints of the affected limb. There was complete take of skin grafts on the wrist, lower arm and anterior upper arm. ciNPT was effective in holding the incision together and promoting healing of the posterior upper arm, and the hydropolymer foam dressing aided with healing and coverage of the elbow region. In this case, healing of a large, complex upper extremity wound and restored limb function were achieved following use of a combination of surgical techniques and customisation of wound therapy modalities.
AMOXICILLIN
Authors: Rees Sharon
Published: May 2019

In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of Tweets. This month she is talking about #amoxicillin
Overprescribing antibiotics
Authors: Winter George
Published: May 2019

The threat of antimicrobial resistance is well known. Here, George Winter discusses how overprescribing antibiotics can contribute to resistance and discusses research on overprescribing in acute respiratory tract infections
Solve the case: unilateral leg swelling
Authors: Nazarko Linda
Published: May 2019

Mrs Tina Foreman was admitted to a mental health hospital for investigation and treatment of her mental health problems. On admission, it was discovered that she had unilateral leg swelling and an arthralgic gait. This case history examines the diagnosis and treatment of her condition.
Understanding randomised controlled trials: a guide for prescribers
Authors: Williamson Jodie , Lloyd Michael
Published: May 2019

Randomised controlled trials are popular studies used to compare two or more groups or treatment interventions. Randomised controlled trials often create evidence to inform clinical practice; therefore, it is important that prescribers are able to interpret the design and findings of these studies, which support formulary and policy decisions, and clinical practice. This article describes the applications of randomised controlled trials in practice, and discusses key features, definitions and terms often used in their reporting that aid interpretation, appraisal and critique of these studies and their outcome measures.
Kandungan senyawa polisiklik aromatik hidrokarbon dalam air laut dan sedimen di Teluk Lampung
Authors: Edward Edward
Published: May 2019

Abstract. Polycyclic Aromatic Hydrocarbons (PAH) are polycyclic aromatic organic compounds that are toxic to humans and aquatic organisms. This research aims to determine the level of pollution of PAH compounds in seawater and sediments in Lampung Bay, Lampung. This research was conducted by survey method in November 2018. Sediments and seawater samples were taken using water and sediment sampling equipment. Sediment and seawater samples were taken at three and two research stations. The levels and types of PAH compounds were determined by using Gas Mass Spectrometry Chromatography and their sources using individual ratio diagnostic methods. The results showed that the levels of PAH total in seawater ranged 295,587-331,133 ppb, this level is relatively high and has passed the threshold values set by the Decision Letter of the Office of the State Minister of Environment No 51, 2004 for marine biota protection, while in the sediments range 51.481-62.448 ppb, this level is relatively small and still in accordance with the criteria for marine life. The results of individual ratios diagnosis analysis indicate that PAHs in seawater and sediment come from various sources, namely petroleum, burning of petroleum and burning of organic matter.Keywords:  Lampung Bay, sediment, seawater, PAH Abstrak. Polisiklik Aromatik Hidrokarbon (PAH) merupakan senyawa organik aromatik polisiklik yang bersifat toksik terhadap manusia dan organisme perairan. Penelitian ini bertujuan untuk mengetahui tingkat pencemaran senyawa PAH  dalam air laut dan di sedimen Teluk  Lampung. Penelitian ini dilakukan dengan metode survei pada bulan November 2018. Contoh air laut dan sedimen diambil dengan menggunakan alat pengambil contoh air dan sedimen. Contoh air laut diambil pada dua stasiun dan sedimen pada tiga stasiun penelitian. Kadar dan jenis senyawa PAH ditentukan dengan menggunakan Kromatografi Gas-Spektrometer Massa dan sumbernya dengan metode diagnosa rasio individu. Hasilnya menunjukkan kadar total PAH dalam air laut berkisar 295,587-331,133 ppb, kadar ini relatif tinggi dan telah melewati nilai ambang batas yang ditetapkan oleh Keputusan Menteri Negara Lingkungan Hidup Nomor 51 Tahun 2004  untuk kepentingan biota laut, sedangkan pada sedimen berkisar 51,481-62,448 ppb, kadar ini relatif kecil dan masih sesuai dengan kriteria untuk kehidupan biota laut.   Hasil analisis diagnosa rasio individu menunjukkan bahwa PAH dalam air laut  dan sedimen berasal dari berbagai sumber yakni minyak bumi, pembakaran minyak bumi, dan pembakaran bahan organik.  Kata Kunci: Teluk Lampung, sedimen, air laut, PAH
Survey frequency of the depression and anxiety levels of infertile women in western Iran
Authors: Rahmati Shoboo , Delpisheh Ali , Moghadam Ashraf Direkvand , Sayehmiri Kourosh , Mohamadian Fathola
Published: May 2019

BACKGROUND Infertility among couples is a painful emotional problem, which results in the feeling of grief in the form of psychological problems such as depression and anxiety. The present study was aimed to survey the frequency of depression and anxiety levels of infertile women in western Iran in 2017.METHODS This cross-sectional study used a simple random sampling method for selecting the sample. The study population consisted of all infertile women who went to Farhangian health center in Ilam. The Beck’s Depression Inventory, Beck’s Anxiety Inventory, and demographic characteristics questionnaire were used for collecting the data. The questionnaires were distributed among midwife experts and patients. The collected data were analyzed by the chi-square test and variance analysis using SPSS version 20.RESULTS Among 200 infertile women, 53.5%, 32%, 11%, and 3.5% suffered from severe, moderate, mild, and no anxiety, respectively. However, 96.5% suffered from various degrees of anxiety with 85.5% from clinical anxiety. In addition, 42%, 19.5%, 14.5%, and 24% suffered from severe, moderate, mild, and no depression, respectively. However, 76% suffered from various degrees of depression with 61.5% from clinical depression. There is a significant relationship between the education level of husbands, education level of women, and type of infertility (p<0.05). Women who had a lower than diploma education level and primary infertility suffered from higher anxiety levels.CONCLUSIONS There was a high level of anxiety and depression in infertile women; therefore, it is necessary to pay attention to these disorders in the process of treatment of infertile women.
Moving forward without leaving the ethical standard of publication
Authors: Hamid Agus Rizal Ardy Hariandy , Widjaja Felix Firyanto
Published: May 2019

[no abstract available]
Flexible Photogrammetric Computations Using Modular Bundle Adjustment: The Chain Rule and the Collinearity Equations
Authors: Börlin Niclas , Murtiyoso Arnadi , Grussenmeyer Pierre , Menna Fabio , Nocerino Erica
Published: May 2019

The main purpose of this article is to show that photogram-metric bundle-adjustment computations can be sequentially organized into modules. Furthermore, the chain rule can be used to simplify the computation of the analytical Jacobians needed for the adjustment. Novel projection models
can be flexibly evaluated by inserting, modifying, or swapping the order of selected modules. As a proof of concept, two variants of the pinhole projection model with Brown lens distortion were implemented in the open-source Damped Bundle Adjustment Toolbox and applied to simulated and calibration
data for a nonconventional lens system. The results show a significant difference for the simulated, error-free, data but not for the real calibration data. The current flexible implementation incurs a performance loss. However, in cases where flexibility is more important, the modular formulation
should be a useful tool to investigate novel sensors, data-processing techniques, and refractive models.
Aiding Indoor Photogrammetry with UWB Sensors
Authors: Masiero Andrea , Fissore Francesca , Guarnieri Alberto , Pirotti Francesco , Vettore Antonio
Published: May 2019

Given the worldwide spread of smartphones, photogram-metric surveying with mobile devices is becoming of significant interest in the research community for providing low cost three-dimensional (3D) models. Since the photogram-metric procedure applied to images produces a projective
model, some external information is needed in order to obtain a 3D metric model. To this aim, Global Navigation Satellite System (GNSS) measurements are typically aided to the photogrammetric reconstruction procedure. How- ever, the quality of the obtained reconstruction is related to the
GNSS positioning accuracy, which is typically at meterlevel for cheap receivers as those embedded in most of the consumer mobile devices, e.g.smartphones. Furthermore, this approach cannot be used in GNSS-denied environments (e.g.indoors). To overcome these issues, this paper investigates
the integration of information provided by an Ultra-Wideband (UWB) positioning system with image-based reconstruction to produce a metric reconstruction. Further-more, the orientation (with respect to North-East directions) of the model is assessed thanks to the use of inertial sensors included
in the UWB devices. Results of this integration are shown on two case studies in indoor environments.
Que bom te ver viva: luta armada e repressão a partir de uma perspectiva de gênero
Authors: Tedesco Marina Cavalcanti
Published: May 2019

No Brasil, como em boa parte dos países latino-americanos, a emergência da segunda onda do feminismo coincidiu com a luta armada contra as ditaduras recém-instauradas na região - e, consequentemente, com a sua repressão. Contrariando seu "destino" de gênero, muitas mulheres pegaram em armas, e não raras vezes foram punidas por esta dupla transgressão. No ano das primeiras eleições diretas para presidente desde o golpe civil-militar de 1964, Lúcia Murat lança Que bom te ver viva, filme que alterna depoimentos de ex-presas políticas que, assim como ela, foram torturadas nos anos 1970, e uma personagem ficcional que passou pela mesma situação. Neste artigo faremos um retrospecto da segunda onda do feminismo brasileiro e suas principais questões, suas (des)articulações com a luta contra a ditadura militar, e seguiremos refletirmos como elas aparecem na obra de Murat, tanto em seu nível documental quanto no ficcional.
Gênero e travestilidade nas telas de cinema: a trajetória de Claudia Wonder em filme documentário
Authors: Franco Stella Maris Scatena , Da Silva Natania Neres , Oliveira Julia Glaciela Silva
Published: May 2019

O presente artigo visa analisar o documentário Meu amigo Cláudia, dirigido por Dácio Pinheiro, que retrata a trajetória da artista e travesti Cláudia Wonder. Lançado em 2009, o documentário percorre a vida de Wonder entre os anos de 1970 e 2000, passando, assim, pelas mudanças na conjuntura política, social e cultural vivenciada pelo país nestas quatro décadas. Neste aspecto, em um primeiro momento, tratamos da produção do longa-metragem e seu caráter biográfico, atentando-nos para as construções e representações que o gênero documentário faz da história e da personagem retratada. Na sequência, abordamos como os contextos cultural, político e social do país são expostos pelo filme, sobretudo no que concerne à esfera artística e às questões de gênero e sexualidade. Por fim, discutimos como o documentário apresenta a multiplicidade artística de Cláudia Wonder e de que maneira sua performatividade corporal ambígua, em termos de gênero e sexo, é trabalhada no filme.