bluuebunny/crossref_metadata_2025 huggingface dataset:
A Mixed Methods Approach to Define Tactile Requirements for a Part-Task Trainer
Authors: Dykens Ian T. , Dorton Stephen L. , Bailey Margaret , Sotomayor Teresita
Published: February 2021

In response to the incidence of oculofacial traumas that were observed during the wars in Iraq and Afghanistan, military medical care provider training programs have placed an increased focus on the treatment of ocular traumas. As such, the Lateral Canthotomy and Cantholysis (LCC) Training System was developed to simulate the anatomy of the human eye and to mimic the symptoms of an eye that is afflicted with a retrobulbar hemorrhage. We report a mixed-methods psychophysics study that was conducted during the development of the LCC Training System to determine the appropriate retrobulbar pressure to be simulated by the trainer to provide anatomically accurate sensations of pressure. More than 200 eye inserts with either pre-or post-LCC pressures were evaluated by oculofacial trauma subject matter experts. The captured evaluations enabled the research team to identify and specify the pressure requirements that would be used by manufacturers to produce an anatomically and tactically-accurate trainer.
Multimodal Displays to Reduce Distraction In Locomotive Engineers
Authors: Grice Rachel , Fisher Donald , Isaacs Matthew , Liu Andrew
Published: February 2021

Multi-modal displays that allow the locomotive engineer to delay safety-critical dispatches in high workload scenarios offer the promise of reducing the cognitive distraction that occurs when the locomotive engineer must listen to a dispatcher’s communication. In an effort to determine whether locomotive engineers could delay safety-critical information from the dispatcher in high workload scenarios, we developed and evaluated such a multi-modal display system. It was hypothesized that locomotive engineers, when provided with the ability to postpone the delivery of information from the dispatcher, would perform better than locomotive engineers who were not provided that capability. Contrary to the above hypothesis, an analysis of the eye tracking measures indicated that the engineers performed more poorly in the multi-modal display system condition, indicating that the system as designed did not allow the engineer to safely delay dispatch messages. We conclude that aspects of the new system that seemed to increase distraction should be redesigned to modify how and when the engineer uses the system to access information and allow for a safe delay of safety-critical information.
Develop and evaluate an augmented reality posture training tool to promote work safety
Authors: Chen Ken , Perera Gimantha , Li Li , Xu Xu , Chen Karen B
Published: February 2021

Conventional work posture training tools included pamphlets, one-time training orientation, and/or videos. These tools did not always yield satisfactory training outcomes, and the incident rate of work-related musculoskeletal disorders did not substantially lower. In this research, modern augmented reality (AR) technology was leveraged to deliver interactive, holistic, whole-body visual information to convey safe work postures. The developmental procedure followed DMAIC by first defining specifications of training content, which led to the development of the training tool, including 3D reconstruction of a virtual instructor and building of user interface based on user-centered framework. This AR training tool was measured and analyzed through usability evaluation, and quantitative and qualitative data were obtained for cross-validation and usability issue source identification. Findings revealed the utility of 3D reconstruction of a virtual instructor and practicality of adopting conventional usability evaluation method for AR user interface usability evaluation. Feedback from the usability evaluation via questionnaire, think aloud, and post-task open-ended responses are employed to iteratively design the next version of the AR posture training tool.
The Design and Assignment of Microgestures to Commands for Virtual and Augmented Reality Tasks
Authors: Li Guangchuan , Rempel David , Liu Yue , Harris-Adamson Carisa
Published: February 2021

Researchers have designed 3D (non-contacting) gestures for human-computer interaction (HCI) for desktop computers, automobiles, and augmented and virtual reality (AR/VR) to improve functionality, and experience. 3D gestures provide a method for HCI in clean and dirty environments and settings where both hands need to be free for other tasks such as warehouse work. However, long-term use of 3D gestures may pose a risk of musculoskeletal fatigue especially if the gestures require movement at larger joints such as the shoulder or elbow. Microgestures involve motions of just the fingers and hands thereby reducing muscle fatigue and distraction. Current microgesture lexicons are not well designed for VR or AR systems because of differences in interactive requirements of the commands and context for their use. The purpose of this study was to design microgestures for AR and VR that follow user experiences with existing gestures while considering application, user preference and hand/wrist postures.
User Support Systems: Lessons Learned from Implementing Multiple Interaction Methods During Testing
Authors: Duke Tyler , Althoff Will , Gerard Michel Schouten Dylan , Harteveld Casper , Maltuk Camillia , Smith Gillian , Sutherland Steven
Published: February 2021

To master the functions and tasks of a game, players must learn how to play the game. When conceptual learning outcomes are expected, additional skills are required to master those concepts. Methods, such as the Wizard of Oz technique, which require users to interact with a computer support tool, have been used to help improve usability and learnability of products and interfaces; however, little attention has been given to how these approaches may help with effective scaffolding with respect to constructionist game design tools. Students created research experiment games in StudyCrafter. We introduced a multiple-interaction technique of providing feedback via querying the “system” or instructor and found that students typically initiate interactions with support tools to address technical issues and rarely ask for assistance with conceptual support. We suggest that the use of this approach allows designers to better gauge how users interact with support and propose considerations for designing creativity support tools for educational content.
Accuracy of Time Duration Estimations in Virtual Reality
Authors: Mallam Steven C. , Ernstsen Jørgen , Nazir Salman
Published: February 2021

Virtual Reality Head Mounted Displays (VR HMDs) offer highly immersive experiences that may alter users’ awareness and perception of the “real-world”. This paper investigates users’ perception of short duration (<5 minutes) time periods during simulated scenarios between two different simulation mediums. Fifty participants (Age: M=29.2 years; SD=10.7 years; 15 Females; 35 Males) were randomly assigned to one of two groups: (i) VR HMD or (ii) desktop computer configuration, where they performed identical searching tasks within a virtual environment three consecutive times. After each virtual session participants were asked to verbally report their perception of time duration. Results reveal that participants across both groups overestimated time duration in virtual environments by an average of 20.3%. As participants gained experience performing the task repeatedly across three consecutive attempts, their task completion time reduced (i.e. learning effect). However, participants’ accuracy of time perception continued to be consistently overestimated across both conditions.
Simulate and sense force exertions during virtual patient transfer tasks
Authors: Chen Ken , Widmayer Rebecca , Chen Karen B.
Published: February 2021

Virtual reality (VR) is commonplace for training, yet simulated physical activities in VR do not require trainees to engage and contract the muscle groups normally engaged in physical lifting. This paper presents a muscle activity-driven interface to elicit the sensation of forceful, physical exertions when lifting virtual objects. Users contracted and attained predefined muscle activity levels that were calibrated to user-specific muscle activity when lifting the physical counterpart. The overarching goal is to engage the appropriate muscles, and thereby encourage and elicit behaviors normally seen in the physical environment. Activities of 12 key muscles were monitored using electromyography (EMG) sensors while they performed a three-part patient lifting task in a Cave Automatic Virtual Environment. Participants reported higher task mental loads and less physical loads for the virtual lift than the physical lift. Findings suggest the potential to elicit sensation of forceful exertion via EMG feedback but needed fine-tuning to offset perceived workload.
Effect of Head-Mounted Augmented Reality Devices on Electric Utility Manhole Workers: Neck Muscle Activity and Eye Blink Rate
Authors: Toll Ashley M. , Marklin Richard W. , Bauman Eric H. , Simmins John J.
Published: February 2021

Two head-mounted augmented reality (AR) systems, Microsoft HoloLens and RealWear HMT-1, were tested to determine their effect on blink rate and muscle activity of the neck and shoulder muscles of electric utility manhole workers. The task of splicing a cable was performed under three conditions: HoloLens, HMT-1, and No AR (normal). Surface electromyography (sEMG) of the right and left sternocleidomastoid, splenius, semispinalis capitis, and upper trapezius muscles were measured on 13 manhole workers, and a small camera recorded blink rate of the right eye. Results revealed, in general, no significant differences in 50th and 90th percentile sEMG between the three conditions. There was no difference in blink rate between the HMT-1 and No AR, but the HoloLens blink rate was 7.8 to 11 blinks/min lower than the HMT-1 for two of the three tasks. A decrease in blink rate of these magnitudes may indicate risk of eye strain to manhole workers who use an OST AR device without appropriate rest breaks. Head-mounted AR devices deployed for underground utility workers warrant further study.
The National Academies Board on Human System Integration (BOHSI) Panel: Promise, Progress and Challenges of Leveraging AI Technology in Healthcare
Authors: Warden Toby , Oswald Fred , Roth Emilie M. , Argall Brenna , Barry Barbara , Carayon Pascale , Czaja Sara , Ratwani Raj
Published: February 2021

The National Academies Board on Human Systems Integration (BOHSI) has organized this session exploring the state of the art and research and design frontiers relating to the application of Artificial Intelligence (AI) technologies to Healthcare. Advances in AI, machine learning, and robotics promise to revolutionize access to and quality of healthcare. At the same time lessons learned from earlier applications of AI technologies suggest a need to carefully consider the user and use context and the need for effective human-machine teaming design to avoid brittle systems that fail to be used or worse that negatively impact patient safety. The Panel brings together prominent researchers from both the Human Factors and Computer Science and AI communities to discuss promising applications, challenges and short-falls and ways forward for achieving the promise of enhanced delivery of health care through application of AI technologies.
Personality Assessment Inventory Clinical Scales in Relation to Patient and Therapist Rated Alliance Early in Treatment
Authors: Cersosimo Bianca H. , Hilsenroth Mark J. , Bornstein Robert F. , Gold Jerold R.
Published: February 2021

We examined relationships between the Personality Assessment Inventory (PAI) clinical scales (e.g., Somatic Complaints [SOM]) and subscales (e.g., Conversion [SOM-C]) with patient- and therapist-rated alliance early in treatment (third or fourth session). We also replicated and extended findings from a previous study examining PAI treatment scales (Treatment Rejection, Treatment Process Index) and early session therapist-rated alliance. We used PAI protocols from a clinical outpatient sample ( N = 84). Data were analyzed using stepwise linear regressions. Results suggest that patients who report lower early session alliance also report more antisocial features (β = −.219, p = .050, f2 = 0.05) specifically more antisocial behaviors (β = −.315, p = .004, f2 = 0.11). Additionally, therapists report higher early session alliance with patients who report more anxiety-related disorders (β = .274, p = .012, f2 = 0.08), specifically traumatic stress (β = .325, p = .003, f2 = 0.12). No significant relationships were found between patient- or therapist-rated alliance and Treatment Rejection and Treatment Process Index, consistent with prior findings. Clinical implications are discussed.
Examining the Psychometric Equivalency of MMPI-3 Scale Scores Derived From the MMPI-3 and the MMPI-2-RF-EX
Authors: Hall Jordan T. , Menton William H. , Ben-Porath Yossef S.
Published: February 2021

The current study evaluated the comparability of Minnesota Multiphasic Personality Inventory–3 (MMPI-3) scale scores derived from the 335-item MMPI-3 to MMPI-3 scale scores derived from the 433-item MMPI-2 restructured form–expanded version (MMPI-2-RF-EX), an enhanced version of the MMPI-2-RF that was used to develop and validate the MMPI-3. To that end, we examined data from 192 college undergraduates who completed both the MMPI-3 and MMPI-2-RF-EX 1 week apart using a counterbalanced design. Across versions, mean T-scores and standard deviations, estimates of internal consistency, and standard error of measurement values, were highly similar, indicating no clinically meaningful differences across versions. We also compared between-version test–retest comparability values with within-version values calculated using a sample of undergraduates ( N = 318) who completed the MMPI-2-RF-EX twice over the same time interval, finding only marginal differences across the two samples. Finally, we computed column-vector correlations between MMPI-3 scores from both versions and several criterion measures, where results reflected no effect of test version on external validity. Overall, we determined that scale scores derived from either booklet are psychometrically interchangeable, indicating that MMPI-3 scale scores obtained from an administration of the MMPI-2-RF-EX can be applied when using the 335-item MMPI-3.
Definitive Radiotherapy in the Management of Non-Resectable or Residual Retroperitoneal Sarcomas: Institutional Cohort Analysis and Systematic Review
Authors: Sobiborowicz Aleksandra , Spałek Mateusz Jacek , Czarnecka Anna Małgorzata , Rutkowski Piotr
Published: February 2021

Background:

There is currently no consensus on optimal management of patients with primary or recurrent non-resectable/residual retroperitoneal sarcomas (RPS). The objective of this study was to document the outcomes of patients with primary or recurrent non-resectable/residual RPS treated in our center with definitive radiotherapy (RT) and to perform a systematic review on the topic.

Methods:

A retrospective analysis of consecutive RPS patients treated in our center between 2000 and 2019 was performed. All consecutive patients who underwent definitive conformal RT with image guidance for primary or recurrent non-resectable or macroscopically residual RPS were included. Additionally, a systematic review compliant with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was performed.

Results:

The study enrolled 14 patients who met the aforementioned criteria. Data on clinicopathological characteristics, RT and response to treatment were assessed. RT allowed achieving prolonged local control of the disease, i.e. no local progression of the disease for more than 12 months after RT in 10 patients. Local control lasted more than 24 months in 6 cases, with minimal or no toxicity. A systemic review of 11 studies revealed concordance of our results with previous reports of primary or recurrent non-resectable/residual RPS.

Conclusions:

RT provided satisfactory local disease control with acceptable treatment tolerance in patients with primary or recurrent non-resectable/residual RPS and represents a valuable treatment modality in the selected group of patients. Additional RT modalities i.e. BT, particle therapy, MRI-guided RT, or GRID/Lattice RT may be introduced to improve local control and further minimize toxicity.
A Matter of State: Diversity in Oligodendrocyte Lineage Cells
Authors: Kamen Yasmine , Pivonkova Helena , Evans Kimberley A. , Káradóttir Ragnhildur T.
Published: February 2021

Oligodendrocyte precursor cells (OPCs) give rise to oligodendrocytes which myelinate axons in the central nervous system. Although classically thought to be a homogeneous population, OPCs are reported to have different developmental origins and display regional and temporal diversity in their transcriptome, response to growth factors, and physiological properties. Similarly, evidence is accumulating that myelinating oligodendrocytes display transcriptional heterogeneity. Analyzing this reported heterogeneity suggests that OPCs, and perhaps also myelinating oligodendrocytes, may exist in different functional cell states. Here, we review the evidence indicating that OPCs and oligodendrocytes are diverse, and we discuss the implications of functional OPC states for myelination in the adult brain and for myelin repair.
Neuroinflammation in Parkinson’s Disease: Triggers, Mechanisms, and Immunotherapies
Authors: Wang Tai , Shi Changhe , Luo Haiyang , Zheng Huimin , Fan Liyuan , Tang Mibo , Su Yun , Yang Jing , Mao Chengyuan , Xu Yuming
Published: February 2021

Parkinson’s disease (PD) is a heterogeneous neurodegenerative disease involving multiple etiologies and pathogenesis, in which neuroinflammation is a common factor. Both preclinical experiments and clinical studies provide evidence for the involvement of neuroinflammation in the pathophysiology of PD, although there are a number of key issues related to neuroinflammatory processes in PD that remain to be addressed. In this review, we highlight the relationship between the common pathological mechanisms of PD and neuroinflammation, including aggregation of α-synuclein, genetic factors, mitochondrial dysfunction, and gut microbiome dysbiosis. We also describe the two positive feedback loops initiated in PD after the immune system is activated, and their role in the pathogenesis of PD. In addition, the interconnections and differences between the central and peripheral immune systems are discussed. Finally, we review the latest progress in immunotherapy research for PD patients, and propose future directions for clinical research.
Historical Overview of the “Firing” Liaison between Brain Tumors and Epilepsy
Authors: Natale Gianfranco , Cucchiara Federico , Bocci Guido
Published: February 2021

This review addresses, in a critical historical perspective, the link between seizures and endocranic neoplasms. Folkloric descriptions of epilepsy can be found in writings from ancient cultures. Hippocrates first provided a medical interpretation. In 1770, Tissot published Traité de l’épilepsie, a milestone in epileptology, whereas the 19th century is considered the golden era of epileptic studies. In 1882, the father of modern epileptology, Jackson, in his article Localized Convulsions from Tumour of the Brain, reported a case of a patient affected by typical Jacksonian seizures in the presence of a brain tumor. However, he did not establish a direct correlation between brain tumors and epilepsy, and an explanation for his clinical case was lacking. Before Jackson’s article, other authors reported similar cases, but only Gairdner in 1834 published a report suggesting the concept of a direct relationship between epilepsy and a brain tumor. From the beginning until the mid of the 20th century several authors reported seizures attributed to intracranial tumors, and in recent years studies have focused on the pathogenesis of tumor-related seizures. Biochemical and molecular changes in brain tumors and their environment opened unprecedented working hypotheses on epileptogenesis and on treatment of epilepsy associated with brain tumors.
The Role of IL-13, IL-15 and Granulysin in the Pathogenesis of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
Authors: Sadek Michael , Iqbal Omer , Siddiqui Fakiha , Till Sean , Mazariegos Melissa , Campbell Edward , Mudaliar Kumaran , Speiser Jodi , Bontekoe Emily , Kouta Ahmed , Farooqui Ambar , Daravath Bharathi , Qneibi Dalia , Sadek Ramy , Hoppensteadt Debra , Fareed Jawed , Bouchard Charles
Published: February 2021

Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are Severe Cutaneous Adverse Reactions (SCARS) characterized by fever and mucocutaneous lesions leading to necrosis and sloughing of the epidermis. Conjunctival lesions are reported in 85% of patients. The pathogenesis of SJS/TEN/SCARS is not completely understood. It is hypothesized that IL-13, IL-15 and Granulysin expressed in plasma and skin may play a role. We measured the circulating levels of these cytokines in the plasma using ELISA and their expression in the skin using immunofluorescence microscopy. A total of 12 SJS/TEN skin biopsy samples (8 SJS, 2 SJS/TEN overlap and 2 TEN) were analyzed. Biopsy samples from patients with Lichen Planus (an inflammatory condition of the skin and mucous membranes) served as controls. Studies were also performed in human corneal epithelial cells where expression of these cytokines were measured following a challenge with TNF-α (0, 1, 10 and 100 ng/ml). The intensity of immunofluorescence was measured Using Imaris® software. The results showed significantly increased expression of these cytokines in the skin biopsy samples as measured by the average intensities of IL-13 (6.1 x 133.0 ± 4.231 x 10^8), and Granulysin (4.2 x 123.0 ± 4.231 x 10^8) compared to Lichen planus control (3.0 x 123.0 ±1.62 x 10^5). Increased expression of IL-13 and IL-15 were noted in cell culture studies and in the plasma samples when compared to Normal Human Plasma as controls. It is concluded that IL-13, IL-15 and Granulysin play a role in the pathogenesis of SJS/TEN.
MDR1 gene polymorphisms and imatinib response in chronic myeloid leukemia: A meta-analysis
Authors: Louati N , Turki F , Mnif H , Frikha R
Published: February 2021

Background

Our study aimed to investigate the association between multidrug resistance (MDR1) C1236T, C3435T and G2677T/A polymorphisms and the response to imatinib (IM) in chronic myeloid leukemia (CML).

Materials and methods

An electronic databases in PubMed, Embase, Web of Knowledge, Scopus and Cochrane were searched using combinations of keywords relating to MDR1 polymorphisms and the response to IM in CML. Studies retrieved from database searches were screened using strict inclusion and exclusion criteria.

Results

In total, 37 studies were initially identified, and 17 studies, involving 4494 CML patients, were eventually included in this meta-analysis. Results of our study revealed significant association between MDR1 G2677T/A and C3435T polymorphisms and response to IM in Caucasian population under recessive model (T or A vs G; OR = 1.43,95%CI [1;06-1.93]; T vs C;OR = 1.13; 95%IC [0.79; 1.63]), dominant (T or A vs G; OR = 0.94; 95%CI [0.74–1.21]; T vs C; OR = 1.49; 95%CI [1.02–2.17]) and heterozygous models (T or A vs G; OR = 0.83; 95%CI [0.64; 1.09]; T vs C; OR = 1.52; 95%CI [1.01–2.28]); respectively. However, never significative association was found between IM response and the MDR1 C1236T polymorphism (OR = 1.25; 95%CI [0.46; 3.33]).

Conclusion

The MDR1 G2677T/A and C3435T polymorphisms might be a risk factor for resistance to IM in Caucasian CML patients.
Co-existence of BCR-ABL and JAK2V617F mutation in resistant chronic myeloid leukemia in the imatinib era: Is there a correlation?
Authors: Frikha Rim , Turki Fatma , Kassar Olfa , Elloumi Moez , Kamoun Hassen
Published: February 2021

Introduction

Diagnoses of myeloproliferative disorder is based on molecular marker. Chronic Myeloid Leukemia and Myeloproliferative neoplasms were considered mutually exclusive and co-existence of BCR/ABL1 and JAK2 mutation is a rare phenomenon.

Case report

Here, we present two cases of co-existence of BCR-ABL and JAK2V617F positivity. We characterize the course of the disease, mainly the minimal residual disease. Management and outcome: The two cases was initially managed as Chronic Myeloid Leukemia and treated by TKI inhibitors. The first one was diagnosed in 2010. He started the first line of TKI, and then switched to second line without obtaining a major molecular response. Hence he was tested for JAK2V617F mutation and positivity was diagnosed. The second patient showed Chronic Myeloid Leukemia phenotype with coexistence of BCR/ABL1 and JAK2 mutation at diagnosis. Molecular monitoring reveals a high BCR-ABL1 transcript level (20%) at the last follow-up (12 months).

Discussion

Ours results highlight that JAK2V617F/BCR-ABL double positivity may be a potential marker of resistance in Chronic Myeloid Leukemia and clonal molecular analysis is mandatory to elucidate the mechanism. Moreover, the combination of JAK and TKI inhibitors might be effective and potentially be guided by molecular monitoring of minimal residual disease.
Surface contamination with nine antineoplastic drugs in 109 canadian centers; 10 years of a monitoring program
Authors: Chabut Claire , Tanguay Cynthia , Gagné Sébastien , Caron Nicolas , Bussières Jean-François
Published: February 2021

Introduction

Healthcare workers exposure to antineoplastic drugs can lead to adverse health effects. Guidelines promote the safe handling of antineoplastic drugs, but no safe exposure limit was determined. Regular surface sampling contributes to ensuring workers safety.

Methods

A cross-sectional monitoring is conducted once a year with voluntary Canadian centers, since 2010. Twelve standardized sampling sites were sampled. Samples were analyzed by high performance mass coupled liquid chromatography. The limits of detection (in ng/cm2) were: 0.001 for cyclophosphamide and gemcitabine; 0.3 for docetaxel and ifosfamide; 0.04 for 5-fluorouracil and paclitaxel; 0.003 for irinotecan; 0.002 for methotrexate; 0.01 for vinorelbine.

Results

The surfaces from 109 centers were sampled between 01/01/2020–18/06/2020. Twenty-six centers delayed their participation because of the COVID-19 pandemic. 1217 samples were analyzed. Surfaces were frequently contaminated with cyclophosphamide (34% positive, 75th percentile 0.00165 ng/cm2) and gemcitabine (16% and <0.001 ng/cm2). The armrest of patient treatment chairs (84% to at least one drug), the front grille inside the biological safety cabinet (BSC) (73%) and the floor in front of the BSC (55%) were frequently contaminated. Centers that prepared ≥5000 antineoplastic drugs annually had higher concentration of cyclophosphamide on their surfaces (p < 0.0001). Contamination measured on the surfaces was reduced from 2010 to 2020.

Conclusions

This large-scale study showed reproducible long term follow up of the contamination of standardized sites of Canadian centers and a reduction in surface contamination from 2010 to 2020. Periodic surface sampling help centers meet their continuous improvements goals to reduce exposure as much as possible. The COVID-19 pandemic had a limited impact on the program.
Increasing pharmacy productivity and reducing medication turnaround times in an Italian comprehensive cancer center by implementing robotic chemotherapy drugs compounding
Authors: Capilli Martina , Enrico Fiorenza , Federici Matteo , Comandone Tiziana
Published: February 2021

Introduction

The management of antineoplastic drugs used for chemotherapy is widely recognized as a high-risk activity. In 2018, our oncology pharmacy implemented workflow improvements to manage the growing workload due to the centralisation of activities from a hospital’s satellite pharmacy, moving towards automated compounding of antineoplastic drugs. The aim of this study was to determine the impact of the centralization on the productivity of the pharmacy department and evaluate the performances of the robotic chemotherapy drugs compounding.

Material and methods

Data were collected from the hospital information system and the workflow management software, and examined over a 3-year period (2017–2019). The total annual throughput in terms of doses prepared and patients treated and the Medication Turnaround Time (MTAT) were determined. Productivity and dosage accuracy were calculated for the robotic system.

Results

In 2018, the number of patients treated increased by 16.6%, consequently, the overall number of intravenous preparations compounded in the pharmacy increased by 17.2%. Regarding manual compounding, the total number of antineoplastic preparations decreased by about 2%. Investigational treatments manually compounded increased by about 27%, in contrast to the non-investigational treatments, which decreased by 9.4%. Regarding robotic compounding, the annual production increased by 50.4%. In 2018, the MTAT decreased about 24%. The dosage accuracy and precision of the total amount of doses were -1.1% and 1.2%, respectively.

Conclusion

This study indicates that in the effort to satisfy an ever-increasing workload, computerization and automation are essential instruments to maintain and ensuring high standards of quality.
Gummy candies production with natural sugar source: Effect of molasses types and gelatin ratios
Authors: Kurt Abdullah , Bursa Kubra , Toker Omer Said
Published: February 2021

Nowadays, attention has been dedicated towards the development of foodstuffs whose constituents are from natural sources. In this study, grape, mulberry, and carob molasses containing natural sugars were evaluated in order to replace the use of sugar syrup and artificial additives in the production of gummy candy which was prepared by varied gelatin ratios. The molasses which have similar °Brix values (78–79) presented different types and amounts of sugar components. High invert sugar with low sucrose was observed in grape and mulberry but high sucrose with low fructose and glucose appeared in carob molasses. Unlike grape and mulberry, carob based jellies had a whitish appearance possibly as a result of the crystallization due to its high sucrose/invert sugar ratio. For all parameters of TPA, carob candy with 5 g/100 g gelatin and grape candy with 10 g/100g gelatin had the lowest and highest values, respectively. Gelatin concentration dependency trend of hardness, gumminess, chewiness and resilience was determined as grape > mulberry > carob. No significant effect ( p > 0.05) on gelling temperatures (21–29 °C) but significant effect (p < 0.05) on melting points (33–39 °C) of molasses types were observed for candies. The properties of grape based candy having higher thermal stability and lower temperature sensitivity were attributed to its higher total sugar contents than other samples. The sensorial acceptability score for molasses gummy candies obtained more than 3.0 on a 5-point hedonic scale. These results illustrate the potential for the use of molasses in a healthier confectionery product development instead of commonly used sugars.
Microstructural and chemical properties of gari and eba: Food products from cassava (Manihot esculenta Cranz)
Authors: Erukainure Ochuko L , Alabi Opeyemi O , Salau Veronica F , Amonsou Eric O
Published: February 2021

The microstructure, elemental distribution and rheological behavior of two varieties of gari and their doughs (eba) were investigated. SEM analysis revealed a concave structure with fibre-strands, which were altered after processing to eba. Gari nanostructures which were analyzed with TEM were not affected when processed to eba. SEM-EDX microanalysis revealed the presence of magnesium, potassium, calcium, manganese, iron, and cobalt for both varieties, which were altered after processing. Rheological analysis revealed increases in storage modulus, with concomitant loss factor for both varieties. Their viscosity decreased with increasing shear rate. GC-MS analysis revealed the presence of sugar, fatty acids, and steroids in both varieties, which were also affected after processing. Both varieties showed significant free radical scavenging activity which was not affected after processing. These results indicate that the conclave microstructure, elements and phytochemicals of both gari varieties are altered after processing to eba, with their nanostructure and antioxidant activity unaltered.
Let’s Chat: Development of a Family Group Chat Cancer Prevention Intervention for Vietnamese Families
Authors: Duong Huong T. , Hopfer Suellen
Published: February 2021

Vietnamese Americans are disproportionately affected by preventable late-stage cancers. This study capitalizes on the protective role of family networks to develop an online social media family group chat intervention promoting cancer screening among Vietnamese American families. A feasibility study was conducted to assess implementing Let’s Chat, a 4-week intergenerational family group chat intervention to increase cancer screenings. Vietnamese American young adults were trained to act as family health advocates on their private family group chats and share cancer screening messages. The intervention covered material on recommended screenings for colonoscopy for those aged 45+ years, HPV (human papillomavirus) vaccination for young adults, and Pap testing for women. Ten families ( n = 41) participated. Family group chat content analysis resulted in (a) sharing personal screening experiences, (b) family members being prompted to schedule cancer screening appointments after discussions in the chat, and (c) family members expressing a sense of urgency to follow up with cancer screening. Postintervention survey results revealed that 48% of participants received screening/vaccination, 77% reported intent to schedule an appointment to discuss recommended screenings, 61% reported discussing cancer screenings outside their group chat, 84% felt comfortable discussing screenings with family after the intervention, and 68% agreed that the group chat facilitated comfort around cancer screening discussions. Family members reported feeling closer to their family and greater comfort discussing cancer and cancer screening. Results from the Let’s Chat feasibility study indicate promise for implementing a randomized trial conditional on grouping family chats by age and gender to increase cancer screenings among Vietnamese American families.
Lateral transorbital canthopexy using a silicone tube in patients with paralytic ectropion
Authors: González-Cannata María G , González-Hinojosa Diana I , Aguilera-Ruíz Karla J , González-Núñez Martha P , Medina-Zarco Alfredo , Acevedo-Moreno Lou-Anne G , González-Navarro Mauricio
Published: February 2021

Purpose:

We describe the efficacy of lateral transorbital canthopexy using a silicone tube in managing severe paralytic ectropion.

Methods:

Patients with paralytic ectropion involving at least two-third of lower eyelid length and scleral exposure of 3 mm or more were considered. A silicone prosthetic was inserted during canthopexy.

Results:

Lateral transorbital canthopexy using a silicone tube was performed on 10 eyelids in nine patients. All patients had corneal surface abnormalities. Scleral exposure resolved completely in three cases. At 8-month follow-up, residual scleral exposure of 1 mm and 2 mm persisted in n = 6 and n = 1 cases, respectively.

Conclusions:

Lateral transorbital canthopexy using a silicone tube is an effective therapeutic option for paralytic ectropion, facilitating both functional and cosmetic results that proved durable over time.
Intracorneal circular ring implant with femtosecond laser: Pocket versus tunnel
Authors: Izquierdo Luis , Rodríguez Ana M , Sarquis Ramón A , Altamirano Diego , Henriquez Maria A
Published: February 2021

Purpose:

To evaluate and compare visual and refractive outcomes after implantation of the intracorneal continuous ring 360° arc (ICCR) versus the intracorneal ring segment 340° arc (ICRS) using femtosecond laser for central keratoconus.

Setting:

Research Department, Oftalmosalud, Instituto de Ojos, Lima, Peru.

Methods:

Randomized study that included 40 eyes of 32 patients diagnosed with central keratoconus between November 2014 and March 2015. Twenty eyes had an implantation of ICCR (MyoRing, Dioptex GmbH, Austria) through an intrastromal pocket and 20 eyes had an implantation of ICRS (Keraring, Mediphacos, Brazil) through an intrastromal tunnel. Both procedures were performed with a femtosecond laser (LDV Z6 model, Ziemer Ophthalmic Systems AG). Visual acuity (VA), refraction, and Scheimpflug imaging analysis were performed pre- and postoperatively at 1 month and 1 year. Comparisons of means were performed using the Student’s t-test.

Results:

At 1 year, uncorrected VA improved 0.77 LogMAR ( p < 0.001) in the ICCR group and 0.79 LogMAR ( p = 0.01) in the ICRS group; mean sphere improvement was 5.13 Diopters (D) in the ICCR group and 6.27 D in the ICRS group ( p < 0.001 both); mean Steeper Keratometry improvement was 4.24 D in the ICCR group and 5.53 D in the ICRS group ( p < 0.001 both). In the ICCR group, mean decrease in the pachymetry at the thinnest point of the cornea was 32.16 µm ( p = 0.01), and in the ICRS group, mean increase was 4.2 µm at 1 year ( p = 0.61).

Conclusion:

Intracorneal continuous ring 360° arc (ICCR) and intracorneal ring segment 340° (ICRS) are effective treatments for central keratoconus. No significant differences between rings were found on visual acuity, refraction, and keratometry improvement.
The FICI grading for a dacryocystorhinostomy ostium
Authors: Ali Mohammad Javed , Gupta Adit , Lakshmi Chittabhathina Sri , Ali Mohammad Hasnat
Published: February 2021

Purpose:

The objective of this study is to propose a simple grading to assess the health of a dacryocystorhinostomy (DCR) ostium.

Methods:

Prospective case series of 237 Ostia evaluated following dacryocystorhinostomy were included in the study. All the ostia were assessed for 10 parameters in detail using the earlier published DCR ostium scoring (DOS scoring). Each of the 10 parameters were scored individually, and final DOS scores were obtained. The anatomical and functional outcomes of each of the surgery were noted. The most significant parameters that influenced the success were determined using the binary recursive partitioning in a conditional inference framework. Data management and statistical tests were performed using the statistical “Software R” and the library “partykit” toolkits.

Results:

The most significant DCR ostium parameters that influenced the outcomes were anatomical and functional fluorescein dye transit ( p < 0.001), dynamicity of internal common opening (ICO) on the blink ( p < 0.001), end-on threats to ICO from granuloma, membrane or a synechia, and cicatricial closure of the Ostia. Each of these significant factors (FICI – Fluorescein endoscopy dye test, ICO dynamicity, Cicatricial ostium closure and ICO threats) were assigned simple scoring and the final scores were graded from 0 (poor DCR ostium) to +5 (excellent DCR ostium). FICI grading can guide the physician on the health status of the DCR ostium and the possible need for intervention.

Conclusion:

FICI DCR ostium grading is a simple, easy to perform, and physician-friendly system. More studies with larger sample size would help in further validating the FICI grading.
Comparative evaluation of visual outcomes after bilateral implantation of an advanced or conventional monofocal intraocular lens
Authors: Lopes Diogo , Loureiro Tomás , Carreira Rita , Rodrigues Barros Sandra , Cardoso João Nobre , Campos Paul , Machado Inês , Campos Nuno
Published: February 2021

Purpose:

To assess the clinical outcomes and patient satisfaction of the Tecnis Eyhance, an advanced monofocal intraocular lens (IOL), compared to a conventional monofocal IOL.

Design:

Retrospective case-control study.

Methods:

This study included 120 eyes of 60 patients (30 patients in each group) who underwent bilateral cataract surgery either with the implantation of conventional monofocal IOLs (Tecnis PCB00), as a control group, or advanced monofocal IOLs (Tecnis Eyhance ICB00). Ophthalmological evaluation included the measurement of binocular corrected distance visual acuity (CDVA), monocular and binocular uncorrected distance visual acuity (UDVA), and uncorrected intermediate VA (UIVA). In addition the binocular defocus curve was analyzed. Furthermore a subjective questionnaire (Catquest-9SF) was used to assess vision and life quality.

Results:

The average binocular UDVA was 20/22 in the ICB00 group and 20/20 in the PCB00 model ( p = 0.62). The average monocular UIVA was 20/32 in the ICB00 group and 20/40 in the control group ( p < 0.001). We found the binocular UIVA, had a mean value of 20/30 in the ICB00, compared to 20/40 in the control group ( p < 0.001). The reported dysphotopsia was not significantly different between both groups ( p = 0.56). Regarding the life quality questionnaire, the ICB00 group showed less difficulty in activities requiring intermediate vision.

Conclusion:

Our results demonstrated a significant improvement in visual acuity for intermediate distance in the ICB00 group compared to the control group, without compromising distance visual acuity. We also found a greater capability for intermediate distance activities (namely for computer use and reading price tags) when comparing ICB00 patients with the control group.
Long-term clinical and radiological outcome in patients with severe Legg-Calvé-Perthes disease after Chiari pelvic osteotomy: a mean of 14 years follow-up
Authors: Dammerer Dietmar , Braito Matthias , Ferlic Peter , Kaufmann Gerhard , Kosiol Juana , Biedermann Rainer
Published: February 2021

Introduction:

The Chiari pelvic osteotomy (CPO) has been recommended as a salvage procedure to improve head coverage in case of hip joint incongruence in paediatric hip disease. In this study, we aimed to assess the long-term results of CPO for severe Legg-Calvé-Perthes disease (LCPD).

Methods:

A total of 39 patients who underwent a CPO at our department between 1995 and 2010 were prospectively followed both radiologically (Stulberg classification) and clinically (Harris Hip Score [HHS], conversion into total hip arthroplasty). In this study, we retrospectively reviewed the cases of 12 hips (12 patients, 3 girls, 8 left hips) treated by CPO for severe LCPD (Catterall grade 3 or 4) with hip joint incongruence. Mean follow-up was 14.0 (range 7.6–21.3) years.

Results:

Mean age at surgery was 10.2 (range 8.2–17.8) years. Additional femoral osteotomy was performed in 8 patients. A good radiological result (Stulberg I or II) was achieved in 2 patients, a fair result (Stulberg III) in 4 patients, and a poor outcome (Stulberg IV or V) in 6 patients. Mean postoperative HHS averaged 93 (range 65–100) points. An excellent functional outcome (HHS 90–100 points) was achieved in 9 patients. No patient underwent total hip arthroplasty during follow-up. Postoperative limb-length discrepancy was found in 3 patients.

Conclusions:

CPO for severe LCPD with hip joint incongruence resulted in good long-term clinical outcome in about ⅔ of our patients after a mean of 14 years. Our results suggest that CPO can still be considered as a salvage joint-conserving procedure in this selected group of younger patients.
Use of a monoblock dual-mobility acetabular component in primary total hip arthroplasty in patients at high risk of dislocation
Authors: Yang JaeWon , Bryan Andrew J , Drabchuk Roman , Tetreault Matthew W , Calkins Tyler E , Della Valle Craig J
Published: February 2021

Introduction:

Dislocation is amongst the most common complications following total hip arthroplasty (THA). Dual-mobility bearings have been suggested as one way to reduce the risk of dislocation, particularly among patients at increased risk. The purpose of this study was to determine the outcomes of a monoblock dual-mobility shell for patients at high risk for dislocation following primary THA.

Methods:

A total of 155 primary THAs with a monoblock, cementless dual-mobility acetabular component were performed in patients at high risk for dislocation. Two patients died prior to their two-year follow-up. The remaining 153 THAs were followed for a mean of 5.1 years (range: 2.1 to 9.3).

Results:

There were no dislocations; however, four patients underwent revision surgery: one for an early periprosthetic acetabular fracture, one for an early periprosthetic femoral fracture, one for a late periprosthetic femoral fracture, and one for leg-length discrepancy. Intraoperative complications included one periprosthetic acetabular fracture treated with protected weight-bearing and one intraoperative proximal femoral fracture treated with cerclage wiring. Harris Hip Scores improved from a mean of 42.4 points preoperatively to a mean of 82.4 points postoperatively ( p < 0.001). No cups were radiographically loose. At a mean follow-up of 5.1 years, survivorship of the acetabular component was 99.3% (95% CI, 98.1–100%) and survivorship without any reoperation was 97.4% (95% CI, 95.9–100%).

Discussion:

Although there were no dislocations in this high-risk population, periprosthetic fractures of the femur and acetabulum were common with the implants utilised.
Application and implications of a standardised reporting system for arteriovenous access graft infection
Authors: Kingsmore David , Stevenson Karen , Jackson Andrew , Richarz Sabine , Isaak Andrej , White Beth , Thomson Peter
Published: February 2021

Introduction:

The perception that arteriovenous graft infection (AVGi) is frequent and severe is not based on contemporary data from large units using modern AVG. Furthermore, older reports compounded misperceptions by using non-standardised reporting that prevents easy comparison against the alternative modalities. The aim of this article is to use a recently published reporting scheme to analyse the frequency, management and outcome of AVGi in a large series of sequential early-cannulation AVG with long-term follow-up.

Methods:

A single-center series analysis was performed of 277 early-cannulation AVG with minimum 1-year follow-up (total 120,082 days). Infections relating to the AVG were classified, root-cause analysed and the outcomes presented.

Results:

Sixteen percent of all AVG implanted (51 episodes) developed infection related to the AVG. Primary AVGi (related to the insertion procedure or within 28 days) occurred in 9 (3%); secondary AVGi (related to AVG in use) occurred 33 times (rate 0.27/1000 haemodialysis days), at a mean of 382 days, and tertiary AVGi (in AVG no longer in use) occurred nine times. Only 1/3 of all AVGi led to bacteraemia, and ½ did not lead to loss of functional access.

AVG infection is not common, caused a systemic infection in only one-third, did not lead to metastatic infection, and importantly, was treatable without loss of access in one-half of all cases. Using an objective system that discriminates between aetiology and outcome allows a more complete objective understanding of relative infection risks and outcomes for AVG that can inform discussions with patients requiring vascular access for haemodialysis.