bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the feasibility of using the Dalhousie Computerized Attention Battery to measure postoperative cognitive dysfunction in older patients
Authors: Sardiwalla Yaeesh , Eskes Gail , Bernard Andre , George Ronald B. , Schmidt Michael
Published: October 2019

Purpose

Postoperative cognitive dysfunction is difficult to predict and diagnose, and can have severe consequences in the long term. The purpose of this study was to examine the feasibility of using a computerised test battery, the Dalhousie Computerized Assessment Battery in the perioperative clinic to detect cognitive changes after surgery.

Methods

Fifty patients were recruited for this study. Patients completed the Dalhousie Computerized Assessment Battery and tests of general cognition, mood and pain at baseline and at three months postoperatively.

Results

This pilot study had a screening rate (85.4%) and low attrition rate (12%). At baseline, patients exhibited no significant cognitive differences compared to a normative dataset. Postoperative cognitive dysfunction incidence was 2.7% on Montreal Cognitive Assessment, 13.6% with Dalhousie Computerized Assessment Battery and 36.3% based on subjective reports.

Conclusion

Computerised cognitive testing in the perioperative setting proved feasible. Deficits in spatial working memory and dual tasks may be most compromised by surgically related variables.
A validated novel preoperative index to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology: A cohort study
Authors: Hajibandeh Shahab , Hajibandeh Shahin , Hobbs Nicholas , Shah Jigar , Harris Matthew , Watton Leo , Huq Zahirul , Dalmia Sanjay , Malik Sohail , Mansour Moustafa
Published: October 2019

Aims

To investigate whether an intraperitoneal contamination index (ICI) derived from combined preoperative levels of C-reactive protein, lactate, neutrophils, lymphocytes and albumin could predict the extent of intraperitoneal contamination in patients with acute abdominal pathology.

Methods

Patients aged over 18 who underwent emergency laparotomy for acute abdominal pathology between January 2014 and October 2018 were randomly divided into primary and validation cohorts. The proposed intraperitoneal contamination index was calculated for each patient in each cohort. Receiver operating characteristic curve analysis was performed to determine discrimination of the index and cut-off values of preoperative intraperitoneal contamination index that could predict the extent of intraperitoneal contamination.

Results

Overall, 468 patients were included in this study; 234 in the primary cohort and 234 in the validation cohort. The analyses identified intraperitoneal contamination index of 24.77 and 24.32 as cut-off values for purulent contamination in the primary cohort (area under the curve (AUC): 0.73, P < 0.0001; sensitivity: 84%, specificity: 60%) and validation cohort (AUC: 0.83, P < 0.0001; sensitivity: 91%, specificity: 69%), respectively. Receiver operating characteristic curve analysis also identified intraperitoneal contamination index of 33.70 and 33.41 as cut-off values for feculent contamination in the primary cohort (AUC: 0.78, P < 0.0001; sensitivity: 87%, specificity: 64%) and validation cohort (AUC: 0.79, P < 0.0001; sensitivity: 86%, specificity: 73%), respectively.

Conclusions

As a predictive measure which is derived purely from biomarkers, intraperitoneal contamination index may be accurate enough to predict the extent of intraperitoneal contamination in patients with acute abdominal pathology and to facilitate decision-making together with clinical and radiological findings.
Tailored combined cytomegalovirus management in lung transplantation: a retrospective analysis
Authors: Solidoro Paolo , Patrucco Filippo , Libertucci Daniela , Verri Giulia , Sidoti Francesca , Curtoni Antonio , Boffini Massimo , Simonato Erika , Rinaldi Mauro , Cavallo Rossana , Costa Cristina
Published: October 2019

Background:

There is no univocal prophylactic regimen to prevent cytomegalovirus (CMV) infection/disease in lung transplantation (LT) recipients. The aim of this study is to evaluate short-term clinical outcomes of a tailored combined CMV management approach.

Methods:

After 1-year follow up, 43 LT patients receiving combined CMV prophylaxis with antiviral agents and CMV-specific IgG were evaluated in a retrospective observational study. Systemic and lung viral infections were investigated by molecular methods on a total of 1134 whole blood and 167 bronchoalveolar lavage (BAL) and biopsy specimens. CMV immunity was assessed by ELISPOT assay. Clinical and therapeutic data were also evaluated.

Results:

We found 2/167 cases of CMV pneumonia (1.2%), both in the donor-positive/recipient-positive (D+/R+) population, and 51/167 cases of CMV pulmonary infection (BAL positivity 30.5%). However, only 32/167 patients (19.1%) were treated due to their weak immunological response at CMV ELISPOT assay. Viremia ⩾100,000 copies/mL occurred in 33/1134 specimens (2.9%). Regarding CMV-serological matching (D/R), the D+/R– population had more CMV viremia episodes ( p < 0.05) and fewer viremia-free days ( p < 0.001).

Conclusions:

Compared to previous findings, our study shows a lower incidence of CMV pneumonia and viremia despite the presence of a substantial CMV load. In addition, our findings further confirm the D+/R– group to be a high-risk population for CMV viremia. Overall, a good immunological response seems to protect patients from CMV viremia and pneumonia but not from CMV alveolar replication. The reviews of this paper are available via the supplemental material section.
Comparative Phytochemical Screening and Cytotoxic Efficacy of Endemic Cephalaria tuteliana
Authors: Dagli Merve , Sarikahya Nazli Boke , Nalbantsoy Ayse , Kirmizigul Suheyla
Published: October 2019

Phytochemical investigation of Cephalaria tuteliana (Caprifoliaceae) endemic to Turkey was carried out for the first time. Thirteen compounds were isolated, including 2 triterpenoid sapogenins, 10 saponins, and 1 iridoid glycoside. This is the ﬁrst report of the isolation of pomolic acid, tormentic acid, and 3- O-α-l-rhamnopyranosyl-(1→3)- β-d-glucopyranosyl hederagenin, not only from the Cephalaria genus, but also from the Caprifoliaceae family. The structures of the isolated compounds were elucidated by a combination of spectroscopy, including one- and two-dimensional nuclear magnetic resonance, and by comparison with the reported data in the literature. Two triterpene sapogenins, hederagenin and oleanoic acid, the latter being the most typical sapogenin of the oleanane type of triterpene saponins, were evaluated by the MTT method for their cytotoxic effect against A549, HeLa, PANC1, and SHSY5Y cancer cells, and the noncancerous HEK293 cell line. The cytotoxic activity of triterpene aglycones was discussed in detail and a structure-activity relationship was established. C. tuteliana may be considered as a useful source for developing new cytotoxic and immunotherapeutic agents due to its biologically active saponin content.
The prevalence of obesity and overweight, associated demographic and lifestyle factors, and health status in the adult population of Jeddah, Saudi Arabia
Authors: Al-Raddadi Rajaa , Bahijri Suhad M. , Jambi Hanan A. , Ferns Gordon , Tuomilehto Jaakko
Published: October 2019

Background:

Obesity is a risk factor for many chronic diseases, and its prevalence and trends vary among populations. Saudi Arabia shows a greater rise in prevalence than many other countries. We aimed to study the association between several chronic disorders, demographic, and lifestyle factors with increased body mass index (BMI) in the adult population of Jeddah.

Methods:

Data were obtained from a door-to-door cross sectional study. A three-stage stratified cluster sampling technique was adopted. Individuals in selected households agreeing to participate were interviewed to complete a predesigned questionnaire covering demographic and lifestyle variables, medical history, and family history of chronic diseases. This was followed by anthropometric and blood pressure measurements. A random capillary plasma glucose (RPG) was measured, followed by further testing using fasting plasma glucose and glycated hemoglobin (HbA1c) to verify whether participants were normal, diabetic, or prediabetic. Multiple logistic regression analyses were used to adjust for confounding factors.

Results:

A total of 1419 individuals were included in the study: 667 men and 752 women. The prevalence of overweight and obesity was 35.1 and 34.8%, respectively, in men, and 30.1% and 35.6%, respectively, in women. Both overweight and obesity increased in prevalence to 60 years of age, and decreased in the oldest age group in both sexes. After adjusting for age, risk of obesity in men was increased with having a postgraduate degree [odds ratio (OR), 95%CI = 2.48, 1.1–5.61] and decreased with increased physical activity (OR, 95%CI = 0.49, 0.26–0.91). Risk of prediabetes and diabetes was increased in obese women (OR, 95%CI = 2.94, 1.34–6.44, and 3.61, 1.58–8.26 respectively), that of hypertension in obese men (OR, 95%CI =2.62, 1.41–4.87), and that of dyslipidemia in both sexes (OR, 95%CI = 2.60, 1.40–4.83 in men, and 2.0, 1.01–3.85 in women). A family history of dyslipidemia was associated with reduced risk of obesity among women (OR, 95%CI = 0.33, 0.12–0.92), whereas, in people with above normal weight (BMI ⩾25), there was increased risks of prediabetes, diabetes, and dyslipidemia among women (OR, 95%CI = 2.50, 1.21–5.17; 3.20, 1.45–7.03, and 1.88, 1.02–3.49, respectively ), and of hypertension among men (OR, 95%CI = 1.80, 1.00–3.23).

Conclusions:

The prevalence of overweight and obesity in the Saudi population remain high, indicating ineffectiveness or lack of preventive measures. Risk of prediabetes, diabetes, dyslipidemia, and hypertension increased with increasing BMI, with some sex differences in these associations.
Cross-currents and undertows: A response
Authors: Steinberg Philip , Peters Kimberley
Published: October 2019

In our response, we address two themes that appear in several of the commentaries. First, we elaborate on our decision to maintain a focus on the ocean, rather than turning to a term that speaks more clearly to geographic categories (e.g. the sea), elemental foundations (e.g. water), earth-system processes (e.g. the hydrosphere). Secondly, we address the critique that, in our effort to highlight the ocean’s geophysical liveliness, we may overlook the ocean’s liveliness as a space continually made through human and more-than-human encounters, cultural understandings and histories.
Impact of right ventricular dyssynchrony on prognosis of patients with idiopathic pulmonary arterial hypertension
Authors: Cheng Xiao‐Ling , Liu Bing‐Yang , Wu Wei‐Chun , Li Wen , Huang Li , Yang Tao , Liu Zhi‐Hong , Wang Hao , He Jian‐Guo , Xiong Chang‐Ming
Published: October 2019

Idiopathic pulmonary arterial hypertension is a progressive disease with high mortality with an increasing burden of right ventricular. Right ventricular dyssynchrony was observed in idiopathic pulmonary arterial hypertension, but the association with mortality is unclear. This study aimed to investigate the impact of right ventricular dyssynchrony on the survival of idiopathic pulmonary arterial hypertension. A total of 116 patients with idiopathic pulmonary arterial hypertension were enrolled in this study. All these patients underwent comprehensive clinical evaluation. Right ventricular dyssynchrony was assessed by two‐dimensional speckle‐tracking echocardiography. The time to peak strain (Tpeak) of right ventricular segments were obtained. Right ventricular dyssynchrony was quantified by the standard deviation of the heart rate‐corrected Tpeak of right ventricular four segments. All patients were followed up and the primary endpoint was all cause of death. Results found patients with significant right ventricular dyssynchrony present with advanced World Health Organization functional class, worse hemodynamic status and right ventricular function. Right ventricular dyssynchrony was an independent predictive factor for the survival of idiopathic pulmonary arterial hypertension. Kaplan–Meier survival curves showed patients with right ventricular dyssynchrony had worse prognosis. In conclusion, right ventricular dyssynchrony analyzed by speckle‐tracking echocardiography provided added value to hemodynamic and echocardiographic parameters in evaluating the survival of patients with idiopathic pulmonary arterial hypertension.
Optimizing imaging of the rat pulmonary microvasculature by micro‐computed tomography
Authors: Deng Yupu , Rowe Katelynn J. , Chaudhary Ketul R. , Yang Anli , Mei Shirley H.J. , Stewart Duncan J.
Published: October 2019

Micro‐computed tomography (micro‐CT) is used in pre‐clinical research to generate high‐resolution three‐dimensional (3D) images of organs and tissues. When combined with intravascular contrast agents, micro‐CT can provide 3D visualization and quantification of vascular networks in many different organs. However, the lungs present a particular challenge for contrast perfusion due to the complexity and fragile nature of the lung microcirculation. The protocol described here has been optimized to achieve consistent lung perfusion of the microvasculature to vessels < 20 microns in both normal and pulmonary arterial hypertension rats. High‐resolution 3D micro‐CT imaging can be used to better visualize changes in 3D architecture of the lung microcirculation in pulmonary vascular disease and to assess the impact of therapeutic strategies on microvascular structure in animal models of pulmonary arterial hypertension.
Cardiovascular care of patients with stroke and high risk of stroke: The need for interdisciplinary action: A consensus report from the European Society of Cardiology Cardiovascular Round Table
Authors: Doehner Wolfram , Mazighi Mikael , Hofmann Bernd M , Lautsch Dominik , Hindricks Gerhard , Bohula Erin A , Byrne Robert A , Camm A John , Casadei Barbara , Caso Valeria , Cognard Christophe , Diener Hans-Christoph , Endres Matthias , Goldstein Patrick , Halliday Alison , Hopewell Jemma C , Jovanovic Dejana R , Kobayashi Adam , Kostrubiec Maciej , Krajina Antonin , Landmesser Ulf , Markus Hugh S , Ntaios George , Pezzella Francesca R , Ribo Marc , Rosano Giuseppe MC , Rubiera Marta , Sharma Mike , Touyz Rhian M , Widimsky Petr
Published: October 2019

Comprehensive stroke care is an interdisciplinary challenge. Close collaboration of cardiologists and stroke physicians is critical to ensure optimum utilisation of short- and long-term care and preventive measures in patients with stroke. Risk factor management is an important strategy that requires cardiologic involvement for primary and secondary stroke prevention. Treatment of stroke generally is led by stroke physicians, yet cardiologists need to be integrated care providers in stroke units to address all cardiovascular aspects of acute stroke care, including arrhythmia management, blood pressure control, elevated levels of cardiac troponins, valvular disease/endocarditis, and the general management of cardiovascular comorbidities. Despite substantial progress in stroke research and clinical care has been achieved, relevant gaps in clinical evidence remain and cause uncertainties in best practice for treatment and prevention of stroke. The Cardiovascular Round Table of the European Society of Cardiology together with the European Society of Cardiology Council on Stroke in cooperation with the European Stroke Organisation and partners from related scientific societies, regulatory authorities and industry conveyed a two-day workshop to discuss current and emerging concepts and apparent gaps in stroke care, including risk factor management, acute diagnostics, treatments and complications, and operational/logistic issues for health care systems and integrated networks. Joint initiatives of cardiologists and stroke physicians are needed in research and clinical care to target unresolved interdisciplinary problems and to promote the best possible outcomes for patients with stroke.
Tackling the Wicked Problem of Measuring What Matters: Framing the Questions
Authors: Zhao Yong , Wehmeyer Michael , Basham James , Hansen David
Published: October 2019

Purpose:

Making policy makers, researcher, education leaders, and assessment developers aware that what matters in education assessment is a wicked problem that cannot be easily solved following traditional approaches.

Design/Approach/Methods:

Starting from the questions that what matters in education assessment, this article presented such questions as a wicked problem because there is no consensus, not right or wrong answer, and certain solutions may lead to side effects on students and society. Therefore, a new approach of ecology should be involved, and different education outcomes or intended qualities of learners are presented in complex relationships.

Findings:

Deciding what matters in education assessment is a wicked question. It is not a tame or technology problem and can be resolved by any conventional approaches. What is pivotal now is to decipher what matters in education and then what should be measured and ultimately how to measure. The ecology and collaborate approach deliberated in this article could expedite such a process.

Originality/Value:

This article advocates paradigm change in understanding and resolving one of the most urgent problems in education. It provides an ecology explanation of the relationships that exist among the different education outcomes and students’ qualities. By guiding through the dissecting of the problem step by step, this article has demonstrated a unique angle of understanding the wicked problem.
A Cross-Sectional Analysis of the BC Children’s Hospital Cleft Palate Program Waitlist
Authors: Leung Leslie Tze Fung , Loock Christine A. , Courtemanche Rebecca , Courtemanche Douglas J.
Published: September 2019

Objective:

A 2016 review of the BC Children’s Hospital Cleft Palate - Craniofacial Program (CPP) revealed that one-third of patients met the program’s care recommendations and half met the American Cleft Palate-Craniofacial Association guidelines. This study reviews patients on the CPP waitlist and determines median wait times and missed clinical assessments as well as identifies how wait times are influenced by medical complexity, specialized speech service needs, vulnerability, and distance from clinic.

Design:

Cross-sectional.

Setting:

BC Children’s Hospital Cleft Palate—Craniofacial Program.

Patients:

Five hundred seventy-six waitlisted patients.

Main Outcome Measures:

Additional wait time after recommended appointment date. Correlation of additional wait time with diagnosis, number of specialists required, speech services needed, vulnerability, and distance from the clinic. Missed plastic surgery, speech, and orthodontic assessments according to CPP team recommendations and ACPA guidelines.

Results:

Patients had a median additional wait time of 11 months (interquartile range: 5-27). Longer additional wait times were associated with a craniofacial diagnosis ( P = .019), a need for formal speech assessments or evaluations ( P < .001), or a requirement to see multiple specialists ( P < .001). Vulnerability and distance from clinic did not affect wait times. Plastic surgery assessments were not available at the preschool and preteen time points for 45 (8%) patients, 355 (62%) patients were unable to access speech assessments, and 120 (21%) were unable to complete an orthodontic assessment.

Conclusion:

Patients wait up to an additional year to be seen by the CPP and miss speech, orthodontic, and surgical assessments at key developmental milestones. Additional resources are required to address these concerns.
Different Suture Materials for Arthroscopic Transtibial Pull-out Repair of Medial Meniscal Posterior Root Tears: A Human Biomechanical Study
Authors: Nakama Gilberto Y. , Aman Zachary S. , Storaci Hunter W. , Kuczmarski Alexander S. , Krob Joseph J. , Strauss Marc J.
Published: October 2019

Background:

Transtibial pull-out repair of the medial meniscal posterior root (MMPR) has been largely assessed through biomechanical studies. Biomechanically comparing different suture types would further optimize MMPR fixation and affect clinical care.

Purpose/Hypothesis:

The purpose of this study was to determine the optimal suture material for MMPR fixation. It was hypothesized that ultra high–molecular weight polyethylene (UHMWPE) suture tape would be biomechanically superior to UHMWPE suture and standard suture.

Study Design:

Controlled laboratory study.

Methods:

The MMPR attachment was divided in 24 human cadaveric knees and randomly assigned to 3 repair groups: UHMWPE suture tape, UHMWPE suture, and standard suture. Specimens were dissected down to the medial meniscus, and the posterior root attachments were sectioned off the tibia. Two-tunnel transtibial pull-out repair with 2 sutures, as determined by the testing group, was performed. The repair constructs were cyclically loaded between 10 and 30 N at 0.5 Hz for 1000 cycles to mimic the forces experienced on the medial meniscus during postoperative rehabilitation. Displacement was recorded at 1, 50, 100, 500, and 1000 cycles. Ultimate failure load, displacement at failure, and load at 3 mm of displacement (clinical failure) were also recorded.

Results:

UHMWPE suture tape had significantly less displacement of the medial meniscus when compared with standard suture at 1 (–0.22 mm [95% CI, –0.41 to –0.02]; P = .025) and 50 (–0.35 mm [95% CI, –0.67 to –0.03]; P = .029) cycles. There were no other significant differences observed in displacement between groups at any number of cycles. UHMWPE suture tape had significantly less displacement at the time of failure than standard suture (–3.71 mm [95% CI, –7.17 to –0.24]; P = .034). UHMWPE suture tape had a significantly higher load to reach the clinical failure displacement of 3 mm than UHMWPE suture (15.64 N [95% CI, 0.02 to 31.26]; P = .05). There were no significant differences in ultimate failure load between groups.

Conclusion:

The meniscal root repair construct with UHMWPE suture tape may be stronger and less prone to displacement than that with standard suture or UHMWPE suture.

Clinical Relevance:

UHMWPE suture tape may provide better clinical results compared with UHMWPE suture and standard suture.
Eltrombopag for immune thrombocytopenia secondary to chronic lymphoproliferative disorders: a phase 2 multicenter study
Authors: Visco Carlo , Rodeghiero Francesco , Romano Alessandra , Valeri Federica , Merli Michele , Quaresimini Giulia , Volpetti Stefano , Santi Roberto M. , Carli Giuseppe , Lucchini Elisa , Passamonti Francesco , Rambaldi Alessandro , Motta Giovanna , Borchiellini Alessandra , d’Amore Emanuele S. G. , Ruggeri Marco
Published: September 2019

Visco and colleagues report excellent response to eltrombopag in immune thrombocytopenia in the setting of chronic lymphoproliferative disease.
Increase coherence, cooperation and cross-compliance of regulations on chemicals and water quality
Authors: Munthe John , Lexén Jenny , Skårman Tina , Posthuma Leo , Brack Werner , Altenburger Rolf , Brorström-Lundén Eva , Bunke Dirk , Faust Michael , Rahmberg Magnus , Sleeuwaert Frank , Slobodnik Jaroslav , van Gils Jos , van Wezel Annemarie
Published: October 2019

An analysis of existing regulatory frameworks for chemicals reveals a fragmented situation with a number of regulatory frameworks designed for specific groups of chemicals; for protection of different end-points and covering different parts of the chemicals´ life cycle stages. Lack of- and fragmented information on chemicals (properties, use, emissions as well as fate, occurrence and effects in the environment) limit the ability for assessment and early action, and existing legislation would benefit from more transparency and openness of information and knowledge. To achieve harmonisation of existing legislation and an efficient control of chemical contamination of European waters, a solution-focused approach is proposed including increased ambitions (in monitoring, modelling, and risk assessment), cooperation and dialogue. More holistic and efficient development and implementation of existing legislation can be achieved by better cooperation, harmonisation and information exchange between different regulatory frameworks and by improved science–policy interactions. The introduction of an organisational structure and incentives for cooperation are proposed. Cooperation should focus on harmonisation of advanced monitoring activities, modelling, prioritisation, risk assessment and assessment of risk prevention (‘safe by design’) and minimisation options. A process for dialogue and information exchange between existing policy frameworks and with stakeholders (industry, NGO´s, etc.) should be included to identify feasible options for mitigation as well as regulatory gaps—on local and EU-scales. There is also a need to increase international cooperation and strengthen global agreements to cover the full life cycle of chemicals (produced and consumed globally) and for exchanging knowledge and experiences to allow early action. This recommended action would also provide knowledge and a framework for a shift towards a sustainable chemistry approach for chemical safety based on a “safe by design” concept.
Mixtures of chemicals are important drivers of impacts on ecological status in European surface waters
Authors: Posthuma Leo , Brack Werner , van Gils Jos , Focks Andreas , Müller Christin , de Zwart Dick , Birk Sebastian
Published: October 2019

The ecological status of European surface waters may be affected by multiple stressors including exposure to chemical mixtures. Currently, two different approaches are used separately to inform water quality management: the diagnosis of the deterioration of aquatic ecosystems caused by nutrient loads and habitat quality, and assessment of chemical pollution based on a small set of chemicals. As integrated assessments would improve the basis for sound water quality management, it is recommended to apply a holistic approach to integrated water quality status assessment and management. This allows for estimating the relative contributions of exposure to mixtures of the chemicals present and of other stressors to impaired ecological status of European water bodies. Improved component- and effect-based methods for chemicals are available to support this. By applying those methods, it was shown that a holistic diagnostic approach is feasible, and that chemical pollution acts as a limiting factor for the ecological status of European surface waters. In a case study on Dutch surface waters, the impact on ecological status could be traced back to chemical pollution affecting individual species. The results are also useful as calibration of the outcomes of component-based mixture assessment (risk quotients or mixture toxic pressures) on ecological impacts. These novel findings provide a basis for a causal and integrated analysis of water quality and improved methods for the identification of the most important stressor groups, including chemical mixtures, to support integrated knowledge-guided management decisions on water quality.
Random fixed point theorems in Banach spaces applied to a random nonlinear integral equation of the Hammerstein type
Authors: Okeke Godwin Amechi , Bishop Sheila Amina , Akewe Hudson
Published: October 2019

The purpose of this paper is to define a new random operator called the generalized ϕ-weakly contraction of the rational type. This new random operator includes those studied by Khan et al. (Filomat 31(12):3611–3626, 2017) and Zhang et al. (Appl. Math. Mech. 32(6):805–810, 2011) as special cases. We prove some convergence, existence, and stability results in separable Banach spaces. Moreover, we produce some numerical examples to demonstrate the applicability of our analytical results. Furthermore, we apply our results in proving the existence of a solution of a nonlinear integral equation of the Hammerstein type.
Risk of Major Complications After Perioperative Norepinephrine Infusion Through Peripheral Intravenous Lines in a Multicenter Study
Authors: Pancaro Carlo , Shah Nirav , Pasma Wietze , Saager Leif , Cassidy Ruth , van Klei Wilton , Kooij Fabian , Vittali Dave , Hollmann Markus W. , Kheterpal Sachin , Lirk Philipp
Published: September 2019

BACKGROUND:

Continuous infusions of norepinephrine to treat perioperative hypotension are typically administered through a central venous line rather than a peripheral venous catheter to avoid the risk of localized tissue necrosis in case of drug extravasation. There is limited literature to estimate the risk of skin necrosis when peripheral norepinephrine is used to counteract anesthesia-associated hypotension in elective surgical cases. This study aimed to estimate the rate of occurrence of drug-related adverse effects, including skin necrosis requiring surgical management when norepinephrine peripheral extravasation occurs.

METHODS:

This retrospective cohort study used the perioperative databases of the University Hospitals in Amsterdam and Utrecht, the Netherlands, to identify surgical patients who received norepinephrine peripheral intravenous infusions (20 µg/mL) between 2012 and 2016. The risk of drug-related adverse effects, including skin necrosis, was estimated. Particular care was taken to identify patients who needed plastic surgical or medical attention secondary to extravasation of dilute, peripheral norepinephrine.

RESULTS:

A total of 14,385 patients who received norepinephrine peripheral continuous infusions were identified. Drug extravasation was observed in 5 patients (5/14,385 = 0.035%). The 95% confidence interval (CI) for infusion extravasation was 0.011%–0.081%, indicating an estimated risk of 1–8 events per every 10,000 patients. There were zero related complications requiring surgical or medical intervention, resulting in a 95% CI of 0%–0.021% and indicating a risk of approximately 0–2 events per 10,000 patients.

CONCLUSIONS:

In the current database analysis, no significant association was found between the use of peripheral intravenous norepinephrine infusions and adverse events.
Hyperspectral imaging for textile sorting in the visible–near infrared range
Authors: Blanch-Perez-del-Notario Carolina , Saeys Wouter , Lambrechts Andy
Published: September 2019

Recycling of textile materials is becoming important due to the increasing amount of textile waste and its large
environmental impact. The Resyntex project aims at dealing with this textile waste by enabling its chemical recycling. To do
so, pure textile materials and blends need to be sorted first. In this paper we evaluate the suitability of hyperspectral
imaging for pure and blend textile sorting. We also test the discrimination capacity between denim and non-denim textile,
since this is required prior to the de-colouration processes. For this purpose, we use a line-scan sensor in the 450–950
nm range, since its cost, compactness and speed characteristics make it suitable for industrial deployment. To deal with
the strong colour interference of the textile a hierarchical classification approach is proposed. The results on the available
sample set show promising discrimination potential for material discrimination as well as for denim versus non-denim
detection.
Nominal Wage Rigidity in Village Labor Markets
Authors: Kaur Supreet
Published: September 2019

This paper develops a new approach to test for downward wage rigidity by examining transitory shocks to labor demand (i.e., rainfall) across 600 Indian districts. Nominal wages rise during positive shocks but do not fall during droughts. In addition, transitory positive shocks generate ratcheting: after they have dissipated, wages do not adjust back down. Ratcheting reduces employment by 9 percent, indicating that rigidities distort employment levels. Inflation, which is unaffected by local rainfall, enables downward real wage adjustments—offering causal evidence for its labor market effects. Surveys suggest that individuals believe nominal wage cuts are unfair and lead to effort reductions. (JEL E24, E31, J23, J31, O15, O18, R23)
Firms’ Internal Networks and Local Economic Shocks
Authors: Giroud Xavier , Mueller Holger M.
Published: September 2019

Using confidential establishment-level data from the US Census Bureau’s Longitudinal Business Database, this paper documents how local shocks propagate across US regions through firms’ internal networks of establishments. Consistent with a model of optimal within-firm resource allocation, we find that establishment-level employment is sensitive to shocks in distant regions in which the establishment’s parent firm is operating, and that the elasticity with respect to such shocks increases with the firm’s financial constraint. At the aggregate regional level, we find that aggregate county-level employment is sensitive to shocks in distant counties linked through firms’ internal networks. (JEL D22, G32, L14, L22, R23, R32)
Por que as empresas fecham o capital no Brasil?
Authors: Saito Richard , Padilha Marco Tulio Clivati
Published: October 2019

Este artigo investiga os possíveis determinantes no fechamento de capital a partir de uma amostra de 119 empresas que deslistaram voluntariamente no período de 1999 a 2013. Encontramos que no ano do fechamento, fatores como a alta concentração de participação acionária dos controladores, baixa rentabilidade
(ROA), menor nível de pagamento de dividendos associados ao maior fluxo de caixa livre associado estão possuem forte influência na deslistagem das ações.
Quanto ao uso de mercado de capitais para acesso a follow on, bem como acesso a dívida, encontramos que as empresas que deslistam possuem menor necessidade de acesso ao mercado de dívida, controlando para empresas com mesmo perfil. Não encontramos evidência de que custo de se manter listada nem que a liquidez sejam determinantes.
Índices Valor-Coppead, Carteiras de Ponderação Igualitária e de Mínima Variância
Authors: Leal Ricardo Pereira Câmara , Campani Carlos Heitor
Published: October 2019

Este artigo apresenta a revisão da literatura que justificou a criação dos índices de ações Valor-Coppead igualmente ponderado e de variância mínima e dá detalhes sobre seu cálculo. Não havia índice brasileiro de ações com estas regras simples de formação de carteiras alcançáveis pelo investidor sem sofisticação. Um índice que use a carteira de menor variância na fronteira eficiente, com restrições sobre os pesos, oferece uma carteira otimizada menos afetada pelos erros nas estimativas. Carteiras igualmente ponderadas com até 20 ações apresentam desempenho superior à maioria dos fundos de ações nacionais e comparável ao da carteira de variância mínima com pesos restritos, mas métodos mais complexos de carteiras otimizadas podem superar a carteira de ponderação igualitária. O critério de formação segundo o Índice de Sharpe nos três ou quatro meses anteriores é relevante. A literatura revista respaldou que os índices Valor-Coppead podem ser padrões de desempenho relevantes para investidores sem sofisticação.
Persistência de Desempenho em Fundos de Ações no Brasil
Authors: Nerasti João Nascimento , Lucinda Claudio Ribeiro
Published: October 2019

Este artigo tem como objetivo investigar a existência de persistência de desempenho superior em fundos de ações brasileiros no período de 2001 a 2014. Para isso, utilizamos uma amostra livre de viés de sobrevivência e três modelos diferentes para a relação retorno e risco. Em nenhum modelo encontramos existência de persistência de desempenho superior, embora a persistência de desempenho inferior exista ao utilizarmos modelo de três fatores de Fama e French (1993). Ao controlarmos o modelo para o fator de momentum a persistência desaparece e o fator parece explicar boa parte do retorno em excesso dos fundos, tanto os que tiveram melhor retorno, quanto os de pior.
Exploring Systemic Risk of Chinese SIFIs using a Simplified SRISK Model
Authors: Haider Muhammad Jamal , Hemmes Adrian , Changchun Gao , Akram Tayyaba
Published: October 2019

The exposure of banks to systemic risk has been rising in an ever more financialized and interconnected economy. In China, economic slowdown and more non-performing loans mean that the financial system has operate in an increasingly stressed environment, strengthening the vulnerability of future systemic shortfall. In this study, systemic risk in Chinese systematically important financial institutions (SIFIs) is analyzed using a simplified SRISK model. The results are set into historical context, its characteristics are illustrated, and compared to an existing risk index. With that the study contributes to the existing literature by exploring application the SRISK model from a regulatory framework and illustrating some of its implications on Chinese SIFIs. The key findings include (1) an increasing trend of systemic risk exposure and (2) evidence for a divergence between volatility and systemic risk since the 2008 financial crisis.
Automedicação entre acadêmicos de medicina de Fernandópolis – São Paulo
Authors: Tognoli Thais do Amaral , Tavares Vinicius de Oliveira , Ramos Ana Paula Domingos , Batigalia Fernando , De Godoy José Maria Pereira , Ramos Rogério Rodrigo
Published: September 2019

Objetivos: buscou-se investigar a automedicação por acadêmicos de curso de graduação em Medicina de instituição privada e analisar possíveis variáveis relacionadas. Métodos: trata-se de um estudo transversal realizado com 320 discentes dos quatro primeiros anos do curso de Medicina da Universidade Brasil, campus Fernandópolis-SP. Foi aplicado questionário validado com variáveis sociais e de consumo de medicamentos, seguido de análise estatística por regressão linear simples. Resultado: como resultado, a automedicação foi considerada uma opção em 309 dos participantes, a maioria deles do sexo feminino, idade entre 21 a 23 anos, solteiros, sem curso superior prévio, com convênio médico e conscientes de eventuais riscos à Saúde, mesmo após acesso a bulas ou a pesquisas on-line. O quadro clínico precedente à automedicação incluiu, principalmente, cefaleia e mialgia. Houve preferência por fármacos anteriormente utilizados com consumo médio (por 1 a 2 dias), principalmente de analgésicos e anti-inflamatórios. Estar mais próximo ao término do curso (p = 0,006) e possuir convênio médico (p = 0,046) se relacionaram com automedicação. Conclusão: o hábito da automedicação aumenta, gradativamente, ao decorrer da graduação, com isso, sugere-se implementação de proposta pedagógica educativa sobre esse assunto em grade curricular de cursos de Medicina.
Αρμογή σπαραγμάτων. Νεότερα για τη βιβλιοθήκη Νικολάου και Κωνσταντίνου Καρατζά
Authors: Αποστολόπουλος Δημήτρης Γ.
Published: September 2019

In the General State Archives, in Athens, specifically in the “Giannis Vlachogiannis” archive collection, there is a file containing seventeen fragments, that are one-sheet, two-sheet, four-sheet and, one among them, five-sheet. Vlachogiannis does not mention anything about their origin; in order to describe, however, the contents of this file, he wrote: “Χειρογράφων αποσπάσματα (βιογραφικά λογίων και κληρικών)” (excerpts from manuscripts (biographical information of scholars and clergymen)). This study aimed initially at tracing the philological identity and origin of these fragments.The identification of two scribes, who have written the majority of the fragments (fifteen out of seventeen), has given the first clue: Nikolaos Karatzas, a scholar, collector and manuscript scribe all together, owner of one of the biggest libraries in Constantinople in the 18th century, has written eleven texts; in the remaining four, we recognize the handwriting of his son and inheritor of his library, Konstantinos Karatzas. The second piece of information arose from the discovery of the fact that the fragments are not actually fifteen, as textual evidence demonstrated their coherence of content: in fact they form six sections.But are they indeed excerpts, fragments from “manuscripts”, as Vlachogiannis had assumed?Evidence from various sources brought forward in this study demonstrate the fact that the fragments were fascicules incorporated into printed books that once belonged to Karatzas' library, probably until the beginning of the second decade of the 19th century.The printed books in question are the following: Meletios Pegas, Ὑπὲρ τῆς χριστιανῶν εὐσεβείας πρὸς Ἰουδαίους ἀπολογία, Léopol 1593.Gregorios Palamas, Λόγοι ἀποδεικτικοὶ… [London 1626-1626].Ioannes Karyophylles, Ἐγχειρίδιον περί τινων ἀποριῶν…, Monastery of Synagovou 1697.Johann Michael Lange, Philologiae Barbaro-Græcæ, Noribergae 1707-1708.Ioannes Komnenos, Προσκυνητάριον τοῦ ἁγίου Ὄρους…, Venice 1745.Gabriel Severos, Συνταγμάτιον περὶ… μυστηρίων, Venice 1791. How were these fragments found in Athens, although they originated from printed books located in Constantinople? The answer to this plausible question is that they followed a labyrinthine path: the books that included them were bought by Lord Guilford and were donated to the Ionian Academy, the School he had established in 1824 on Corfu. After Guilford's death, when the books of his library were to be given back to the heirs of the donor, the librarian on Corfu, who was claiming his unpaid salaries, detached the fragments. They remained in the hands of A. Papadopoulos-Vretos and when his archive was sold to the General State Archives in 1920, Vlachogiannis put them aside in order to study them. It should be noted that most of the printed books from which the fragments were detached were bought by the British Museum in an auction, and are today located in the British Library.DIMITRIS G. APOSTOLOPOULOS
Feature selection with the R package MXM
Authors: Tsagris Michail , Tsamardinos Ioannis
Published: September 2019

Feature (or variable) selection is the process of identifying the minimal set of features with the highest predictive performance on the target variable of interest. Numerous feature selection algorithms have been developed over the years, but only few have been implemented in R and made publicly available R as packages while offering few options. The R package MXM offers a variety of feature selection algorithms, and has unique features that make it advantageous over its competitors: a) it contains feature selection algorithms that can treat numerous types of target variables, including continuous, percentages, time to event (survival), binary, nominal, ordinal, clustered, counts, left censored, etc; b) it contains a variety of regression models that can be plugged into the feature selection algorithms (for example with time to event data the user can choose among Cox, Weibull, log logistic or exponential regression); c) it includes an algorithm for detecting multiple solutions (many sets of statistically equivalent features, plain speaking, two features can carry statistically equivalent information when substituting one with the other does not effect the inference or the conclusions); and d) it includes memory efficient algorithms for high volume data, data that cannot be loaded into R (In a 16GB RAM terminal for example, R cannot directly load data of 16GB size. By utilizing the proper package, we load the data and then perform feature selection.). In this paper, we qualitatively compare MXM with other relevant feature selection packages and discuss its advantages and disadvantages. Further, we provide a demonstration of MXM’s algorithms using real high-dimensional data from various applications.
Solar activity research at the Baikal Astrophysical Observatory of ISTP SB RAS
Authors: Боровик Александр , Borovik Aleksandr , Головко Алексей , Golovko Aleksey , Поляков Владимир , Polyakov Vladimir , Трифонов Виктор , Trifonov Viktor , Язев Сергей , Yazev Sergey
Published: September 2019

The article presents the main results of solar studies carried out at the Baikal Astrophysical Observatory (BAO) of the Institute of Solar-Terrestrial Physics SB RAS (ISTP SB RAS) for 40 years. It outlines the history of BAO and lists its telescopes. Much attention is given to the Large Solar Vacuum Telescope (LSVT) designed to observe solar formations with high spatial and spectral resolution. Technical parameters of this instrument are specified along with some results of the studies carried out with it. Information about the full-disk chromospheric telescope and scientific problems solved with it is represented together with the basic scientific results. The telescope is used to study solar activity complexes and solar flares. References to the basic publications that have used BAO results are presented.
PEMBEKALAN KETERAMPILAN OJEK DIFA CITY TOUR UNTUK MEWUJUDKAN KESETARAAN KAUM DISABILITAS
Authors: Ratnawati Dianna , Rufaidah Desy , Handoyono Nurcholish Arifin
Published: September 2019

Difa City Tour merupakan usaha jasa ojek online satu-satunya di Indonesia dengan driver dan mayoritas member kaum disabilitas di Yogyakarta. Namun di lingkungan masyarakat masih terjadi diskriminasi disamping kemandirian yang diunjukkan ojek ini. Pengabdian kepada masyarakat ini bertujuan untuk : (1) memberi penyuluhan prinsip ergonomi dalam berkendara; (2) melatih keterampilan desain autocad; (3) melatih keterampilan pengelasan; (4) melatih keterampilan pengecatan; dan (5) melatih keterampilan public speaking. Metode yang digunakan adalah pelatihan dan pendampingan. Tim pelaksana program terdiri dari tiga dosen dan dua mahasiswa. Pelaksanaan kegiatan diselenggarakan di unit produksi bengkel pendidikan teknik mesin Universitas Sarjana Wiyata Taman Siswa. Hasil dari pelaksanaan pengabdian kepada masyarakat adalah peningkatkan ilmu bidang ergonomic dari peserta 90%, 75% peserta terampil mengoperasikan aplikasi autocad, 85% terampil las dasar, 85% terampil mengecat, dan 90% terampil berkomunikasi. Program yang telah dilaksanakan tersebut memberikan dampak positif bagi peserta yang dapat dilihat dari peningkatan pengetahuan, keterampilan dan pelayanan terhadap member sehingga berpengaruh terhadap produktivitas dan peningkatan kepercayaan pelanggan ojek Difa city tour.
SOSIALISASI TENTANG KELUARGA BERENCANA DAN JENIS KONTRASEPSI DI DESA JAMBIDAN KECAMATAN BANGUNTAPAN, BANTUL
Authors: Ayu Suci Musvita
Published: September 2019

Program Keluarga Berencana mempunyai kontribusi penting dalam upaya meningkatkan kualitas penduduk. Untuk mengoptimalkan manfaat keluarga berencana bagi kesehatan, pelayanannya harus digabungkan dengan pelayanan kesehatan reproduksi. Metode yang digunakan adalah dengan memberikan penyuluhansecara langsung kepada masyarakat umum dengan materi keluarga berencana dan jenis kontrasepsi menggunakan metode ceramah,diskusi,tanya jawab. Hasil yang diperoleh adalah kegiatan penyuluhan berjalan dengan baik dan peserta aktif mengikuti kegiatan penyuluhan sampai selesai. Penyuluhan dilakukan dengan interaktif antara narasumber dengan peserta yang hadir.
Getting home for haemodialysis: sharing experience to improve the patient experience
Authors: Dobbs David
Published: September 2019

Home haemodialysis has many advantages when compared with conventional in-centre haemodialysis, but its uptake remains lower than predicted. This article explores the reasons for this low uptake, and the work of a Special Interest Group of Nurses for Home Haemodialysis
Scientists reveal how a faulty gene leads to kidney disease
Authors: Tennant Maria
Published: September 2019

Research funded by Kidney Research UK has provided new insights into why a faulty gene involved in nephrotic syndrome leads to disease in some patients. The findings could pave the way for new ways to prevent or treat the condition, by revealing new targets to intervene in the process. Around 1 in 50,000 children are diagnosed with nephrotic syndrome each year.
We need you!
Authors: Hurst Helen
Published: September 2019

Helen Hurst, ANNUK secretary, discusses the benefits of ANNUK membership and how you can get involved with making ANNUK a success