bluuebunny/crossref_metadata_2025 huggingface dataset:
The Activist Company: Examining a Company’s Pursuit of Societal Change Through Corporate Activism Using an Institutional Theoretical Lens
Authors: Eilert Meike , Nappier Cherup Abigail
Published: August 2020

Companies are more frequently taking public stands on often controversial social, political, economic, and environmental issues. Despite the importance of the topic, research on understanding the role of companies in societal change through activism is scarce. Using institutional theory, this article defines corporate activism as a company’s willingness to take a stand on social, political, economic, and environmental issues to create societal change by influencing the attitudes and behaviors of actors in its institutional environment. This framework conceptualizes corporate activism as a response to barriers that hinder the solution of an issue. These barriers stem from institutional actors’ attitudes and behaviors toward the issue, and corporate activism can address these barriers through influence and change strategies that can target the institutional environment “top-down” or “bottom-up.” This framework further investigates how the identity orientation of the company facilitates corporate activism. This research has important implications for managers, policy makers, and any other agents that aim to facilitate social change.
Design and implementation of human driving data–based active lane change control for autonomous vehicles
Authors: Chae Heungseok , Jeong Yonghwan , Lee Hojun , Park Jongcherl , Yi Kyongsu
Published: August 2020

This article describes the design, implementation, and evaluation of an active lane change control algorithm for autonomous vehicles with human factor considerations. Lane changes need to be performed considering both driver acceptance and safety with surrounding vehicles. Therefore, autonomous driving systems need to be designed based on an analysis of human driving behavior. In this article, manual driving characteristics are investigated using real-world driving test data. In lane change situations, interactions with surrounding vehicles were mainly investigated. And safety indices were developed with kinematic analysis. A safety indices–based lane change decision and control algorithm has been developed. In order to improve safety, stochastic predictions of both the ego vehicle and surrounding vehicles have been conducted with consideration of sensor noise and model uncertainties. The desired driving mode is decided to cope with all lane changes on highway. To obtain desired reference and constraints, motion planning for lane changes has been designed taking stochastic prediction-based safety indices into account. A stochastic model predictive control with constraints has been adopted to determine vehicle control inputs: the steering angle and the longitudinal acceleration. The proposed active lane change algorithm has been successfully implemented on an autonomous vehicle and evaluated via real-world driving tests. Safe and comfortable lane changes in high-speed driving on highways have been demonstrated using our autonomous test vehicle.
New atmospheric data model for constant altitude accelerated flight performance prediction calculations and flight trajectory optimization algorithms
Authors: Dancila Radu I , Botez Ruxandra M
Published: August 2020

This article presents a new method for storing and computing the atmospheric data used in time-critical flight trajectory performance prediction calculations, such as flight performance prediction calculations in flight management systems and/or flight trajectory optimization, of constant altitude cruise segments. The proposed model is constructed based on the forecast data provided by Meteorological Service Agencies, in a GRIB2 data file format, and the set of waypoints that define the lateral component of the evaluated flight profile(s). The atmospheric data model can be constructed/updated in the background or off-line, when new atmospheric prediction data are available, and subsequently used in the flight performance computations. The results obtained using the proposed model show that, on average, the atmospheric parameter values are computed six times faster than through 4D linear interpolations, while yielding identical results (value differences of the order of 10e−14). When used in flight trajectory performance calculations, the obtained results show that the proposed model conducts to significant computation time improvements. The proposed model can be extended to define the atmospheric data for a set of cruise levels (usually multiple of 1000 ft).
Models of semiotic borders in psychology and their implications: From rigidity of separation to topological dynamics of connectivity
Authors: De Luca Picione Raffaele
Published: August 2020

In this article, I discuss some implications deriving from different models of the notion of border, starting from interdisciplinary contributions and in particular from semiotics, psychoanalysis, cultural psychology, and topology. The starting point is a reflection on the notion of sign, as a device used to realize at the same time both a first form of discretization and to instantiate a system of relations with the environment. The article goes on to describe the importance of borders for the construction of human experience and for the processes of psychic and relational development. Lastly, the differences between three different forms of conceptualizing borders are discussed: rigid boundaries, permeable boundaries, and topological boundaries of the Möbius strip type. For each of the three models, the different implications will be presented and discussed.
Evaluation of belimumab treatment in patients with systemic lupus erythematosus in a clinical practice setting: Results from a 24-month OBSErve study in Argentina
Authors: Babini A , Cappuccio A M , Caprarulo C , Casado G , Eimon A , Figueredo H , García M A , Magri S , Mannucci P , Perez Rodriguez S , Pons-Estel B A , Velozo E J , Iglesias-Rodriguez M , Streger G
Published: August 2020

Objective

To describe clinical effectiveness of belimumab for systemic lupus erythematosus (SLE) in real-world practice in Argentina.

Methods

This retrospective, observational study analysed medical record data of patients with SLE treated with belimumab in 15 centres in Argentina. Primary endpoint: overall clinical response (assessed on a scale similar to the 6-point Physician Global Assessment) at months 6, 12, 18 and 24, all versus index (belimumab initiation). Secondary endpoints: improvement in disease activity (SELENA-SLEDAI), SLE manifestations, and corticosteroid dose change.

Results

Records for 81 patients (91% female) were analysed. Clinical improvements were reported for 95%, 95%, 98% and 100% patients at 6, 12, 18, and 24 months post index, respectively. Mean SELENA-SLEDAI score decreased from 11.21 at index to 4.76, 3.77, 3.86 and 2.17 at 6, 12, 18, and 24 months post index, respectively. Number of flares decreased from 1.05 at index to 0.21, 0.09, 0.22 and 0.30 at 6, 12, 18, and 24 months post index, respectively. Mean corticosteroid dose was 14.59 mg/day at index, and 6.45, 5.18, 5.17 and 4.78 mg/day at 6, 12, 18, and 24 months post index, respectively.

Conclusions

Real-world patients with SLE treated with belimumab in Argentina demonstrated clinical improvements and reductions in corticosteroid dose.
Simplest Way to Establish COVID-19 Quarantine Observation Wards Within 24 Hours
Authors: Huang Wen-Nan , Zhuang Mao-Song , Cheng Tsun-Jen , Hsiao Shih-Huai
Published: August 2020

Reducing nosocomial transmission within health care facilities is important, but the number of negative-pressure airborne infection isolation rooms for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is limited. It is a daunting challenge to cope with a surge of suspected infectious patients in hospitals. We installed air exhaust fans on the windows to change the pressure direction within the wards rapidly. The best location for the fans was 90 cm from the floor and 90 cm from the edge of bed whether the indoor air conditioners were on or off. The noise level should be <60 dB(A) as per government regulations. General wards can be transformed into makeshift negative-pressure rooms easily and effectively within 24 hours, which is really the simple, fast, and effective way for the transformation being applied.
Sensitivity and specificity of artificial intelligence with Microsoft Azure in detecting pneumothorax in emergency department: A pilot study
Authors: Lai Kwok Hung Alastair , Ma Shu Kai
Published: August 2020

Background:

Artificial intelligence is becoming an increasingly important tool in different medical fields. This article aims to evaluate the sensitivity and specificity of artificial intelligence trained with Microsoft Azure in detecting pneumothorax.

Methods:

A supervised learning artificial intelligence is trained with a collection of X-ray images of pneumothorax from National Institutes of Health chest X-ray dataset online. A subset of the image dataset focused on pneumothorax is used in training. Two artificial intelligence programs are trained with different numbers of training images. After the training, a collection of pneumothorax X-ray images from patient attending emergency department is retrieved through the Clinical Data Analysis & Reporting System. In total, 115 pneumothorax patients and 60 normal inpatients are recruited. The pneumothorax chest X-ray and the resolution chest X-ray of the above patient group and a collection of normal chest X-ray from inpatients without pneumothorax will be retrieved, and these three sets of images will then undergo testing by artificial intelligence programs to give a probability of being a pneumothorax X-ray.

Results:

The sensitivity of artificial intelligence-one is 33.04%, and the specificity is at least 61.74%. The sensitivity of artificial intelligence-two is 46.09%, and the specificity is at least 71.30%. The dramatic improvement of 46.09% in sensitivity and improvement of 15.48% in specificity by addition of around 1000 X-ray images is encouraging. The mean improvement of AI-two over AI-one is 19.7% increase in probability difference.

Conclusions:

We should not rely on artificial intelligence in diagnosing pneumothorax X-ray solely by our models and more training should be expected to explore its full function.
Promotion of Advance Care Planning Among Young Adults: A Pilot Study of Health Engagement Workshop Feasibility, Implementation, and Efficacy
Authors: Barrison Philip , Davidson Lindy Grief
Published: August 2020

Objective:

This pilot study set out to evaluate the feasibility and efficacy of an interactive, peer-led, health engagement workshop to improve confidence and comprehension related to advance care planning (ACP) among young adults. Secondarily, this study evaluated if such workshops could promote ACP related behavior changes within this population.

Methods:

This observational cohort study utilized a repeated measures, mixed-method design. Six hour-long, in-person workshops were conducted with undergraduate students during meetings of university student organizations. Participants were evaluated across 3 mixed-method surveys, evaluating confidence, knowledge, and behaviors related to ACP prior to participation, directly after, and during a 2-week follow-up.

Results:

Workshop participation improved the average participant confidence and knowledge related to ACP as well as encouraged some participants to engage in discussions related to end-of-life care with friends and family. Alongside the impact of the workshops on knowledge and confidence, participants positively evaluated the design of the workshops through collected qualitative feedback.

Conclusion:

These results are encouraging in assessing this population’s willingness to learn about end-of-life care planning. The tools developed and the corresponding results should be used for further exploration of engaging the young adult population in ACP to promote improved healthcare outcomes.
Effect of Age on Complication Rates and Outcomes Following First Metatarsophalangeal Arthrodesis for Hallux Rigidus
Authors: Lunati Matthew P. , Manz Wesley J. , Maidman Samuel D. , Kukowski Nathan R. , Mignemi Danielle , Bariteau Jason T.
Published: August 2020

Background:

Hallux rigidus is one of the most common toe pathologies in patients greater than 50 years old. Although metatarsophalangeal (MTP) arthrodesis is used to improve pain and function, older patients are often considered to be higher-risk operative candidates. There are minimal data on outcomes of MTP fusion and no studies comparing outcomes between geriatric and younger patients.

Methods:

This is a single-center, prospective study of all patients who underwent MTP fusion between August 1, 2015, and July 1, 2018. Patient-reported outcomes were assessed using the Short Form Health Survey (SF-36), Life-Space Assessment survey (LSA), and visual analog scale (VAS) for pain administered preoperatively as well as 6 months and 1 year postoperatively. Baseline characteristics and operative outcomes were collected from the electronic medical record. Clinical and patient-reported outcomes were compared between patients <65 years old and ≥65 years old. Of 143 included patients, 79 were in the younger group (mean of 56.5 years) and 64 were in the older group (mean of 72.0 years).

Results:

Compared with the younger group, the older group was more predominantly female (95.3% older group, 77.2% younger group, P = .002). More patients in the older group had hypertension (73.4% older group, 50.6% younger group, P = .005) and coronary artery disease (9.4% older group, 0.0% younger group, P = .005). Both age groups had similar rates of postoperative wound complications requiring operative irrigation and debridement, deep vein thrombosis, deformity recurrence, and revision surgery. No differences were detected in SF-36, LSA, and VAS surveys administered at baseline, 6 months postoperation, or 1 year postoperation between younger and older patients.

Conclusion:

Despite more comorbidities, older patients had similar rates of postoperative complications and reported similar outcomes for pain, function, and mobility following MTP fusion. These findings support increased implementation of MTP fusion surgery for older patients with hallux rigidus.

Level of Evidence:

Level II, prospective cohort.
Is There a “Blind Spot” in Point-of-Care Testing for Residual Heparin After Cardiopulmonary Bypass? A Prospective, Observational Cohort Study
Authors: Wand Saskia , Heise Daniel , Hillmann Nadine , Bireta Christian , Bräuer Anselm , Ahsen Nicolas von , Quintel Michael
Published: August 2020

Identifying the cause of a bleeding complication after cardiac surgery can be crucial. This study sought to clarify whether the application of unprocessed autologous pump blood influences anti-factor Xa activity after cardiac surgery and evaluated 2 point-of-care methods regarding their ability to identify an elevated anti-factor Xa activity at different timepoints after cardiopulmonary bypass. Anti-factor Xa activity, heparin/protamine titration and the clotting time ratio of thromboelastometry in the INTEM and HEPTEM were measured at baseline (T1), after the application of protamine (T2) and after the complete application of autologous pump blood (T3). Anti-factor Xa activity decreased significantly between T2 and T3 as well did the absolute number of patients with an elevated anti-factor Xa activity. Receiver Operating Curve analyses were performed for both point-of-care methods. At T2 neither could identify patients with an elevated anti-factor Xa activity, while both methods were able to do so at T3 with high sensitivity and specificity. This difference suggests that an interference in the detection of residual heparinization with point-of-care methods exists right after the application of protamine, which seems to subside after a short time span. Nevertheless, results of point-of-care testing for residual heparinization after cardiopulmonary bypass need to be interpreted considering the protamine-heparin ratio and the timepoint of protamine administration.
Range of Neurological Signs in Cynomolgus Monkeys After Intrathecal Bolus Administration of Antisense Oligonucleotides
Authors: Korte Sven , Runge Frank , Wozniak Magdalena M. , Ludwig Florian T. , Smieja Daniela , Korytko Peter , Mecklenburg Lars
Published: August 2020

Intrathecal (IT) dosing (ie, injection into the subarachnoidal space at the lumbar region) is a common route of administration in cynomolgus monkey preclinical safety studies conducted for antisense oligonucleotides (ASO) that target central nervous system diseases. Herein we report on neurological signs that have been observed in 28 IT studies conducted in 1,016 cynomolgus monkeys. Neurological signs were classified into 5 groups: (1) A nonadverse transient absence of lower spinal reflexes. This observation occurred at low incidence in nontreated animals and in those that were injected artificial cerebrospinal fluid. The incidence increased in animals that were injected an ASO. Reflexes were present again at 24 hours or 48 hours after dosing. The incidence appeared to increase with dose. (2) Test-article-related adverse muscle tremor or muscle spasticity occurring during the injection procedure or immediately thereafter. In one-third of animals this finding responded to treatment with diazepam, in two-third it required euthanasia. (3) Neurological findings occurring between 30 minutes and 4 hours after dosing were characterized by any combination of ataxia, paresis, nystagmus, urinary incontinence, or muscle tremor. Those conditions either spontaneously resolved or they slowly worsened, eventually resulting in a poor general condition. (4) Neurological findings due to spinal cord injury were characterized by rapidly progressing paralysis of hind limbs. Magnetic resonance imaging revealed a focal hyperintense lesion, indicative of spinal cord necrosis. (5) Test-article-related adverse hind limb paresis or paralysis that occurred between 2 and 18 days after dosing. Those findings were rare and resulted in a poor general condition requiring euthanasia.
Characteristics of uveitic glaucoma in Turkish patients
Authors: Tekeli Oya , Elgin Ufuk , Takmaz Tamer , Ekşioğlu Ümit , Baş Zeynep , Yarangümeli Alper , Karakurt Ahmet , Evren Kemer Özlem , Mumcuoğlu Tarkan , Aktaş Zeynep , Akman Ahmet , Bayer Atilla
Published: August 2020

Purpose:

To evaluate the prevalence of uveitic glaucoma (UG) in the Turkish population and investigate the primary underlying diseases.

Methods:

This multicenter, cross-sectional, prospective study included patients who presented to the glaucoma units of 10 tertiary ophthalmology departments in Ankara, Turkey from 15th March to 16th May 2015 and fulfilled the criteria of UG. Patients were inspected for age, sex, medical history, best corrected visual acuity, biomicroscopic findings, intraocular pressure values, and visual field results.

Results:

During the study period, 4604 eyes of 2541 patients with glaucoma were screened and 145 eyes of 104 patients (4.1%) were identified as having UG. One hundred and thirty-four eyes (92.4%) had open-angle glaucoma and 11 eyes (7.6%) had closed-angle glaucoma. The mean patient age was 47 ± 16 (6–90) years. Idiopathic uveitis (54 eyes), Behçet’s disease (26 eyes), Fuchs heterochromic cyclitis (21 eyes), Herpes Simplex virus infectious uveitis (14 eyes), and ankylosing spondylitis (six eyes) were the leading types of uveitis associated with glaucoma. Acute anterior uveitis was the most common type of uveitis diagnosed in 72 patients (105 eyes), whereas 21 patients (27 eyes) had panuveitis, eight patients (nine eyes) had intermediate uveitis, and three patients (four eyes) had posterior uveitis. The need for surgical intervention was 37.2% among all cases and the most common surgery was trabeculectomy in 45 eyes.

Conclusion:

UG is a vision-threatening complication commonly seen in patients with uveitis. This study demonstrates the epidemiological features and underlying etiologies of UG in the Turkish population. The most common primary causes of UG were Behçet’s disease and Fuchs heterochromic cyclitis.
Novel technique of percutaneous bypass in a brachiocephalic arteriovenous fistula with cephalic arch occlusion: A case report
Authors: Tan Hiang Jin , Shi Lew Pei , Meng Lai Yu , Chunyin Ho Derek , Pitumpe Harsha , Kum Steven , Lim Darryl
Published: August 2020

Objective:

Arteriovenous fistulas are a principal mainstay of long-term dialysis access for patients with end stage renal failure. However, the patency of arteriovenous fistulas is limited, often requiring percutaneous transluminal angioplasty as a salvage procedure. We report a case of percutaneous method of arteriovenous fistula salvage.

Methods:

A gentleman with brachiocephalic arteriovenous fistula created in 2015 was admitted under us for dialysis access issue. His fistula history was notable for recurrent and refractory venous outflow stenosis of the cephalic vein and the cephalic arch with multiple previous interventions. Ultrasound showed cephalic arch occlusion with high venous pressures. He underwent left brachicephalic fistula percutaneous bypass. We describe the percutaneous creation of a brachial–subclavian arteriovenous fistula via a bypass graft from a worsening brachial-cephalic fistula with cephalic arch occlusion that is not amendable to angioplasty.

Results:

Final angiogram showed smooth flow to central vein. He is 2 years post procedure, and his fistula remained patent with no interventions required.

Conclusion:

Percutaneously created jump bypass grafts can reliably produce sustained long-term patency.
Patient-Level Factors Associated with Oncology Provider-Delivered Brief Tobacco Treatment Among Recently Diagnosed Cancer Patients
Authors: Neil JM , Price SN , Friedman ER , Ponzani C , Ostroff JS , Muzikansky A , Park ER
Published: August 2020

Background:

A cancer diagnosis is seen as a “teachable moment” for patients to consider changing their behavioral risk factors, such as smoking. It also offers an opportunity for oncology providers to engage in a dialogue about how they can support patients changing their smoking behaviors. Brief, evidence-based tobacco cessation treatment delivered by oncology providers through the 5As (Ask, Advise, Assess, Assist Arrange) model is recommended, but provision to cancer patients remains suboptimal.

Aim:

Explore patient-level factors associated with 5As receipt among current smokers with a newly diagnosed cancer.

Method:

A total of 303 patients self-reported whether they received each of the 5As during their most recent oncology care visit. Multivariable regression analyses were conducted to identify patient-level factors associated with 5As receipt.

Results:

Oncology provider-delivered 5As rates ranged from 81.5% (Ask) to 30.7% (Arrange). 5As receipt was associated with: reporting lower illness-related stigma, diagnosis of a comorbid smoking-related disease, diagnosis of a smoking-related cancer, and diagnosis of a non-advanced cancer.

Conclusion:

Findings support previous literature in which smoking-related diagnoses were associated with greater receipt of 5As; however, disparities in the receipt of 5As existed for patients with more advanced cancer diagnoses and illness-related stigma. Inequities in the provision of quit assistance may further decrease treatment effectiveness and survival expectancy among certain patient populations. These findings are, therefore, important as they identify specific patient-level factors associated with lower 5As receipt among newly diagnosed cancer patients.
‘It’s nice to be appreciated’: Understanding heterosexual men’s engagements with sexting and sharing Dick Pics
Authors: Waling Andrea , Kerr Lucille , Bourne Adam , Power Jennifer , Kehler Michael
Published: August 2020

This paper explores heterosexual men’s experiences of sexting with a primary focus on how, when and why men send sexually explicit photos to women. Previous research has focused either on gay and bisexual men’s experiences or considered sexting within a broader youth context. This research considers young men and their engagement with sexting practices and its relationship to how they view and understand their bodies as desirable and sexual. Drawing from work that has called for more reflexive considerations of men’s emotions and sexuality, we explore the processes by which men engage in the practice of sexting (how/where they take photos), the affects that sexting provides (how it makes them feel), their rationale for engaging in the practice (why they do it) and their expectations from partners (e.g. reciprocal photos, partner’s responses). The findings of this paper suggest that while men highlight a range of affects and experiences with sexting, on the whole, it helps boost sexual confidence with partners and create and sustain intimacy, particularly in between seeing (in person) a partner or partners. Our research further suggests that men share similar concerns to women in other studies who are concerned about their photos becoming public, thus revealing a primary reason why this particular population of heterosexual men may not engage in the sending of erotic photos.
“My own corner of loneliness:” Social isolation and place among Mexican immigrants in Arizona and Turkana pastoralists of Kenya
Authors: Pike Ivy L. , Crocker Rebecca M.
Published: August 2020

This article explores the intersection of two growing health concerns: the rising incidence of loneliness and the negative health impacts of migration and displacement. To better evaluate loneliness across diverse populations, we emphasize the cultural shaping of expectations for social lives and the ways in which structural vulnerability and violence can undermine these expectations. We draw on ethnographic research with two groups of migrants: Mexican immigrants living in southern Arizona and Turkana pastoralists of Kenya who experience displacement and unpredictable mobility as a result of low intensity violence. For Mexican immigrants, feelings of loneliness intertwine with the emotions of fear, trauma, and sadness, all closely associated with social isolation. The Turkana describe loneliness associated with the loss of their animals, or the shifting social landscapes they must traverse to keep their families safe. The culturally salient experiences described by these two communities highlight the complexity of defining loneliness. Given the pace of global migration and the number of refugees and displaced persons, closer scrutiny of how cultural expectations and structural violence interact to produce feelings of loneliness seems overdue.
Conditional secondary transfer effect: The moderating role of moral credentials and prejudice
Authors: Jasinskaja-Lahti Inga , Vezzali Loris , Ranta Mona , Pacilli Maria Giuseppina , Giacomantonio Mauro , Pagliaro Stefano
Published: August 2020

This survey experiment examined the role of prejudice and moral licensing as two moderators of the secondary transfer effect (STE) of positive and negative intergroup contact. We collected a quota-randomized sample of 299 majority Finns (52.6% female; experimental condition: n = 118, control condition: n = 181) in order to test whether moral credentials prevent attitude generalization (from primary towards secondary outgroup), particularly among prejudiced individuals. The results showed that STEs of both positive and negative contact were prevented among more prejudiced majority group members who had the possibility to obtain moral credentials in the moral licensing task. These results point at the unstable nature of attitude generalization in STE among prejudiced individuals and at the potential of a normative moral act to intervene into the generalization of intergroup attitudes following intergroup contact. We discuss these findings in relation to the literature on moral licensing and moral reinforcement, framing them in the context of an integration of contact research and research on morality in general.
Association of Body Mass Index and Waist to Hip Ratio With Gallstone Disease in Patients Visiting Rural Tertiary Care Center in North India
Authors: Malik Pushpendra , Singla Deepak , Garg Mahinder K , Sangwan Mukesh
Published: August 2020

Introduction. In India the prevalence of gall stone disease varies in different parts of India. Malhotra in 1996 conducted an epidemiological study in Indian Railway employees and showed that North Indians has 7 times higher prevalence of gall stones compared to South Indian employees. It is said that Gall bladder is a disease of “Fatty, Fertile, Females in their Forties”. In our daily routine we observe that it is found not only in fatty females but common in average built patients also. Material and Methods. Study includes patients visiting to BPS GMC Khanpur Kalan with diagnosis of gall stone diseases and operated at our center with sample size of 135. Body mass index (BMI) and Waist to Hip ratio are calculated using their standard formulas. All data was compiled in IBM SPSS statistics (20.0). Result. Normal BMI is considered up to 25 and more than 50% patients lie in normal BMI range. Only 13% of cases lie in obese group that is BMI greater than 30. Waist to hip ratio, maximum patients that is BMI greater than 30. Waist to hip ratio, maximum patients that is (83%) lie in group more than 0.85. Minimum Waist to Hip ratio is .77 and maximum Waist to Hip ratio is 1.45. Out of 135 patients 90 patients are having high Waist to Hip ratio. Conclusion. Waist to Hip Ratio (abdominal adiposity) is better indicator of Gall stone diseases than BMI.
Comprehensive evaluation of robotic global performance based on modified principal component analysis
Authors: Li Liming , Zhao Jing , Wang Chunrong , Yan Chaojie
Published: August 2020

The multivariate statistical method such as principal component analysis based on linear dimension reduction and kernel principal component analysis based on nonlinear dimension reduction as the modified principal component analysis method are commonly used. Because of the diversity and correlation of robotic global performance indexes, the two multivariate statistical methods principal component analysis and kernel principal component analysis methods can be used, respectively, to comprehensively evaluate the global performance of PUMA560 robot with different dimensions. When using the kernel principal component analysis method, the kernel function and parameters directly have an effect on the result of comprehensive performance evaluation. Because kernel principal component analysis with polynomial kernel function is time-consuming and inefficient, a new kernel function based on similarity degree is proposed for the big sample data. The new kernel function is proved according to Mercer’s theorem. By comparing different dimension reduction effects of principal component analysis method, the kernel principal component analysis method with polynomial kernel function, and the kernel principal component analysis method with the new kernel function, the kernel principal component analysis method with the new kernel function could deal more effectively with the nonlinear relationship among indexes, and its calculation result is more reasonable for containing more comprehensive information. The simulation shows that the kernel principal component analysis method with the new kernel function has the advantage of low time consuming, good real-time performance, and good ability of generalization.
Prior antiplatelet therapy in patients undergoing endovascular treatment for acute ischemic stroke: Results from the MR CLEAN Registry
Authors: van de Graaf Rob A , Zinkstok Sanne M , Chalos Vicky , Goldhoorn Robert-Jan B , Majoie Charles BLM , van Oostenbrugge Robert J , van der Lugt Aad , Dippel Diederik WJ , Roos Yvo BWEM , Lingsma Hester F , van Es Adriaan CGM , Roozenbeek Bob ,   on behalf of the MR CLEAN Registry investigators
Published: August 2020

Background

Antiplatelet therapy may increase the risk of symptomatic intracranial hemorrhage after endovascular treatment for ischemic stroke but may also have a beneficial effect on functional outcome. The aim of this study is to compare safety and efficacy outcomes after endovascular treatment in patients with and without prior antiplatelet therapy.

Methods

We analyzed patients registered in the MR CLEAN Registry between March 2014 and November 2017, for whom data on antiplatelet therapy were available. We used propensity score nearest-neighbor matching with replacement to balance the probability of receiving prior antiplatelet therapy between the prior antiplatelet therapy and no prior antiplatelet therapy group and adjusted for baseline prognostic factors to compare these groups. Primary outcome was symptomatic intracranial hemorrhage. Secondary outcomes were 90-day functional outcome (modified Rankin Scale), successful reperfusion (extended thrombolysis in cerebral infarction score ≥2B) and 90-day mortality.

Results

Thirty percent ( n = 937) of the 3154 patients were on prior antiplatelet therapy, who were matched to 477 patients not on prior antiplatelet therapy. Symptomatic intracranial hemorrhage occurred in 74/937 (7.9%) patients on prior antiplatelet therapy and in 27/477 (5.6%) patients without prior antiplatelet therapy adjusted odds ratio 1.47, 95% confidence interval 0.86–2.49. No associations were found between prior antiplatelet therapy and functional outcome (adjusted common odds ratio 0.87, 95% confidence interval 0.65–1.16), successful reperfusion (adjusted odds ratio 1.23, 95% confidence interval 0.77–1.97), or 90-day mortality (adjusted odds ratio 1.15, 95% confidence interval 0.86–1.54).

Conclusion

We found no evidence of an association of prior antiplatelet therapy with the risk of symptomatic intracranial hemorrhage after endovascular treatment, nor on functional outcome, reperfusion, or mortality. A substantial beneficial or detrimental effect of antiplatelet therapy on clinical outcome cannot be excluded. A randomized clinical trial comparing antiplatelet therapy versus no antiplatelet therapy is needed.
Comparing real-world evidence among patients with metastatic pancreatic ductal adenocarcinoma treated with liposomal irinotecan
Authors: Koeller Jim , Surinach Andy , Arikian Steven R. , Zivkovic Marko , Janeczko Patrick , Cockrum Paul , Kim George
Published: August 2020

There are questions surrounding the real-world effectiveness of chemotherapeutic treatments for pancreatic ductal adenocarcinoma. This literature review compared the clinical characteristics and outcomes of available real-world evidence (RWE) for liposomal irinotecan in combination with 5-fluorouracil (5-FU) and leucovorin (LV), a treatment regimen indicated for patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) who previously progressed on gemcitabine-based therapy.

A targeted literature search was conducted in the PubMed Central® and Embase® databases to identify available RWE regarding patients with mPDAC receiving liposomal irinotecan published within the last 5 years (January 2014–September 2019). Data were extracted for prior lines of therapy, performance status, overall survival (OS), progression-free survival (PFS), duration of exposure, and adverse events.

Six studies met inclusion criteria. A comparison of baseline patient characteristics and results with the included evidence reveals a clinically fragile, real-world patient population in terms of age (range: 61–68), prior lines of therapy with 34–61% of patients receiving ⩾2 lines of lines of prior therapy and performance status [49.8–100% of patients with Eastern Cooperative Oncology Group (ECOG) 0–1]. Studies observed wide OS (range: 5.3–9.4 months) and similar PFS (range: 2.3–4.1 months), with two studies measuring duration of exposure (7.3 weeks, 3.1 months). Patients analyzed by RWE studies tended to be older with significant disease progression, poor performance status, and more heavily pretreated compared with the phase III registrational trial (NAPOLI-1). Despite this, patients treated with liposomal irinotecan + 5-FU/LV therapy had similar outcomes as those in NAPOLI-1.
Securing the Airway in Maxillofacial Trauma Patients: A Systematic Review of Techniques
Authors: Patel Akshilkumar , Saadi Robert , Lighthall Jessyka G.
Published: August 2020

Study Design:

The present study is a systematic review of the literature.

Objective:

The goal of this study is to review our experience and the current literature on airway management techniques in maxillofacial trauma.

Methods:

Independent searches of the PubMed and MEDLINE databases were performed from January 1, 2019 to February 1, 2019. Articles from the period of 2008 to 2018 were collected. All studies which described both airway management and maxillofacial trauma using the Boolean method and relevant search term combinations, including “maxillofacial,” “trauma,” and “airway,” were considered.

Results:

A total of 452 relevant articles in total were identified. Articles meeting inclusion criteria by abstract review included 68 total articles, of which 16 articles were focused on airway management techniques for maxillofacial trauma in the general population and were deemed appropriate for inclusion in the literature review.

Conclusions:

Establishing an effective and stable airway in patients with maxillofacial trauma is of paramount concern. In both the acute setting and during delayed reconstruction, special considerations must be taken when securing a reliable airway in this patient population. The present article provides techniques for securing the airway and algorithms for utilization of these techniques, including both during the initial evaluation and the definitive operative management.
Advances in the understanding of poor graft function following allogeneic hematopoietic stem-cell transplantation
Authors: Chen Juan , Wang Hongtao , Zhou Jiaxi , Feng Sizhou
Published: August 2020

Poor graft function (PGF) following allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is a life-threatening complication and is characterized by bilineage or trilineage blood cell deficiency and hypoplastic marrow with full chimerism. With the rapid development of allo-HSCT, especially haploidentical-HSCT, PGF has become a growing concern. The most common risk factors illustrated by recent studies include low dose of infused CD34+ cells, donor-specific antibody, cytomegalovirus infection, graft versus host disease (GVHD), iron overload and splenomegaly, among others. Because of the poor prognosis of PGF, it is crucial to uncover the underlying mechanism, which remains elusive. Recent studies have suggested that the bone marrow microenvironment may play an important role in the pathogenesis of PGF. Deficiency and dysfunction of endothelial cells and mesenchymal stem cells, elevated reactive oxygen species (ROS) levels, and immune abnormalities are believed to contribute to PGF. In this review, we also discuss recent clinical trials that evaluate the safety and efficacy of new strategies in patients with PGF. CD34+-selected stem-cell boost (SCB) is effective with an acceptable incidence of GVHD, despite the need for a second donation. Alternative strategies including the applications of mesenchymal stem cells, N-acetyl-l-cysteine (NAC), and eltrombopag have shown favorable outcomes, but further large-scale studies are needed due to the small sample sizes of the recent clinical trials.
Mobile phone-based e-diary for assessment and enhancement of medications adherence among patients with multiple sclerosis
Authors: Golan Daniel , Sagiv Smadar , Glass-Marmor Lea , Miller Ariel
Published: August 2020

Background

Adherence to multiple sclerosis (MS) disease-modifying drugs (DMDs) is essential for realization of their optimal effectiveness and benefits.

Objective

To evaluate the usefulness and validity of a smartphone-based e-diary as a tool for adherence assessment as well as its effectiveness as a promoter of adherence to DMDs.

Methods

An MS tailored e-diary (MyMS&Me) reminded patients to take their DMDs on time. DMD intake was self-recorded in the e-diary by the participants. Three methods of adherence evaluation were compared: e-diary derived, retrospective self-reported, and the medication possession rate (MPR). The proportion of patients with poor adherence to DMDs (defined as MPR <80%) among e-diary users was compared with a control group without intervention.

Results

Sixty-two patients downloaded the e-diary (Female: 41 (66%), Expanded Disability Status Scale 3.2 ± 2.2) and 55 controls were enrolled. The median difference between e-diary-derived adherence and the MPR was –3% (95% limits of agreement: −53% to 12%). The median difference between retrospective self-reported adherence and the MPR was 0.3% (95% limits of agreement: −20% to 42%). The proportion of participants with poor adherence to DMDs was similar in the e-diary and control groups (10% vs. 13%, p = 0.6).

Conclusions

Substantial and clinically important disagreement between methods of medication adherence evaluation was noted. Smartphone reminders did not significantly improve the MPR of DMDs.
A Limited Fixation, Olecranon Sparing Approach, for Management of Geriatric Intra-Articular Distal Humerus Fractures
Authors: Kaiser Philip B. , Newman Erik T. , Haggerty Christopher , Appleton Paul T. , Wixted John J. , Weaver Michael J. , Rodriguez Edward K.
Published: August 2020

Purpose:

We propose that geriatric comminuted intra-articular distal humerus fractures can be effectively treated with a limited fixation approach aimed at achieving varus/valgus stability with columnar fixation, but allowing intra-articular comminution to heal by secondary congruency against an intact olecranon, thus avoiding an olecranon osteotomy.

Methods:

Fifty-six elderly patients with AO 13-C type fractures, who underwent surgical fixation with ≥12-months of follow-up were retrospectively reviewed. Thirty patients were treated with intra-articular open reduction internal fixation (ORIF) with an olecranon osteotomy and 26 patients were treated with our limited fixation (L-ORIF) approach. Outcomes were range of motion (ROM), complications, additional surgery, and patient-reported outcome measures (PROMIS).

Results:

At final follow-up, the average elbow ROM was 97° (40°-155°) in the ORIF group and 86.5° (20°-145°) in the L-ORIF group. There was a trend toward more complications and additional surgery in the ORIF group. PROMIS scores for pain were 53.1 and 52.14, and PROMIS functional scores were 41.7 and 41.4 in the ORIF and L-ORIF group respectively. No differences in outcomes were statistically significant.

Conclusion:

A limited fixation technique based on achieving varus/valgus stability with columnar fixation, demonstrated equivalent outcomes in elderly patients with intra-articular distal humerus fractures when compared to intra-articular ORIF with an olecranon osteotomy
Duty of Karius: Media Framing of Concussion Following the 2018 UEFA Champions League Final
Authors: White Adam J. , D. Parry Keith , Humphries Connor , Phelan Simon , Batten John , Magrath Rory
Published: August 2020

Concussion is a growing issue within sport, including within soccer. Despite the developing medical understanding of concussion, there is still an array of sociocultural discourses and misconceptions around it. In the 2018 UEFA Champions League Final, Liverpool Football Club goalkeeper Loris Karius suffered a head collision in the 48th minute. Postmatch, he was subsequently diagnosed as being concussed. As a result of his concussion, Karius’ performance was arguably impeded, with suggestions that this may have resulted in him making some key errors in the game. Through an analysis of media framing in 52 news articles in the days following the incident, four dominant frames were identified: deflection away from concussion, misunderstanding concussion, education on concussion, and recommendations. Frames that focussed on the lack of awareness and preventative measures that are present in soccer served to highlight the lack of significance afforded to concussion at this particular point in time. In particular, we highlight differences in concussion discourses between those working inside and outside the soccer industry. Overall, these findings contribute to the growing body of sociological work examining concussion in sport.
Orthopedics and Traumatology Inpatient Satisfaction Survey
Authors: Erden Arzu , Emirzeoğlu Murat
Published: August 2020

Inpatient satisfaction evaluation is essential for orthopedics serves. So the aim of this study was to develop a survey to evaluate the inpatients satisfaction in the orthopedics and traumatology service. The study was conducted with 102 patients (22 females and 80 males), who were hospitalized in an orthopedics and traumatology service. Data collection was performed with face to face interview. The survey development process was carried out in 4 steps: defining the problem and determining the subdimensions (1), composition an item pool (2), counselling expert (3), and reformation and implementation the survey (4). The final version of the survey have had 6 subdimensions: physiotherapist (1-3 items), inpatient administration (4,5 items), technical equipment and hygiene (6-8), doctor (9-11 items), nurse (12-14 items), and general satisfaction (15,16 items). In survey development process, internal consistency and item analysis were used for the reliability analysis. Cronbach alpha coefficient was calculated. The mean age of the participants was 41.43 ± 17.85 years, 85 of the patients underwent surgery on the knee, 13 on the hip, 3 on the leg, and 1 on the thigh. Six items were excluded from 22-itemed basic form of the survey as a result of the item analysis. The internal consistency of the final version of the survey was found good reliable (Cronbach alpha: 0.880). So health providers will be able to use it reliably on orthopedic inpatients speaking Turkish. Also it could be translate to other language to widely use.
Metabolic Syndrome or Insulin Resistance: Evolution, Controversies and Association With Cardiovascular Disease Risk
Authors: Chopra Arun K.
Published: August 2020

Metabolic syndrome is a clinical entity characterized by abdominal obesity, atherogenic dyslipidemia, impaired glucose tolerance, and hypertension (HT). Despite various attempts at definition, the syndrome has remained mired in controversy over its components and utility. Insulin resistance and its association with risk of cardiovascular disease are discussed at length in this article.

This review also discusses the controversies in the definition of this syndrome, the unique role of insulin resistance in its development, and the causes and implications of this clustering of risk factors characteristic to it, along with suggestions for a more comprehensive approach to this common problem.
How I treat thrombotic thrombocytopenic purpura in pregnancy
Authors: Ferrari Barbara , Peyvandi Flora
Published: August 2020

Thrombotic thrombocytopenic purpura (TTP) is an acute, life-threatening thrombotic microangiopathy (TMA) caused by acquired or congenital severe deficiency of ADAMTS13. Pregnancy is a recognized risk factor for precipitating acute (first or recurrent) episodes of TTP. Differential diagnosis with other TMAs is particularly difficult when the first TTP event occurs during pregnancy; a high index of suspicion and prompt recognition of TTP are essential for achieving a good maternal and fetal outcome. An accurate distinction between congenital and acquired cases of pregnancy-related TTP is mandatory for safe subsequent pregnancy planning. In this article, we summarize the current knowledge on pregnancy-associated TTP and describe how we manage TTP during pregnancy in our clinical practice.