bluuebunny/crossref_metadata_2025 huggingface dataset:
Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report
Authors: Koseki Kazunori , Mutsuzaki Hirotaka , Yoshikawa Kenichi , Endo Yusuke , Kanazawa Atsushi , Nakazawa Ryo , Fukaya Takashi , Aoyama Toshiyuki , Kohno Yutaka
Published: October 2020

The Honda Walking Assist® (HWA) is a light and easy wearable robot device for gait training, which assists patients’ hip flexion and extension movements to guide hip joint movements during gait. However, the safety and feasibility of gait training with HWA after total knee arthroplasty (TKA) remains unclear. Thus, we aimed to evaluate the safety and feasibility of this gait training intervention using HWA for a patient who underwent TKA. The patient was a 76-year-old female who underwent a left TKA. Gait training using HWA was conducted for 18 sessions in total, from 1 to 5 weeks after TKA. To verify the recovery process after TKA surgery, knee function parameters and walking ability were measured at pre-TKA and 1, 2, 4, and 8 weeks after TKA. The gait patterns at self-selected walking speed (SWS) without HWA at pre- and 5 weeks after TKA were measured by using 3-dimensional (3D) gait analysis. The patient completed a total of 18 gait training interventions with HWA without any adverse complications such as knee pain and skin injury. The postoperative knee extension range of motion (ROM), knee extension torque, SWS, and maximum walking speed were remarkably improved. Regarding gait kinematic parameters, though this patient had a characteristic gait pattern with decreased knee ROM (called stiff knee gait) preoperatively, the knee flexion angle at 5 weeks after TKA showed knee flexion movement at loading response phase (LR; called double knee action), increased knee ROM during gait, and increased knee flexion angle at swing phase. In this case, the gait training using HWA was safe and feasible, and could be effective for the early improvement of gait ability, hip function, and gait pattern after TKA.
“I Don’t Think I Have, But I’ve Heard.”: Examining Perceptions of Race Relations in the Los Angeles Police Department Among Male Mexican-American Police Officers
Authors: Gallardo Roberto
Published: October 2020

Male Mexican-American police officers in the LAPD were interviewed about their perception of race relations in the department. The data shows that while officers are aware of the existence of racial tensions, they do not believe or are unsure about if they have experienced racism or discrimination in the department. Respondents do describe hearing claims of racism and discrimination, mostly by African-American officers. It is argued this is due to officers being unversed in how modern forms of racism and discrimination are manifested, as well as respondents comparing their experiences to African-American officers and in the process reifying their version of the Black/White racial binary in the institution, more accurately manifesting as a Non-Black/Black binary.
Accuracy of acetabular cup placement using an angle-adjusting alignment guide with laser pointer in total hip arthroplasty
Authors: Okanoue Yusuke , Aso Koji , Dan Junpei , Takaya Shogo , Izumi Masashi , Kawakami Teruhiko , Ikeuchi Masahiko
Published: October 2020

Purpose:

To evaluate cup-positioning accuracy in total hip arthroplasty (THA) using a novel angle-adjusting alignment guide with laser pointer and determine whether level of surgical experience affects accuracy of cup placement or not.

Methods:

We included 117 hips in 104 patients who underwent THA using the novel guide. We retrospectively reviewed 44 hips in 40 patients who underwent THA before the novel guide was introduced. We compared differences in cup angles between the novel guide group and the conventional guide group as well as the discrepancies in targeted angles between the experienced surgeon group and the inexperienced surgeon group.

Results:

There were 114/117 hips (97.4%) within the Lewinnek safe zone in the novel guide group and 32/44 hips (72.7%) within the safe zone in the conventional guide group. There were significantly fewer outliers in the novel guide group ( p < 0.001). In the experienced surgeon group, the mean absolute errors in inclination and anteversion were 2.0 ± 1.7° and 2.1 ± 2.3°, respectively; which were not significantly different from those in the inexperienced surgeon group (2.3 ± 2.1° and 2.8 ± 2.3°, respectively).

Conclusion:

The novel angle-adjusting alignment guide with laser pointer is a simple tool that provides better accuracy of cup position than that obtained using conventional guides. Accurate cup placement is possible using the novel guide, regardless of surgeons’ experience.
The advantage of navigation for knee with lateral femoral bowing in total knee arthroplasty
Authors: Nam Jun Ho , Song Suk-Kyoon , Cho Myung-Rae , Kang Dae-Won , Choi Won-Kee
Published: October 2020

Purpose:

We have analyzed the surgical outcomes of primary total knee arthroplasty (TKA) using computer-assisted (CA) navigation in terms of postoperative coronal alignment depending on preoperative lateral femoral bowing.

Methods:

We conducted a retrospective study of patients who have undergone navigated primary TKA from January 2016 through January 2020. Two hundred and ninety-nine cases with lateral femoral bowing of 3° or less were assigned to group 1, 95 cases of lateral femoral bowing between 3° and 5° were assigned to group 2, and 89 cases with lateral femoral bowing of more than 5° were assigned to group 3. The postoperative mechanical hip–knee–ankle (mHKA) angle was measured from scanograms, which were taken 3 months after surgery. The appropriate range of coronal alignment was set as 0 ± 3°.

Results:

The number of outliers of mHKA occurred was 31 cases (10.4%) in group 1, 17 cases (17.9%) in group 2, and 17 cases (19.1%) in group 3. There was a significant correlation between the degree of lateral femoral bowing and the occurrence rate of mHKA outliers. Multiple variables logistic regression analysis showed occurrence rate of outliers in group 3 to be 2.04 times higher than group 1. After adjusting the patient’s age, sex, body mass index, and preoperative HKA deformity, the occurrence rate of outliers in group 3 was still 1.96 times higher than group 1.

Conclusion:

The benefit of CA navigation during TKA in obtaining coronal alignment within 0 ± 3° may be lessened when the preoperative lateral femoral bowing is severely advanced.
Isoproterenol Causing Coronary Vasospasm and ST Elevations During Tilt Table Testing
Authors: Duong Hanh , Masarweh Omar Maher , Campbell Grant , Win Theingi Tiffany , Joolhar Fowrooz
Published: October 2020

Syncope is a sudden but reversible brief loss of consciousness secondary to an acute reduction of cerebral perfusion. Reflex syncope denotes neurologically mediated syncope, which includes vasovagal, carotid sinus syndrome, and other situational syncope. The most frequent form of syncope is vasovagal, which is triggered by emotional stress or prolonged standing, and may be diagnosed with the tilt table test. A thorough investigation of syncope is necessary as serious cardiovascular disorders may also be a cause. A tilt table test is a widely used tool utilized by clinicians to diagnose vasovagal syncope and is sometimes augmented with isoproterenol, a β-sympathomimetic that acts on the heart. This report seeks to explain a case of a 48-year-old previously healthy woman who experienced inferior wall ST elevations during tilt table test supplemented with isoproterenol. There is reason to believe that the results of this patient’s tilt table test were due to vasovagal syncope in conjunction with right coronary artery vasospasm.
Membranous Glomerulonephritis as an Uncommon Presentation of Secondary Syphilis: A Reminder on Therapeutic Decision-Making in Clinical Practice
Authors: Inayat Faisal , Almas Talal , Bokhari Syed Rizwan A. , Muhammad Aun , Sharshir Moh’d A.
Published: October 2020

Membranous glomerulonephritis is one of the common causes of nephrotic syndrome in the adult population. It is idiopathic in the majority of patients, but the secondary forms can be seen in the setting of autoimmune disease, cancer, infection, and following exposure to certain medications. However, subclinical syphilis-related membranous nephropathy remains a particularly rare clinicopathologic entity in modern times. In this article, we chronicle an interesting case of latent syphilis masquerading as membranous glomerulonephritis, which resolved with benzathine penicillin without requiring immunosuppressive treatment. We further supplement this paper with a concise review of the relevant literature that delineates the utility of appropriate antibiotic therapy in the management of luetic membranous nephropathy. Clinicians should remain cognizant of secondary syphilis while evaluating patients for possible glomerulonephritis or those presenting with proteinuria. Additionally, patients with hepatitis B, hepatitis C, and human immunodeficiency virus infections are not infrequently coinfected with Treponema pallidum. Therefore, a high index of suspicion for systemic manifestations of syphilis such as nephrotic syndrome is warranted in the setting of a coinfection. Prompt diagnosis and treatment of syphilis may result in resolution of proteinuria, without the need for standard immunosuppressive therapy commonly used in clinical practice.
Systematic Review of Preinjury Mental Health Problems as a Vulnerability Factor for Worse Outcome After Sport-Related Concussion
Authors: Iverson Grant L. , Williams Michael W. , Gardner Andrew J. , Terry Douglas P.
Published: October 2020

Background:

It is difficult to predict who will experience prolonged health problems after sustaining a sport-related concussion.

Purpose:

To synthesize the literature and conduct a gap analysis on the association between preinjury mental health problems and clinical outcome from sport-related concussion.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

Data sources were PubMed, PsycINFO, MEDLINE (and MEDLINE in Process), CINAHL, Cochrane Library, EMBASE, SPORTDiscus, Scopus, and Web of Science. Studies published before February 2019 that addressed preinjury mental health problems as a possible predictor of worse clinical outcome or clinical recovery from concussion were eligible for inclusion.

Results:

Of 4013 studies screened, 358 full texts were reviewed, and 12 studies involving 3761 participants (n = 471 [12.5%] with preexisting mental health problems) were ultimately included. The participants with a preinjury history of mental health problems were at greater risk for having persistent symptoms or worse outcome in 9 of 12 studies. The studies had major methodological differences, and most studies were not focused on mental health as a primary predictor or prognostic factor. Rather, they included it as a secondary or tertiary predictor. The sample sizes with preinjury mental health problems in most studies were small or very small (ie, <25). The age of onset, type, course, severity, and duration of mental health problems were not defined. The extent to which mental health problems were present before the season, during baseline testing, was not reported.

Conclusion:

Preinjury mental health problems appear to confer risk for worse clinical outcome after sport-related concussion. Future research is needed to (1) examine this risk factor in large representative populations of middle school students, high school students, and collegiate athletes; (2) quantify the risk for each mental health condition; (3) understand the mechanisms underlying this increased risk; and (4) develop more refined treatment and rehabilitation approaches for these student-athletes.
Preoperative Knee Instability Affects Residual Instability as Evaluated by Quantitative Pivot-Shift Measurements During Double-Bundle ACL Reconstruction
Authors: Kawanishi Yusuke , Nozaki Masahiro , Kobayashi Makoto , Yasuma Sanshiro , Fukushima Hiroaki , Murase Atsunori , Takenaga Tetsuya , Yoshida Masahito , Kuroyanagi Gen , Kawaguchi Yohei , Nagaya Yuko , Murakami Hideki
Published: October 2020

Background:

The pivot-shift test is an important indicator of functional outcomes after anterior cruciate ligament (ACL) reconstruction (ACLR). Preoperative instability as indicated by the pivot-shift test is associated with residual instability after ACLR. Few studies have used quantitative means to evaluate the pivot shift after ACLR.

Purpose:

To investigate the relationship between preoperative and residual instability and to identify the risk factors for residual instability by using quantitative measurements of the pivot shift.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 91 patients undergoing primary double-bundle ACLR were retrospectively enrolled. Quantitative measurements of instability for ACL-deficient knees (ACLD) and uninjured contralateral knees (intact) preoperatively, as well as ACLR knees intraoperatively, were performed under general anesthesia using the pivot-shift test, with inertial sensors to measure acceleration and external rotational (ER) angular velocity. The ratios of intact to ACLD (ACLD/I) and intact to ACLR (ACLR/I) were measured. Patients who showed an ACLR/I of >1 were classified into the residual instability group, and those with an ACLR/I of ≤1 were classified into the noninstability group. Regarding demographic, surgical, and quantitative measurement factors, between-group comparisons and multivariate logistic regression were conducted for predictors of residual instability. Receiver operating characteristic curves were used to evaluate the correlations between ACLD/I and ACLR/I and the cutoff value of ACLD/I in predicting residual instability.

Results:

The predictive factors for intraoperative residual instability included female sex (odds ratio [OR], 0.3 [95% CI, 0.1-0.9]; P = .034) and ACLD/I for acceleration (OR, 1.6 [95% CI, 1.2-2.1]; P < .001), and ACLD/I for ER angular velocity (OR, 1.9 [95% CI, 1.2-3.1]; P = .013). Correlations between ACLD/I and ACLR/I were moderate with respect to both acceleration ( r = 0.435; P < .001) and ER angular velocity ( r = 0.533; P < .001). The cutoff points for ACLD/I were 4.9 for acceleration (sensitivity, 65.1%; specificity, 85.7%; area under the curve [AUC], 0.76) and 2.4 for ER angular velocity (sensitivity, 80.0%; specificity, 50.0%; AUC, 0.74).

Conclusion:

Greater preoperative instability was a risk factor for residual instability as measured intraoperatively by a quantitatively evaluation in the pivot shift during ACL reconstruction. Quantitative measurements of instability during the pivot shift mechanism under general anesthesia may enable surgeons to predict postoperative residual instability.
The Virtual Shoulder and Knee Physical Examination
Authors: Lamplot Joseph D. , Pinnamaneni Sridhar , Swensen-Buza Stephanie , Lawton Cort D. , Dines Joshua S. , Nawabi Danyal H. , Young Warren , Rodeo Scott A. , Taylor Samuel A.
Published: October 2020

The COVID-19 crisis has forced a sudden and dramatic shift in the way that clinicians interact with their patients, from outpatient encounters to telehealth visits utilizing a variety of internet-based videoconferencing applications. Although many aspects of pre–COVID-19 outpatient sports medicine care will ultimately resume, it is likely that telehealth will persist because of its practicality and because of patient demand for access to efficient and convenient health care. Physical examination is widely considered a critical obstacle to a thorough evaluation of sports medicine patients during telehealth visits. However, a closer reflection suggests that a majority of the examination maneuvers are possible virtually with limited, if any, modifications. Thus, we provide a comprehensive shoulder and knee physical examination for sports medicine telehealth visits, including (1) verbal instructions in layman’s terms that can be provided to the patient before or read verbatim during the visit, (2) multimedia options (narrated videos and annotated presentations) of the shoulder and knee examination that can be provided to patients via screen-share options, and (3) a corresponding checklist to aid in documentation.
Epidemiology of Traumatic and Overuse Injuries in Swiss Professional Male Ice Hockey Players
Authors: Brunner Romana , Bizzini Mario , Niedermann Karin , Maffiuletti Nicola A.
Published: October 2020

Background:

Ice hockey injury patterns in Europe were last evaluated in the 1990s.

Purpose:

The aim of this study was to assess the frequency, type, location, and incidence of traumatic injuries, as well as the prevalence and relative effect of overuse injuries in professional male ice hockey players.

Study Design:

Descriptive epidemiology study.

Methods:

Traumatic injuries were assessed using a standardized injury report form over a 1-year period (including the preparatory phase and season). The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire was used to determine overall and substantial overuse injuries and their relative effect on ice hockey players.

Results:

Five Swiss National League teams participated in the study. From a total of 321 recorded injuries, 179 led to time loss from sport. The game-related time-loss injury incidence during the season was 88.6/1000 player-game hours.Time-loss injuries affected mainly the hip/groin/thigh region (23%), followed by the head (17%). Most time-loss injuries were classified as muscle strains (24%), followed by concussions (18%). The most common injury mechanism involved collision with an opponent’s body (31%), and right forward players (23%) were most likely to report a game-related injury. Most injuries (27%) occurred within the defending zone along the boards. The average prevalence rates of all overuse and substantial overuse injuries were 49% and 13%, respectively. The hip/groin displayed the highest average prevalence for all overuse problems (16%), translating to the highest relative effect.

Conclusion:

Muscle strains and concussions were the most frequent time-loss injuries in Swiss professional ice hockey players. The hip/groin was the most affected region for both traumatic and overuse injuries.
“Workarounds and Roadblocks”: Risk and Resistance among Food Movement Activists
Authors: Raridon Andrew , Mix Tamara L. , Einwohner Rachel L.
Published: October 2020

This article examines how activists involved in the food movement use different tactics intended to challenge and subvert the agrifood structures they encounter. We use data from interviews and participant observations with 57 food movement activists operating in less robust alternative food systems throughout the Southern Plains states of Texas, Arkansas, Oklahoma, and Kansas. Our respondents describe how they interpret their regional food systems as deliberately restrictive to the food movement and explain some of the tactical choices they make to maneuver around various constraints they claim hinder their food movement activism. In actively resisting the agricultural status quo, we find that some activists knowingly engage in forms of high-risk activism. We then examine the different framing devices food movement activists use to explain the risks generated by their tactical workarounds. Our findings contribute to the social movements and food system literature by showing how activists interpret and justify the risks generated by their resistance and by emphasizing the contextual nature of tactical choices and risk in social movement activism.
Application of Bayesian Active Learning to the Estimation of Auditory Filter Shapes Using the Notched-Noise Method
Authors: Schlittenlacher Josef , Turner Richard E. , Moore Brian C. J.
Published: October 2020

Time-efficient hearing tests are important in both clinical practice and research studies. This particularly applies to notched-noise tests, which are rarely done in clinical practice because of the time required. Auditory-filter shapes derived from notched-noise data may be useful for diagnosis of the cause of hearing loss and for fitting of hearing aids, especially if measured over a wide range of center frequencies. To reduce the testing time, we applied Bayesian active learning (BAL) to the notched-noise test, picking the most informative stimulus parameters for each trial based on nine Gaussian Processes. A total of 11 hearing-impaired subjects were tested. In 20 to 30 min, the test provided estimates of signal threshold as a continuous function of frequency from 500 to 4000 Hz for nine notch widths and for notches placed both symmetrically and asymmetrically around the signal frequency. The thresholds were found to be consistent with those obtained using a 2-up/1-down forced-choice procedure at a single center frequency. In particular, differences in threshold between the methods did not vary with notch width. An independent second run of the BAL test for one notch width showed that it is reliable. The data derived from the BAL test were used to estimate auditory-filter width and asymmetry and detection efficiency for center frequencies from 500 to 4000 Hz. The results agreed with expectations for cochlear hearing losses that were derived from the audiogram and a hearing model.
Investigating the Effects of Four Auditory Profiles on Speech Recognition, Overall Quality, and Noise Annoyance With Simulated Hearing-Aid Processing Strategies
Authors: Wu Mengfan , Sanchez-Lopez Raul , El-Haj-Ali Mouhamad , Nielsen Silje G. , Fereczkowski Michal , Dau Torsten , Santurette Sébastien , Neher Tobias
Published: October 2020

Effective hearing aid (HA) rehabilitation requires personalization of the HA fitting parameters, but in current clinical practice only the gain prescription is typically individualized. To optimize the fitting process, advanced HA settings such as noise reduction and microphone directionality can also be tailored to individual hearing deficits. In two earlier studies, an auditory test battery and a data-driven approach that allow classifying hearing-impaired listeners into four auditory profiles were developed. Because these profiles were found to be characterized by markedly different hearing abilities, it was hypothesized that more tailored HA fittings would lead to better outcomes for such listeners. Here, we explored potential interactions between the four auditory profiles and HA outcome as assessed with three different measures (speech recognition, overall quality, and noise annoyance) and six HA processing strategies with various noise reduction, directionality, and compression settings. Using virtual acoustics, a realistic speech-in-noise environment was simulated. The stimuli were generated using a HA simulator and presented to 49 habitual HA users who had previously been profiled. The four auditory profiles differed clearly in terms of their mean aided speech reception thresholds, thereby implying different needs in terms of signal-to-noise ratio improvement. However, no clear interactions with the tested HA processing strategies were found. Overall, these findings suggest that the auditory profiles can capture some of the individual differences in HA processing needs and that further research is required to identify suitable HA solutions for them.
Is a College Promise Program an Effective Use of Resources? Understanding the Implications of Program Design and Resource Investments for Equity and Efficiency
Authors: Perna Laura W. , Wright-Kim Jeremy , Leigh Elaine W.
Published: October 2020

Also known as “free tuition,” college promise programs are emerging across the United States as a potential mechanism for improving college access and affordability, Whether these initiatives are an effective use of resources depends on whether programs advance societal goals for equity and efficiency. Although some emerging research explores the role of program design, few studies have probed how program design and resource investments influence program outcomes, efficiency, and equity. To address this knowledge gap, this study draws on case studies of programs that offer free tuition to attend four community colleges. Findings illustrate how program outcomes, efficiency, and equity may be influenced by the criteria used to determine program eligibility and the resources invested in the financial award and other program components. We hope the findings are useful to policymakers and institutional leaders, as they strive to allocate resources to advance both efficiency and equity.
The role of formalization and organizational trust as antecedents of ambidexterity: An investigation on the organic agro-food industry
Authors: Chams-Anturi Odette , Moreno-Luzon Maria D. , Romano Pietro
Published: October 2020

This article investigates the influence of specific key organizational factors (i.e., enabling formalization, coercive formalization, and trust) as antecedents of ambidexterity. Moreover, we propose a new way of operationalizing ambidexterity, under a holistic vision, including the synergies between exploration and exploitation. The study has been developed in the Spanish organic agro-food industry; a total of 239 usable responses were received from two respondents from each company—the general manager and the quality manager. The findings show that enabling formalization and organizational trust are positively related to ambidexterity, but contrary to our predictions, we found no evidence to show that coercive formalization is related to ambidexterity. In turn, we found different results for trust as a moderating factor on the types of formalization and ambidexterity.
A Method for Balancing Provider Schedules in Outpatient Specialty Clinics
Authors: Berg Bjorn P. , Erdogan S. Ayca , Lobo Jennifer Mason , Pendleton Kathryn
Published: October 2020

Background. Variability in outpatient specialty clinic schedules contributes to numerous adverse effects including chaotic clinic settings, provider burnout, increased patient waiting times, and inefficient use of resources. This research measures the benefit of balancing provider schedules in an outpatient specialty clinic. Design. We developed a constrained optimization model to minimize the variability in provider schedules in an outpatient specialty clinic. Schedule variability was defined as the variance in the number of providers scheduled for clinic during each hour the clinic is open. We compared the variance in the number of providers scheduled per hour resulting from the constrained optimization schedule with the actual schedule for three reference scenarios used in practice at M Health Fairview’s Clinics and Surgery Center as a case study. Results. Compared to the actual schedules, use of constrained optimization modeling reduced the variance in the number of providers scheduled per hour by 92% (1.70–0.14), 88% (1.98–0.24), and 94% (1.98–0.12). When compared with the reference scenarios, the total, and per provider, assigned clinic hours remained the same. Use of constrained optimization modeling also reduced the maximum number of providers scheduled during each of the actual schedules for each of the reference scenarios. The constrained optimization schedules utilized 100% of the available clinic time compared to the reference scenario schedules where providers were scheduled during 87%, 92%, and 82% of the open clinic time, respectively. Limitations. The scheduling model’s use requires a centralized provider scheduling process in the clinic. Conclusions. Constrained optimization can help balance provider schedules in outpatient specialty clinics, thereby reducing the risk of negative effects associated with highly variable clinic settings.
National Prevalence of Disability and Clinical Accommodations in Medical Education
Authors: Meeks Lisa M , Case Ben , Plegue Melissa , Moreland Christopher J , Jain Sharad , Taylor Nichole
Published: October 2020

Background:

This study aimed to evaluate and report the national prevalence of disability across undergraduate medical education (UME) and examine differences in the category of disability, and accommodation practices between allopathic (MD)- and osteopathic (DO)-granting programs.

Methods:

Between May 20 and June 30, 2020, 75% of institutional representatives at eligible DO schools responded to a web-based survey. The survey assessed the aggregate prevalence of disabled DO students, prevalence of DO students by category of disability, and prevalence of accommodations granted. Descriptive statistics were used to summarize results. Using 2019 MD data, comparisons were made between MD and DO programs to calculate overall prevalence and differences in accommodation practices across undergraduate medical education.

Results:

DO-granting programs reported a disability prevalence of 4.27% of the total enrollment. Attention-deficit/hyperactivity disorder (ADHD), psychological disabilities, and chronic health disabilities were reported most frequently. DO-granting programs reported higher rates of ADHD than the MD-granting program. The national pooled prevalence of disability across MD- and DO-granting programs was 4.52%. MD-granting programs reported a higher number of students with disabilities and higher rates of psychological disabilities when compared with DO-granting programs. One hundred percent of DO students disclosing disability received some form of accommodation. General clinical accommodations were more frequently provided in MD-granting programs when compared to DO-granting programs.

Conclusions:

This study provides the first comprehensive prevalence of US medical student disability and accommodations. Additionally, these data may serve as a benchmark for DO programs, with implications for curricular development, instructional planning and disability support, and resource allocation in medical education.
Risk Aversion, Entrepreneurial Attitudes, Intention and Entry Among Young People in Uganda and Germany: A Gendered Analysis
Authors: Baluku Martin Mabunda , Nansubuga Florence , Otto Kathleen , Horn Lisa
Published: October 2020

Extant research has consistently indicated that personality and cultural variables are important predictors of entrepreneurial behaviour and outcomes. Using a longitudinal approach, the article examines the effects of risk aversion on general entrepreneurial attitudes, entrepreneurial intentions and entry into self-employment, as well as how these effects differ according to gender and country contexts. Study 1 (T1) assessed risk aversion, entrepreneurial attitude and intentions among 573 students in the final year of their studies (284 at a German university and 289 at a Ugandan university). Study 2 (T2) established participants’ employment status 6–24 months after graduation. We were able to match 104 valid responses. Our results revealed negative effects of risk aversion on both general entrepreneurial attitude and intention. A moderated mediation effects model suggesting that risk aversion predicts entrepreneurial intention through general entrepreneurial attitude shaped by gender and country was confirmed. Moreover, risk aversion and entrepreneurial intentions had substantial effects on the likelihood of being self-employed while country differences were also observed.
The impact of bike network indicators on bike kilometers traveled and bike safety: A network theory approach
Authors: Kamel Mohamed Bayoumi , Sayed Tarek
Published: October 2020

There has been recent interest in the use of network analysis to quantify bike network features and their impact on biking levels and safety. However, limited bike network indicators have been evaluated. This study introduces a list of network indicators to quantify the bike network and study its effect on bike kilometers traveled and bike–vehicle crashes. Data from the city of Vancouver, Canada, are used as a case study. Full Bayesian modeling incorporating spatial effects is employed to develop Bike Kilometers Travelled (BKT) and bike–vehicle crash models. The developed BKT models show that the bike network centrality, assortativity, and weighted slope have negative associations with BKT, while the bike network directness, length, complexity and development, and connectivity have positive associations with BKT. The developed crash models show that the bike network length, centrality, assortativity, and continuity have negative associations with bike–vehicle crashes. On the other hand, the bike network complexity and development, connectivity, and linearity have positive associations with bike–vehicle crashes. The models provide insights that can be useful for planning bike networks to increase bike traffic and improve bike safety. The models also show that some changes to a bike network to increase bike traffic should be accompanied by crash risk-mitigating measures. As well, the models can be used to identify zones within a city that require safety improvements.
Shoot and Post: The Making of Educational Videos
Authors: Naik Jaee M. , Thieringer Florian M. , Beck-Broichsitter Benedicta , Girod Sabine , Naik Milind N.
Published: October 2020

Study Design:

Descriptive technical write-up.

Objective:

To describe the making of educational videos in 4 simple steps.

Methods:

There are 4 steps in the creation of an educational video, namely theme and script, preparation and equipment, filming, and postproduction.

Results:

The authors give details of each step of the video making process, with practical tips from personal experiences, product suggestions, and photo documentation.

Conclusion:

A 4-step approach to make high-quality educational videos for your patients, residents, and social media platforms is presented.
Mammalian PITPs at the Golgi and ER-Golgi Membrane Contact Sites
Authors: Cockcroft Shamshad , Lev Sima
Published: October 2020

Phosphatidylinositol (PI)-transfer proteins (PITPs) have been long recognized as proteins that modulate phosphoinositide levels in membranes through their intrinsic PI/PC-exchange activity. Recent studies from flies and mammals suggest that certain PITPs bind phosphatidic acid (PA) and possess PI/PA-exchange activity. Phosphoinositides and PA play critical roles in cell signaling and membrane trafficking, and numerous biochemical, genetic and functional studies have shown that PITPs regulate cellular lipid metabolism, various signaling pathways and intracellular membrane transport events. In this mini-review, we discuss the function of mammalian PITPs at the Golgi and ER-Golgi membrane contact sites (MCS) and highlight DAG (Diacylglycerol) as a central hub of PITPs functions. We describe PITPs-associated phospho-signaling network at the ER-Golgi interface, and share our perspective on future studies related to PITPs at MCSs.
Is the Concept of Corporate Governance a Strategic Plan for Firms’ Optimum Capital Structure? Evidence from Manufacturing Companies
Authors: Das Chandrika Prasad , Agarwall Himanshu , Swain Rabindra Kumar
Published: October 2020

The aim of the article is to examine the relationship as well as measure the impact of corporate governance as a strategic plan on capital structure decision of top Bombay Stock Exchange-listed manufacturing firms in India.

Panel regression analysis is employed to estimate the relationship and measure the impact of corporate governance, namely, size, meetings, independent director, women director and audit committee meetings, on the capital structure mix (debt–equity ratio) of the sample corporate, during a 10-year period of 2008–2017.

The results of study reveal that the components of corporate governance, namely, size, board meetings, independent director, and audit committee meetings have a positive association with the capital structure variable (debt–equity ratio) of the sample manufacturing companies. However, there is a negative relationship between the control variables (ROCE and NWTA) and the dependent variable of the sample corporate. Overall, as per the study results, a statistically significant impact prevails on the capital structure, of corporate governance variables, taken as a whole.

This article adds on to the existing study by highlighting a new prospect of relation and influence of corporate governance on capital structure decisions. The statistical findings of the study provide evidence to the corporate sector in deciding the optimum capital structure, affecting its costs and performance, and to the regulatory authorities in framing and implementing corporate governance mechanisms more effectively and efficiently for improving the economy of the country.
Relationship Between N-Terminal Probrain Natriuretic Peptide (NT-Pro BNP) Level, Infarct Type and Infarct Volume in Ischemic Cerebrovascular Disease
Authors: Tekin Selma , Öncel Çağatay Hilmi , Özdemir Mehmet Bülent , Yaylalı Yalın Tolga , Tekin Işık , Güneş Özcan , Rota Simin , Kurbetli Nuriye
Published: October 2020

Background:

N-terminal probrain natriuretic peptide, which is a neurohormone produced mainly by the heart, is increased in acute ischemic cerebrovascular disease. Here we aimed to investigate the relationship of N-terminal probrain natriuretic peptide levels with cerebrovascular disease subtypes, infarct volume, and prognosis in cerebrovascular disease, and to determine if N-terminal probrain natriuretic peptide could be a biomarker for ischemic cerebrovascular disease.

Methods:

Consecutive 105 patients with a diagnosis of acute ischemic cerebrovascular disease and 50 healthy controls were examined for serum N-terminal probrain natriuretic peptide concentration, cerebrovascular disease subtypes, infarct volumes, and clinical outcomes with the National Institute of Health Stroke Scale assessment.

Results:

Mean N-terminal probrain natriuretic peptide values of cardioembolic group were significantly higher than lacunar infarct group ( P < .005) and transient ischemic attack group ( P = .005). There was a relation between worsening in the National Institute of Health Stroke Scale and elevation at N-terminal probrain natriuretic peptide ( P = .001). However, between N-terminal probrain natriuretic peptide levels and infarct volume, significant correlation was not detected ( P = .44).

Conclusion:

N-terminal probrain natriuretic peptide can be used as a valuable marker to distinguish between cardioembolic infarct and lacunar infarct. In addition, N-terminal probrain natriuretic peptide levels might be used as a biomarker for differential diagnosis of transient ischemic attack group and to provide insight into the prognosis.
Study of Dhat Syndrome in Men in West Bengal: A Clinic-Based Study
Authors: Chakraborty Abhijit , Mukhopadhyay Debshankar , Mandal Alok Kumar , Ghosh Srijit
Published: October 2020

Background:

Dhat syndrome is a culture-bound syndrome of the Indian subcontinent. Traditional and cultural teachings through generations, and myths and misconceptions about sex are its principal contributing factors. Although prevalent, there is scarcity in studies on Dhat syndrome, particularly from Bengal.

Aims and objectives:

1. To study the phenomenology of Dhat syndrome in men attending the out patients department (OPD). 2. To study the comorbid sexual and psychiatric disorders associated with Dhat syndrome.

Methodology:

This was a cross-sectional observational study conducted in the psychiatric OPD in a tertiary care medical college hospital in West Bengal. The duration of the study was 18 months. 122 patients were included in this study that fulfilled the inclusion and exclusion criteria. The diagnosis of Dhat syndrome was made as per International Classification of Diseases, Tenth Revision, diagnostic criteria for research (DCR) criteria. A semi-structured pro forma was used to obtain sociodemographic variables along with numerous physical and sexual symptoms. Mini International Neuropsychiatric Interview was applied for psychiatric comorbidities. Data were analyzed using Statistical Package for Social Studies 17 by SPSS Inc., Chicago.

Results:

122 patients met the inclusion and exclusion criteria. Majority of patients were among age group of 20 to 30 years (60.7%). 56.6% were from the Muslim community and 43.4% were from the Hindu community. 54.1% population was unmarried and 39.3% were newly married. Routes of passage were night falls in 62.3% patients, and 52.5% patients pointed toward passage through urine. Many patients reported passage of semen more than one route. All patients (100%) complained about generalized weakness and thinning of semen. 66.4% had generalized body ache, 55.7% complain about headache, 60.7% decreased body glow, 50% had loss of appetite, 98.4% had decreased self-confidence, sleep disturbance was reported in 34.3% patients, 58.2% reported that their penis was becoming smaller, and 49.2% patients reported decreased sexual capability. The most common comorbid condition was sexual dysfunction (39.3%) followed by depressive disorders (27.9%). Premature ejaculation was found in 54.17% patients and erectile dysfunction in 33.33%.

Conclusion:

Dhat syndrome is a common culture-bound syndrome in Bengal. It is widespread in the Muslim community also. The importance of exploration of sexual comorbidities in Dhat syndrome is very much needed.
Role of red free imaging, retinal reflectance and fundus autofluorescence in Bietti crystalline dystrophy: case report
Authors: Surve Abhidnya , Balaji Akshaya , Azad Shorya Vardhan , Kumar Vinod , Vohra Rajpal , Venkatesh Pradeep
Published: October 2020

Bietti crystalline dystrophy (BCD), a rare autosomal recessive hereditary disorder, is identified by its clinical features. It is characterised by crystalline deposits and hence called crystalline retinopathy. The retinopathy progresses with age, showing a decrease in the number of crystalline deposits and increase in the area of chorioretinal degeneration, which spreads in a centrifugal pattern. Thus, BCD can be confused with other disorders with crystalline-like deposits and chorioretinal degenerations. The red-free and near-infrared reflectance allows prominent visualisation of crystalline deposits that may be missed. The non-inferiority of red-free imaging and its wider availability could allow its use as a screening tool. The enhanced depth imaging optical coherence tomography shows crystalline deposits throughout the retina and outer retinal tubulation. Thus, multimodality imaging can act as an adjunct in diagnosis, monitoring and follow up in these cases, acting not only as a teaching tool but also giving an insight into the underlying pathophysiology of the disorder.

Plain language summary

Use of imaging in diagnosis of Bietti crystalline dystrophy Bietti crystalline dystrophy is a rare familial disorder but is not shown in all family members and may skip generations, as it has an autosomal recessive pattern of inheritance. It shows refractile yellow-white crystalline deposits and degenerative changes in the retina. These crystalline deposits disappear with age while degenerative changes increase and spread from centre to the periphery. This may cause difficulty in early detection, and confusion with similar degenerative diseases of the retina. The use of various imaging modalities can help in diagnosis and follow up of these cases. These modalities also provide understanding of the basic disease process.
Significance of tungsten disulfide on the mechanical and machining characteristics of phosphor bronze metal matrix composite
Authors: Sangaravadivel P , Rajamurugan G , Krishnasamy Prabu
Published: October 2020

The phosphor bronze (PB) is widely preferred in various engineering applications due to its high strength, toughness, fine grain size, low coefficient of friction, and better corrosion resistance. The present work is to investigate the effect of tungsten disulfide (WS2) solid lubricant particle reinforcement in the phosphor bronze metal matrix composite (PBMC) through the mechanical and machining characteristics. The different variant of the composite is fabricated using stir casting technique by varying the volume percentage of WS2 particle from 0% to10%. The prepared PBMC samples are subjected to mechanical and machining (boring and high-speed turning) characterizations. The hardness (Brinell hardness) and flexural strength of the composites are examined as per the ASTM standard. The surface roughness (Ra) of the PBMC sample is analyzed through the boring and high-speed turning operations by varying the spindle speed, feed rate, and depth of cut. The scanning electron microscope (SEM) is employed to confirm the uniform dispersion of the reinforcement particle through the microstructural analysis. The presence of WS2 particles and other ingredients is ensured by X-ray diffraction analysis in the composites. The influence of WS2 reinforcement particles on tool life is analyzed on the PBMC4 (PBMC with 8% WS2) with the predefined machining parameters in the high-speed turning operation. The increase in WS2 particle (0–10%) improves the hardness (11.85%) and flexural strength in PBMC4 as compared to PBMC1 (PBMC with 0% WS2). At a higher spindle speed (1200 r/min), the Ra is reduced in PBMC1 as compared to 900 r/min, whereas the rest of the PBMC sample show higher surface irregularity at 1200 r/min.
Reliability analysis assessment of the wind turbines system under multi-dimensions
Authors: Zheng Yuqiao , Wei Jianfeng , Zhu Kai , Dong Bo
Published: October 2020

Aiming at the frequent occurrence of the wind turbines failures, a set of analytical methods was developed to carry out the reliability assessment from multi-dimensions, considering the fault characteristics of the wind turbines subsystems, the variation of its failure process, and the wind turbines reliability indexes. Through classification processing of failure data, the Pareto diagram was applied to search the weak subsystem. A fault tree model is constructed, which can figure out the logical relationship between its failure events by the Fussell–Vesely algorithm. According to various characteristics of the bathtub curve, the failure process based on power law process (PLP) model was proposed, it has been discussed that the change criteria of the wind turbines failure with the running time. At last, reliability indexes such as availability were solved and compared to judge the wind turbine performance status. A case study was given in which the failure data are from a wind farm in China. The results indicate that electrical control and pitch subsystems are weak subsystems, and the minimum bottom event in their fault tree model may lead to system failure. Besides, the PLP model can describe the failure process of wind turbines.
Isatuximab as monotherapy and combined with dexamethasone in patients with relapsed/refractory multiple myeloma
Authors: Dimopoulos Meletios , Bringhen Sara , Anttila Pekka , Capra Marcelo , Cavo Michele , Cole Craig , Gasparetto Cristina , Hungria Vania , Jenner Matthew , Vorobyev Vladimir , Ruiz Eduardo Yanez , Yin Jian Y. , Saleem Rao , Hellet Maeva , Macé Sandrine , Paiva Bruno , Vij Ravi
Published: October 2020

This phase 2 study evaluated isatuximab as monotherapy or combined with dexamethasone in relapsed/refractory multiple myeloma (RRMM). Patients had RRMM refractory to an immunomodulatory drug (IMiD) and a proteasome inhibitor (PI) or had received ≥3 prior lines of therapy incorporating an IMiD and PI. Patients received isatuximab either as monotherapy (20 mg/kg on days 1, 8, 15, and 22 [once weekly] of cycle 1 followed by 20 mg/kg on days 1 and 15 of subsequent cycles; Isa group) or in combination with dexamethasone (40 mg/d [20 mg/d in patients aged ≥75 years] once weekly; Isa-dex group). Treated patients (N = 164) had received a median of 4 (range, 2-10) prior treatment lines. Patients received a median of 5 (1-24) and 7 (1-22) treatment cycles; at data cutoff, 13 (11.9%) of 109 and 15 (27.3%) of 55 patients remained on treatment in the Isa and Isa-dex arms, respectively. Overall response rate (primary efficacy end point) was 23.9% in the Isa arm and 43.6% in the Isa-dex arm (odds ratio, 0.405; 95% confidence interval, 0.192-0.859; P = .008). Median progression-free survival and overall survival were 4.9 and 18.9 months for Isa, and 10.2 and 17.3 months for Isa-dex. Infusion reactions (mostly grade 1/2) and hematologic abnormalities were the most common adverse events. There was a similar incidence of grade 3 or higher infections in both groups (22.0% and 21.8%). In conclusion, addition of dexamethasone to isatuximab increased response rates and survival outcomes with no detrimental effect on safety. This trial was registered at www.clinicaltrials.gov as #NCT01084252.