bluuebunny/crossref_metadata_2025_split huggingface dataset:
Internal Auditors and the Prevention and Detection of Computer Fraud
Authors: Marston Claire , Dixon Rob , Collier Paul 
Published: September 2020

This study examines the involvement and attitudes of internal auditors to the prevention and detection of computer fraud. This approach differs from previous research which has concentrated on learning from frauds which have occurred. The main enquiry was by means of a questionnaire sent to members of the Institute of Internal Auditors. Verification and additional information was forthcoming by visiting some respondents. Almost a fifth of internal audit departments reported that they had no specific responsibility for either prevention or detection of computer fraud. It was clear that where responsibility was acknowledged, it is generally on an informal basis or is self imposed. Internal auditors reported that most reliance was placed on computer assisted tools and manual techniques like input/output reconciliation for detection of computer fraud. Few of the organisations surveyed had any laid down guidelines what to do in the case of a fraud discovery. Where guidelines did exist they called for dismissal and prosecution. In smaller firms, external auditors have a larger role in the prevention and detection of computer fraud than in larger firms. Opinion on the prevention and detection of computer fraud included the view that as network systems become more common, so detection and prevention will become more difficult. In addition it was claimed that management did not appreciate the level of the threat. Internal auditors feel that they have a role to play, but highlighted the fact that there is a shortage of staff with the requisite skills.
Improving Acute Treatment of Pediatric Primary Headache Disorders With a Novel Headache Treatment Center: Retrospective Review of Preliminary Outcomes
Authors: Esparham Anna , Boorigie Madeline , Ablatt Saniya , Connelly Mark , Bickel Jennifer 
Published: September 2020

Objective: To determine preliminary outcomes of targeted headache treatments provided at a novel outpatient acute care pediatric headache treatment center. Background: Limitations exist in acute management of pediatric headaches, including inadequate access to specialty headache therapies and headache specialists in acute settings, variable success of emergency room treatments, and omission of comfort measures. An outpatient acute headache care clinic (the “Headache Treatment Center”) was strategically initiated at a Midwestern pediatric academic hospital to provide acute and targeted headache therapies for children with active headaches. Methods: We conducted a retrospective chart review of 154 visits from September through November 2018 of patients ages 7-18 years visiting the Headache Treatment Center. Results: On average, headache intensity (measured on an 11-point pain numeric rating scale) decreased after interventions used in the Headache Treatment Center (mean change = 2.85 ± 2.81, P < .05, Cohen d = 1.01). Large effect sizes for reducing headache intensity were observed for pericranial, occipital/auriculotemporal, and occipital nerve blocks, Cohen d = 1.56, 1.64 and 1.02, respectively. Large effect sizes for reducing headache intensity also were observed for a transcutaneous supraorbital nerve stimulator device (Cefaly) (Cohen d = 1.02), acupuncture (Cohen d = 1.09), and intravenous migraine cocktails (Cohen d = 0.91-1.34). Conclusion: Targeted headache therapies to abort pediatric primary headaches as part of a novel headache clinic model may be beneficial for short-term management.
Outcome of Patients With Necrotizing Vasculitis Admitted to the Intensive Care Unit (ICU) for Sepsis: Results of a Single-Centre Retrospective Analysis
Authors: Krasselt Marco , Baerwald Christoph , Petros Sirak , Seifert Olga 
Published: September 2020

Introduction/Background: Vasculitis patients have a high risk for infections that may require intensive care unit (ICU) treatment in case of resulting sepsis. Since data on sepsis mortality in this patient group is limited, the present study investigated the clinical characteristics and outcomes of vasculitis patients admitted to the ICU for sepsis. Methods: The medical records of all necrotizing vasculitis patients admitted to the ICU of a tertiary hospital for sepsis in a 13-year period have been reviewed. Mortality was calculated and multivariate logistic regression was used to determine independent risk factors for sepsis mortality. Moreover, the predictive power of common ICU scores was further evaluated. Results: The study included 34 patients with necrotizing vasculitis (mean age 69 ± 9.9 years, 35.3% females). 47.1% (n = 16) were treated with immunosuppressives (mostly cyclophosphamide, n = 35.3%) and 76.5% (n = 26) received glucocorticoids. Rituximab was used in 4 patients (11.8%).The in-hospital mortality of septic vasculitis patients was 41.2%. The Sequential Organ Failure Assessment (SOFA) score (p = 0.003) was independently associated with mortality in multivariate logistic regression. Acute Physiology And Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II) and SOFA scores were good predictors of sepsis mortality in the investigated vasculitis patients (APACHE II AUC 0.73, p = 0.02; SAPS II AUC 0.81, p < 0.01; SOFA AUC 0.898, p < 0.0001). Conclusions: Sepsis mortality was high in vasculitis patients. SOFA was independently associated with mortality in a logistic regression model. SOFA and other well-established ICU scores were good mortality predictors.
Acceptability and Preliminary Outcomes of a Parenting Intervention for Syrian Refugees
Authors: Sim Amanda L. , Bowes Lucy , Maignant Sandra , Magber Sara , Gardner Frances 
Published: September 2020

Purpose: Forced displacement may increase the risk of child maltreatment and mental health problems among children and caregivers. This study assessed the acceptability and preliminary outcomes of a parenting intervention to prevent child maltreatment and improve parental and child mental health among Syrian refugees in Lebanon. Method: 292 parents and 88 children participated in a structured assessment before and after a group-based parenting intervention implemented by an international nongovernmental organization serving refugee and vulnerable Lebanese communities. Results: Paired sample t tests showed significant reductions in harsh punishment and rejecting parenting behavior and significant improvements in measures of parental and child mental health from pre- to postintervention. On average, parents completed 7.7 of 10 sessions. Discussion: Preliminary results suggest that the parenting intervention was acceptable to refugee parents and may show promise in reducing child maltreatment and improving parental and child mental health in a humanitarian setting.
Economic Analysis and Clinical Outcomes of Short-Stay Versus Inpatient Total Ankle Replacement Surgery
Authors: Akoh Craig C. , Fletcher Amanda N. , Chen Jie , Wang Juanto , Adams Samuel A. , DeOrio James K. , Nunley James A. , Easley Mark E. 
Published: September 2020

Background: We aimed to perform an economic analysis and compare the clinical outcomes between inpatient and short-stay designation total ankle replacement (TAR). Methods: We performed a retrospective study on 178 consecutive patients undergoing primary inpatient versus short-stay designation TAR during the 2016 and 2017 fiscal years. Patient demographics, concomitant procedures, perioperative complications, patient-reported outcomes, and perioperative costs were collected. Results: The mean age of our cohort was 62.5 ± 9.6 years (range, 30-88 years), with a significant difference in age (64.1 vs 58.5 years) ( P = .005) and Charlson Comorbidity Index (3.3 ± 1.9 vs 2.3 ± 1.4; P = .002) for the inpatient and short-stay designation groups, respectively. At a mean follow-up of 29.6 ± 11.8 months (range, 12-52.3 months), there was no difference in complications between groups ( P = .97). The inpatient designation TAR group had a worse baseline Short Musculoskeletal Functional Assessment (SMFA) function score (76.1; 95% CI, 70.5-81.6) than the short-stay designation TAR group (63.9; 95% CI, 52.5-75.3) while achieving similar final postoperative SMFA function scores for the inpatient (55.2; 95% CI, 51.1-59.2) and short-stay (56.2; 95% CI, 48.2-64.2) designation TAR groups ( P > .05). However, the inpatient designation TAR group showed a significantly greater mean improvement in SMFA function score (20.9; 95% CI, 19.4-22.4) compared with the short-stay designation TAR group (7.7; 95% CI, 3.7-11.1) ( P = .0442). The total direct cost was significantly higher for the inpatient designation group ($15 340) than the short-stay designation group ($13 002) ( P < .001). Conclusion: While inpatient designation TARs were more comorbid, short-stay designation TARs were associated with a 15.5% reduction in perioperative costs, comparable complication rates, and similar final postoperative patient-reported outcome scores compared with inpatient TARs. Level of Evidence: Level III, retrospective comparative study.
Changes in vascular access blood flow: Etiological factors and clinical implications
Authors: Lopot František , Malík Jan , Švára František , Polakovič Vladimír 
Published: September 2020

Changes in access blood flow (QVA) are of utmost importance in vascular access (VA) management when deciding on VA referral for an intervention. The article elucidates impact of different factors on QVA changes. Methods: Records of 10,000 QVA measurement performed in 549 patients over 20 years were used as retrospective and anonymized data source, making ethical commission involvement unnecessary. Two approaches are used to elucidate association of QVA changes with different factors: analyses of smaller cohorts in which both the QVA and the respective factor were measured (e.g. association of QVA with cardiac output (CO)), or—in case of rare phenomena—a form of a well illustrated case reports was used (e.g. association of QVA and Kt/V). Results: Significant increase in CO after permanent VA creation (3-4-fold of the QVA value) was found. Impact of intradialytic CO changes on QVA is attenuated by relatively stable VA resistance compared to systemic resistance. Blood pressure impact is much stronger and it should therefore be noted at each QVA measurement. As reproducibility of different QVA measurement methods varies, use of the same method should be preferred. Direction of the arterial needle insertion in VA affects the QVA measured, especially in synthetic grafts, too. Also patient’s own QVA variability may be quite high. All this makes KDOQI/EBPG recommended acceptable QVA drops too strict, they should be revised. In re-stenoses prone patients, measurement intervals should be shortened, too. Conclusion: QVA values are significantly affected by many factors. Their knowledge appears essential for safe and effective VA surveillance and management.
Effects of Nonpharmacological Interventions in Chemotherapy-Induced Peripheral Neuropathy: An Overview of Systematic Reviews and Meta-Analyses
Authors: Hao Jie , Zhu Xiaoshu , Bensoussan Alan 
Published: September 2020

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the prevalent and disabling side effects of cancer treatment. However, management strategies for CIPN currently remain elusive, with treatment restricted to neuropathic pain medications, supportive care, and chemotherapy dosing adjustments. This overview explores evidence on the potential benefits and safety of nonpharmacological interventions in preventing and treating CIPN in cancer patients. Methods: Seven databases were searched for systematic reviews of randomized controlled trials (RCTs). The methodological quality of the selected reviews was assessed by AMSTAR 2, and the quality of evidence was judged by GRADE. Twenty-eight systematic reviews were considered eligible for this review. Results: It was found that nonpharmacological interventions (acupuncture, exercise, herbal medicine, nutritional supplements) provided potential benefits for patients with CIPN. Furthermore, Chinese herbal medicine, administered orally or externally, significantly prevented and/or relieved the incidence and severity of CIPN in comparison to control groups (no additional treatment, placebo, and conventional western medicine). However, the quality of evidence and strength of recommendations were compromised by the inconsistencies and imprecision of included studies. The main concerns regarding the quality of systematic reviews included the lack of sufficiently rigorous a priori protocols, and the lack of protocol registration adopted in the included studies. Conclusions: Though looking across reviews, Chinese herbal medicine appear generally effective in CIPN, uncertainty remains about the effects of many other nonpharmacological interventions. The evidence on what works was particularly compromised by reporting and methodological limitations, which requires further investigation to be more certain of their effects.
Endovascular Repair of a Ruptured Thoracoabdominal Aortic Aneurysm With the Sandwich Technique: A Case Report
Authors: Marchal Jérémy , Verhelst Robert , Astarci Parla , Elens Maxime 
Published: September 2020

Introduction: aortic aneurysms involving the renal and visceral arteries are endovascular challenges, especially for emergencies. We report a case of ruptured thoracoabdominal aortic aneurysm (TAAA) in a morbidly obese 71-year-old man. The patient was admitted with a stable hemodynamic state. A computed tomography angiogram (CTA) revealed a contained ruptured TAAA with an occluded celiac trunk and left renal artery due to previous nephrectomy. Due to the emergency and his comorbidities, we performed an endovascular aortic repair with the sandwich technique and 2 chimneys. Two bridging stents (chimneys) were deployed between the aorta and the target vessels (superior mesenteric and right renal arteries) in a space created in-between 2 aortic straight endografts. Ten days postoperative, acute renal failure appeared and right renal stent occlusion was diagnosed on CTA. Unfortunately, no adequate kidney revascularization could be obtained, requiring permanent hemodialysis. At a 3-month follow-up visit, the patient did well with stable aneurysm dimensions. Conclusions: encouraging outcomes of chimney-EVAR techniques, comparable to those in published reports of fenestrated-EVAR and branched-EVAR, support this procedure as a valid off-the-shelf available alternative in emergency situations. Nevertheless, only few midterm results achieved are actually available and long-term outcomes are actually unknown.
Ankle Joint Pressure in Supination–External Rotation Injuries: A Biomechanical Study in an Unrestrained Cadaver Model
Authors: Fösel Andreas C. , Seidel Angela , Attinger Marc C. , Zderic Ivan , Gueorguiev Boyko , Krause Fabian G. 
Published: September 2020

Background Previous biomechanical studies simulating supination–external rotation (SER) IV injuries revealed different alterations in contact area and peak pressure. We investigated joint reaction forces and radiographic parameters in an unrestrained, more physiological setup. Methods Twelve lower leg specimens were destabilized stepwise by osteotomy of the fibula (SER II) and transection of the superficial (SER IVa) and the deep deltoid ligament (SER IVb) according to the Lauge-Hansen classification. Sensors in the ankle joint recorded tibio-talar pressure changes with axial loading at 700 N in neutral position, 10° of dorsiflexion, and 20° of plantarflexion. Radiographs were taken for each step. Results Three of 12 specimen collapsed during SER IVb. In the neutral position, the peak pressure and contact area changed insignificantly from 2.6 ± 0.5 mPa (baseline) to 3.0 ± 1.4 mPa (SER IVb) ( P = .35) and from 810 ± 42 mm2 to 735 ± 27 mm2 ( P = .08), respectively. The corresponding medial clear space (MCS) increased significantly from 2.5 ± 0.4 mm (baseline) to 3.9 ± 1.1 mm (SER IVb) ( P = .028). The position of the ankle joint had a decisive effect on contact area ( P = .00), center of force ( P = .00) and MCS ( P = .01). Conclusion Simulated SER IVb injuries demonstrated radiological, but no biomechanical changes. This should be considered for surgical decision making based on MCS width on weightbearing radiographs. Levels of Evidence: Not applicable. Biomechanical study
Different cytokine patterns associate with melancholia severity among inpatients with major depressive disorder
Authors: Primo de Carvalho Alves Lucas , Sica da Rocha Neusa 
Published: September 2020

Background Six melancholic features (MFs) of the Hamilton Depression Rating Scale (HAM-D6) represent the construct of melancholia along a continuum of severity (from least to most severe: depressed mood, work and activities, somatic symptoms, psychic anxiety, guilty feelings, psychomotor retardation). We aimed to evaluate the association between these MFs and inflammatory cytokines (IC) in the blood. Methods Each IC [interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 2 (IL-2), IL-4, IL-6, IL-10, and IL-17] was associated with the HAM-D6 MFs of 139 severely depressed inpatients, using multiple linear regressions adjusted for covariates. Levels were compared with those of 100 healthy controls. Results Depressed mood was associated with higher levels of IL-4 ( β = 0.167; p = 0.041). Psychic anxiety: lower IL-17 levels ( β = –0.173; p = 0.039). Guilt feelings: lower IL-2 levels ( β = −0.168; p = 0.041) Psychomotor retardation: higher IL-6 levels ( β = 0.195; p = 0.017). Depressed patients’ TNF-α, INF-γ, and IL-4 levels were not significantly different from controls. Depressed patients’ IL-2, IL-6, IL-10, and IL-17 levels were higher than those of controls ( p <0.001). Conclusion Less severe MFs (depressed mood, psychic anxiety, and guilt feelings) were associated with an anti-inflammatory pattern (higher IL-4, lower IL-17 and lower IL-2, respectively). The presence of the most severe MF, psychomotor retardation, was associated with a higher pro-inflammatory response (higher IL-6).
Bisphosphonate-related atypical femoral fractures: A novel strategy to improve patient outcomes
Authors: Sahemey Rajpreet , Nikolaides AP , Bhattacharya S , Simons A , Makrides P 
Published: September 2020

Background: Atypical femoral fracture (AFF) is a serious adverse event associated with bisphosphonate therapy and prone to complications and delayed union. We propose a technique and management strategy to maximise bone healing and outcomes. Methods: We report on a cohort of patients with AFF using our novel technique of preparing the intramedullary canal and rigid fixation with cephalomedullary nailing. Patients were admitted under a multidisciplinary team with rehabilitation goals of early mobilisation and teriparatide initiation. Clinical and radiographic data were retrospectively reviewed. Results: Twenty-eight AFFs were treated with a mean follow-up of 58.5 weeks and a mean age of 75.2 years old. All cases achieved radiological union by a mean of 6 months and post-operative thigh pain experienced up to 8.7 weeks. No cases underwent revision or experienced intraoperative complication. Conclusion: Our surgical technique and multidisciplinary management are reproducible with excellent results in patients with this rare yet challenging injury.
Outcome of triamcinolone acetonide injection for lateral malleolar bursitis
Authors: Goh Tae Sik , Ahn Tae Young , Kim Kyeongbaek , Shin Won Chul , Moon Nam Hoon , Woo Seung Hun 
Published: September 2020

Purpose: This study aimed to evaluate the feasibility and effect of triamcinolone acetonide (TA) injection for lateral malleolar (LM) bursitis. Methods: We retrospectively reviewed data of 49 consecutive patients (49 ankles) who received TA injection between March 2016 and March 2019. All cases received 1 ml (40 mg) of TA injection after aspiration of fluid in the LM bursal sac. Subsequently, the ankle was compressed with an elastic cohesive bandage for 2 weeks. Treatment responses were assessed according to the degree of fluctuation, shrinkage of the bursal sac, and soft tissue swelling. We used the Medical Outcomes Study Short Form Health Survey (SF-36) and complications at 2 and 4 weeks and at 3 and 6 months after TA injection. Results: Forty-four patients (89.8%) experienced complete resolution, four (8.2%) had partial resolution, and one (2.0%) had no resolution after the first or second TA injection. The physical component scores of SF-36 improved from 72.8 ± 6.0 to 82.3 ± 6.5 at the last follow-up ( p < 0.001). Associated complications included skin atrophy in three patients (6.1%) and transient hyperglycemia in four (8.2%). Conclusion: TA injection is an effective and safe procedure for LM bursitis. It should be considered as a primary treatment method.
Biomechanical Comparison of Augmentation of Engineered Tendon-Fibrocartilage-Bone Composite With Acellular Dermal Graft Using Double Rip-Stop Technique for Canine Rotator Cuff Repair
Authors: Wang Zhanwen , Long Zeling , Amadio Peter C. , Gingery Anne , Moran Steven L. , Steinmann Scott P. , Zhao Chunfeng 
Published: September 2020

Background: The retear rate after rotator cuff repair remains unacceptably high. Various biological engineered scaffolds have been proposed to reduce the retear rate. We have developed a double rip-stop repair with medial row knot (DRSK) technique to enhance suture-tendon strength and a novel engineered tendon-fibrocartilage-bone composite (TFBC) for rotator cuff repair. Hypothesis: DRSK rotator cuff repair augmented with TFBC will have better biomechanical properties than that of DRSK repair with an acellular dermal graft (DG). Study Design: Controlled laboratory study. Methods: Fresh-frozen canine shoulders (n = 30) and knees (n = 10) were used. TFBCs were harvested from the patellar tendon–tibia complex and prepared for rotator cuff repair. The infraspinatus tendon was sharply detached from its bony attachment and randomly assigned to the (1) control group: DRSK repair alone, (2) TFBC group: DRSK repair with TFBC, and (3) DG group: DRSK repair with DG. All specimens were tested to failure, and videos were recorded. The footprint area, tendon thickness, load to create 3-mm gap formation, failure load, failure modes, and stiffness were recorded and compared. Data were recorded as mean ± SD. Results: The mean load to create a 3-mm gap in both the control group (206.8 ± 55.7 N) and TFBC group (208.9 ± 39.1 N) was significantly higher than that in the DG group (157.7 ± 52.3 N) ( P < .05 for all). The failure load of the control group (275.7 ± 75.0 N) and TFBC group (275.2 ± 52.5 N) was significantly higher compared with the DG group (201.5 ± 49.7 N) ( P < .05 for both comparisons). The stiffness of the control group (26.4 ± 4.7 N/mm) was significantly higher than of the TFBC group (20.4 ± 4.4 N/mm) and the DG group (21.1 ± 4.8 N/mm) ( P < .05 for both comparisons). Conclusion: TFBC augmentation showed superior biomechanical performance to DG augmentation in rotator cuff tears repaired using the DRSK technique, while there was no difference between the TFBC and control groups. Clinical Relevance: TFBC may help to reduce retear or gap formation after rotator cuff repair using the DRSK technique.