bluuebunny/crossref_metadata_2025_split huggingface dataset:
The information and support needs of patients living with inflammatory bowel disease: A qualitative study
Authors: Karadag Paige , Morris Beth , Woolfall Kerry 
Published: October 2020

Objectives To explore patients’ experiences of living with inflammatory bowel disease (IBD) with a focus on their information and support needs. Methods Qualitative interview study involving adults diagnosed with IBD recruited through social media. Interviews were audio recorded, transcribed and data were analysed thematically. Results Interviews with 15 patients (9 females, 6 males) highlighted how misdiagnosis or hesitation to diagnose had caused frustration and anxiety. Once diagnosed, only a few participants received detailed information about IBD from their doctor. Negative experiences shared on social media caused initial anxiety, as individuals assumed that they may have a similar experience, yet online communities enabled insights into the experiences of others, helping patients adjust to living with IBD. Participants described both positive and negative impacts of living with IBD, including improved confidence and periods of anxiety. Discussion: Our findings highlight the importance of clear information and support from health professionals, as well as the benefits of online communities for ongoing support. At the point of diagnosis, patients would benefit from information about what IBD is, as well as how it may impact day to day life from doctors so that social media is not the only source of initial information about IBD.
Nivolumab treatment in advanced non-small cell lung cancer: real-world long-term outcomes within overall and special populations (the UNIVOC study)
Authors: Assié Jean-Baptiste , Corre Romain , Levra Matteo Giaj , Calvet Christophe Yannick , Gaudin Anne-Françoise , Grumberg Valentine , Jouaneton Baptiste , Cotté François-Emery , Chouaïd Christos 
Published: October 2020

Objective: To describe long-term outcomes of patients treated with nivolumab for advanced non-small cell lung cancer (aNSCLC) in everyday clinical practice in France, with a focus on patients aged ⩾80 years, patients with renal impairment and patients with brain metastases. Methods: The study included all patients with aNSCLC recorded in the French national hospital database, starting nivolumab in 2015–2016 and followed until December 2018. Patients were stratified by age, the presence of renal impairment and brain metastasis, as documented in the hospital discharge summaries. Information was retrieved on demographics, comorbidities and treatment history at baseline. Time to discontinuation of nivolumab treatment and overall survival were estimated using Kaplan–Meier survival analysis. Results: Overall, 10,452 patients were included, of whom 514 were octogenarians, 479 had renal impairment and 1800 had brain metastases at baseline. Median duration of nivolumab treatment was 2.8 months in the overall population and in both the octogenarian and renally impaired subgroups, and 2.3 months in patients with brain metastases. Median overall survival in these patient groups was 11.7 months (95% confidence interval: 11.3–12.2), 11.7 months (11.3–12.1), 11.7 months (11.3–12.2) and 9.9 months (9.0–10.9) respectively. Three-year overall survival rates were 19.1% (18.1–20.2) in the overall population, 16.5% (11.6–23.4) in octogenarians, 15.9% (11.8–21.4) in patients with renal impairment and 21.7% (19.4–24.2) in those with brain metastases. Conclusion: This large nationwide retrospective real-life cohort provided narrow estimates of long-term overall survival, which reached 19% at 3 years, consistent with data from phase III trials of nivolumab. Survival rates were comparable in the three special populations of interest and the overall population.
Level of Digitalization in Germany: Results of the Diabetes Digitalization and Technology (D.U.T) Report 2020
Authors: Roos Timm , Hochstadt Sabine , Keuthage Winfried , Kröger Jens , Lueg Andreas , Mühlen Hansjörg , Schütte Lisa , Scheper Nikolaus , Ehrmann Dominic , Hermanns Norbert , Heinemann Lutz , Kulzer Bernhard 
Published: October 2020

Background: New diagnostic and therapeutic technologies are increasingly changing the treatment of people with diabetes (PWD), along with increased usage of digital tools. To date, however, there is little data to which level and how diabetologists and PWD implement digitalization. Also, not much is known about the view of diabetologists on the current status and future developments in this respect. Method: In an online survey, diabetologists working in clinics and practices across Germany provided responses regarding their view on digitalization and the adoption of new technologies in diabetology to 56 questions. These comments reflect the opinion of several experts about the current importance and use of specific digital/technological topics. Results: Overall, 326 diabetologists took part in the survey. They reported a positive attitude (75.8%) toward new technologies and digitalization, and they see more advantages rather than disadvantages. Younger age of the diabetologists was significantly associated with a more positive attitude ( r = −0.176; P < .01), and there was no gender effect ( P = .738). On average, in each practice, 5.5% of PWD are using an insulin pump for therapy, 4.8% a real-time continuous glucose monitoring system, 16.9% an intermittent scanning continuous glucose monitoring system, and 0.3% an automated insulin delivery (AID) system. With respect to digitalization, the three most important current topics are software for glucose data analysis (average rank on a scale from one to six, with one being the most important: 2.4), compatibility with other systems (2.9), and AID systems (3.8)). Conclusions: This survey, which is going to be repeated annually, showed that the diabetologists who participated predominantly have a positive attitude toward new technologies and digital applications and were aware of the associated advantages. However, perceived disadvantages need to be addressed to enable wider adoption of new technologies and digital solutions.
“It Got Likes, But I Don’t Think People Understood”: A Qualitative Study of Adolescent Experiences Discussing Type 1 Diabetes on Social Media
Authors: Chalmers Kristen , Smith Mia , Moreno Megan , Malik Faisal 
Published: October 2020

Background: The majority of adolescents with type 1 diabetes (T1D) integrate social media engagement into their daily lives. The aim of this study was to explore adolescents’ experiences and perspectives discussing their T1D on social media. Methods: Semi-structured interviews with adolescents with T1D were conducted in person and via telephone. Questions focused on the participant’s experiences utilizing social media to discuss T1D and factors that informed the nature of T1D-related social media engagement. Open coding and thematic content analysis were used to identify emergent themes that aligned with accepted domains of social media affordances. Results: Participants included 35 adolescents with T1D. Adolescents’ experiences related to discussing T1D on social media aligned with four affordances of social media: identity, cognitive, emotional, and social. The identity affordances of social media platforms allowed adolescents to curate online personas that selectively included their diagnosis of T1D, while managing the potential negative emotional and social implications linked to the stigma of T1D. Adolescents who decided to discuss T1D on social media leveraged cognitive affordances by providing and receiving diabetes management advice, emotional affordances by obtaining affirmation from peers, and social affordances by extending their network to include other individuals with T1D. Conclusions: Adolescents with T1D flexibly leverage the affordances offered by social media to access emotional support, information, and identity affirmation resources while navigating stigma-based social consequences. Our findings highlight the value of developing tools to support adolescents with T1D in comfortably discussing and receiving appropriate support about T1D on social media.
Successful Treatment of Femoral Chondral Lesions with a Novel Customized Metal Implant at Midterm Follow-Up
Authors: Martinez-Carranza Nicolas , Rockborn Peter , Roberts David , Högström Magnus , Stålman Anders 
Published: October 2020

Background Full-depth cartilage lesions do not heal spontaneously and may progress to osteoarthritis (OA). Treatment for these lesions is warranted when symptomatic. At younger age, biological treatment remains the gold standard, but treatment in the middle-aged patient remains a clinical challenge and focal metal implants have been proposed. We aim to present the subjective outcome at 2 years and the risk of reoperation for any reason at midterm after surgery with a novel customized implant for focal femoral chondral lesions in the knee. Methods In a prospective cohort study, 30 patients were included between January 2013 and December 2017 at 9 different clinics in Sweden. The primary outcome was subjective outcome measurements (Visual Analogue Scale [VAS], EuroQoL [EQ5D], Knee injury and Osteoarthritis Outcome Score [KOOS]) at a minimum of 2 years. The secondary outcome was reoperations for any reason during the follow-up period until December 2019 (mean of 55 months) studied retrospectively by analyzing medical records. Results The VAS, EQ5D, and all the KOOS subscales showed significant improvements from preoperatively to the 2-year follow-up. The VAS showed the greatest improvement at the early (3 months) postoperative stage ( P < 0.001). Five (7%) patients underwent reoperations and one of these was revised to hemiarthroplasty due to OA progression. No implant loosening was detected in any of the cases. Conclusions This customized resurfacing metal implant showed good safety and patient satisfaction. The risk of OA progression and implant loosening is low. Subjective function and pain improved significantly.
Achieving Lean Warehousing Through Value Stream Mapping
Authors: Abhishek P.G.  , Pratap Maheshwar 
Published: October 2020

This article applies value stream mapping (VSM) in a distribution warehouse after identifying and categorizing different warehousing wastes. The study suggests solutions for the reduction of each type of waste and employs lead time as the metric to understand the overall effectiveness of the suggested remedies. The distribution warehouse faced severe stock-out situations and high lead time for all deliveries. Current state and future state maps were utilized for mapping the current and revamped system, respectively. While existing studies on lean warehousing have utilized VSM to study a specific type of waste, this study extends it to include all types of warehousing waste, classifies them into seven types and provides a real case study along with evidence for improvement schemes for each category. This research, employing a case study, suggests an integrated lean warehousing method for design and operation of distribution warehouses. Dilemma/research question/purpose: Can the warehouse avoid stock-outs and decrease the lead time by identifying and reducing or eliminating the seven types of wastes in the warehouse operations? Theory: Lean management principle applied to a warehouse using value stream mapping to eliminate wastes. Type of the case: A problem-solving using lean tools carried out in a warehouse. Protagonist: Not needed. Options: Allow the current state to continue causing stock-outs and high lead times, or identify and reduce the wastes in the warehouse operations and avoid stock-outs, decrease lead times, and improve the overall efficiency of the warehouse. Discussions and case questions: Is it possible for the firm to go one step further than what the future state map has shown in the study? What other lean tools do you see fit to reduce or eliminate the types of waste outlined in this article?
The Role of Senior Resident Clinics in Plastic Surgery Education in Canada
Authors: McGuire Connor , Crawley Emma , Tang David 
Published: October 2020

Background: Senior resident clinics are a means to encourage independent practice and problem solving and enhance surgical skills. The objective of this study is to investigate senior resident clinics across Canada and their utility in providing comprehensive plastic surgery training. Methods: A web-based survey was sent to all plastic surgery program directors (PDs) and senior residents (SRs; postgraduate years 3, 4, and 5) across Canada. The surveys focused on demographics, clinic structure, procedures commonly performed, perceived autonomy, educational benefit, competency-based design considerations, and areas for improvement. Chi-square tests were used to compare responses between PDs and SRs. Results: A total of 10 PDs (100% response rate) and 26 SRs (41% response rate) responded. Half of the training programs across Canada currently have senior clinics, and the format varies between institutions. Clinics generally focus on hand trauma and aesthetics. Both PDs and SRs felt that there is considerable autonomy for resident care in both the pre/post-operative and operative setting. Common barriers to implementing a senior clinic include not enough staff, not enough time, and the medicolegal risk. Most core competencies are felt to be addressed through the use of senior clinics. Methods to improve senior clinics could include more regular and higher volume clinics, enhanced equipment, and separation of hand and aesthetics clinics. Conclusions: Senior clinics are a useful method to improve plastic surgery education and address many core aspects of plastic surgery training. Implementation of supported clinics focused on hand and aesthetics surgery separately may be useful for training programs that currently lack a senior clinic.
Prevalence of Female Athlete Triad Risk Factors and Iron Supplementation Among High School Distance Runners: Results From a Triad Risk Screening Tool
Authors: Skorseth Paige , Segovia Nicole , Hastings Katherine , Kraus Emily 
Published: October 2020

Background: Investigations of the female athlete triad (Triad) in high school athletes have found that 36% had low energy availability, 54% had menstrual abnormalities, and 16% had low bone mineral density (BMD). Limited data are available showing the prevalence of these risk factors in high school distance runners or regarding best practice on screening for the Triad in the adolescent population. Purpose: To (1) evaluate the prevalence of Triad risk factors and iron supplementation in high school distance runners and (2) pilot a screening tool for Triad risk score. Study Design: Descriptive epidemiology study. Methods: The study population included female high school athletes who participated in cross-country/track. Participants completed a survey including questions regarding dietary habits, menstrual history, and bone stress injury (BSI) history. They then underwent evaluation of 25-hydroxyvitamin D, free triiodothyronine (T3), and dual-energy x-ray absorptiometry scan to measure body fat and BMD through use of age-, sex-, and ethnicity-matched Z scores. Triad scores were calculated. Relationships were analyzed using Spearman correlation coefficient. Results: There were 38 study participants (mean age, 16.9 years). Average body mass index was 19.8 kg/m2. Disordered eating or eating disorders were reported in 76.3% of runners; in addition, 23.7% reported delayed menarche, 45.9% had a history of amenorrhea or oligomenorrhea, 42.1% had low BMD ( Z score < –1.0), and 15.8% reported prior BSI. Low free T3 was significantly associated with higher Triad risk scores ( r S = –0.36; P = .028). More than 42% of athletes were supplementing iron. Conclusion: The prevalence of Triad risk factors in high school distance runners was high. Free T3 was inversely associated with Triad score, which may serve as an indicator of low energy availability. Nearly half of the athletes were using iron supplementation.
Strength of ties and pioneering orientation: The moderating role of scanning capabilities
Authors: Ruiz-Ortega María José , Molina-Morales F Xavier , Parra-Requena Gloria , García-Villaverde Pedro M 
Published: October 2020

The purpose of this article is to study the curvilinear effect on pioneering orientation of one of its key relational backgrounds: strength of ties. The study is based on a sample of 224 companies in the footwear industry in Spain. A hierarchical regression analysis was performed. The results show a curvilinear U-shaped relationship between the strength of ties and pioneering orientation. This curvilinear relationship is increasingly pronounced as scanning capabilities grow. Managers wishing to develop a pioneering orientation should avoid excessive levels of strength in their ties and unduly low levels. Furthermore, firms might benefit from developing scanning capability. JEL CLASSIFICATION: M100; o320
The Importance of the Cognitive Aspects of Vocational Rehabilitation for Individuals With Multiple Sclerosis
Authors: Kennedy Winston , Fruin Robert 
Published: October 2020

Background: Individuals with multiple sclerosis (MS) face symptoms that affect them physically and cognitively; 80% of individuals diagnosed with MS are out of work within 10 years, and 58% are unemployed. It appears that a diagnosis of MS creates a barrier to individuals obtaining and maintaining work. To combat this, vocational rehabilitation (VR) has been utilized by individuals with MS but with limited success. This may be due to the lack of interventions that address cognitive symptoms that occur. Purpose: The purpose of this perspective is to review the interaction between individuals with MS and the components of VR and discuss implications that could potentially increase the success of individuals with MS obtaining work. Implications: Approximately 48.1% of clients with MS receiving services from state VR agencies obtain or retain employment compared to 60% of clients with other diagnoses. This disparity highlights a disconnect in VR services. It has been seen that individuals with MS who were employed at application were more likely to receive services that include cognitive retraining-type services. Including more opportunities for cognitive retraining-type services may decrease this disparity and help more individuals with MS maintain or obtain work.
Multimodal Imaging in Ocular Siderosis
Authors: Bui Anh D. , Diep Anna L. , Lin Qiyin , Minckler Donald S. , Browne Andrew W. , Wang Angeline L. 
Published: October 2020

Purpose: This report aims to characterize ocular changes in a case of ocular siderosis with iron toxicity using multimodal imaging and electroretinography. Methods: A 34-year-old woman presented with ocular siderosis of the left eye following penetrating injury with an iron-containing foreign body. The patient’s uncorrected visual acuities were 20/60 and 20/150 in the right and left eye, respectively, with abnormal pupillary function and presence of a cataract in the left eye. She underwent successful intraocular foreign body removal and cataract surgery with no postoperative complications. Cone contrast threshold (CCT), full-field electroretinogram, spectral-domain optical coherence tomography (OCT), and OCT angiography (OCTA) were used to characterize ocular alterations preoperatively and postoperatively. Results: CCT color vision testing showed abnormal color vision, and OCTA revealed increased vascular flow density associated with the foreign body. Conclusions: CCT color vision testing, OCTA, OCT, and full-field electroretinogram can characterize retinal changes in cases of ocular siderosis.
Design of Self-Reconfigurable Multiarm Robot Mechanism Based on Deployable Kinematic Chains
Authors: Zhao Fu-Qun , Guo Sheng , Su Hai-Jun , Qu Hai-Bo , Chen Ya-Qiong 
Published: October 2020

AbstractAs the structures of multiarm robots are serially arranged, the packaging and transportation of these robots are often inconvenient. The ability of these robots to operate objects must also be improved. Addressing this issue, this paper presents a type of multiarm robot that can be adequately folded into a designed area. The robot can achieve different operation modes by combining different arms and objects. First, deployable kinematic chains (DKCs) are designed, which can be folded into a designated area and be used as an arm structure in the multiarm robot mechanism. The strategy of a platform for storing DKCs is proposed. Based on the restrictions in the storage area and the characteristics of parallel mechanisms, a class of DKCs, called base assembly library, is obtained. Subsequently, an assembly method for the synthesis of the multiarm robot mechanism is proposed, which can be formed by the connection of a multiarm robot mechanism with an operation object based on a parallel mechanism structure. The formed parallel mechanism can achieve a reconfigurable characteristic when different DKCs connect to the operation object. Using this method, two types of multiarm robot mechanisms with four DKCs that can switch operation modes to perform different tasks through autonomous combination and release operation is proposed. The obtained mechanisms have observable advantages when compared with the traditional mechanisms, including optimizing the occupied volume during transportation and using parallel mechanism theory to analyze the switching of operation modes.
Obstacle Avoidance and Multitarget Tracking of a Super Redundant Modular Manipulator Based on Bezier Curve and Particle Swarm Optimization
Authors: Chen Li , Ma Ying , Zhang Yu , Liu Jinguo 
Published: October 2020

Abstract
A super redundant serpentine manipulator has slender structure and multiple degrees of freedom. It can travel through narrow spaces and move in complex spaces. This manipulator is composed of many modules that can form different lengths of robot arms for different application sites. The increase in degrees of freedom causes the inverse kinematics of redundant manipulator to be typical and immensely increases the calculation load in the joint space. This paper presents an integrated optimization method to solve the path planning for obstacle avoidance and discrete trajectory tracking of a super redundant manipulator. In this integrated optimization, path planning is established on a Bezier curve, and particle swarm optimization is adopted to adjust the control points of the Bezier curve with the kinematic constraints of manipulator. A feasible obstacle avoidance path is obtained along with a discrete trajectory tracking by using a follow-the-leader strategy. The relative distance between each two discrete path points is limited to reduce the fitting error of the connecting rigid links to the smooth curve. Simulation results show that this integrated optimization method can rapidly search for the appropriate trajectory to guide the manipulator in obtaining the target while achieving obstacle avoidance and meeting joint constraints. The proposed algorithm is suitable for 3D space obstacle avoidance and multitarget path tracking.