bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal Navigation for Cervical Pedicle Screws: Surgical Pearls and Pitfalls
Authors: Gan Gerrard , Kaliya-Perumal Arun-Kumar , Yu Chun Sing , Nolan Colum Patrick , Oh Jacob Yoong-Leong 
Published: January 2020

Study Design: Retrospective cohort study. Objective: We intend to evaluate the accuracy and safety of cervical pedicle screw (CPS) insertion under O-arm-based 3-dimensional (3D) navigation guidance. Methods: This is a retrospective study of patients who underwent CPS insertion under intraoperative O-arm-based 3D navigation during the years 2009 to 2018. The radiological accuracy of CPS placement was evaluated using their intraoperative scans. Results: A total of 297 CPSs were inserted under navigation. According to Gertzbein classification, 229 screws (77.1%) were placed without any pedicle breach (grade 0). Of the screws that did breach the pedicle, 51 screws (17.2%) had a minor breach of less than 2 mm (grade 1), 13 screws (4.4%) had a breach of between 2 and 4 mm (grade 2), and 4 screws (1.3%) had a complete breach of 4 mm or more (grade 3). Six screws were revised intraoperatively. There was no incidence of neurovascular injury in this series of patients. 59 of the 68 breaches (86.8%) were found to perforate laterally, and the remaining 9 (13.2%) medially. It was noted that the C5 cervical level had the highest breach rate of 33.3%. Conclusions: O-arm-based 3D navigation can improve the accuracy and safety of CPS insertion. The overall breach rate in this study was 22.9%. Despite these breaches, there was no incidence of neurovascular injury or need for revision surgery for screw malposition.
Founder Leaders and Organization Culture: A Comparative Study on Indian and American Founder Leaders Based on Schein’s Model of Organizational Culture
Authors: Mamatha S.V.  , Geetanjali P.  
Published: January 2020

Organizational culture is created gradually by founder leaders on the basis of their values, assumptions and beliefs. Organizational culture is tangible in terms of the architecture of the company, office layout and exhibits and intangible in terms of behaviour of employees, decisions, policies and procedures. This article aims to perform a comparative analysis of some of the founder leaders of Indian and American businesses and their influence on the culture of the organization. The study adopts the case method research design where the focus is on the specific interesting cases, articles and interviews of the founder(s) in their formational years and cases when the company had a stable organizational culture. The unit of analysis is the founder leader. The company’s culture is evaluated using Schein’s Model of Organizational Culture while that of the founder leader is evaluated using Hofstede’s model of cultural dimensions. This study does not equate national culture to individual’s culture to avoid ecological fallacy of interpreting country-level relationships being applied to individuals. The study shows that there exist layers of subcultures in each individual. The article discusses an interesting paradigm, that is, the culture in which they are born/trained and the culture they adopt intentionally. When founders adopt other cultures, some traces of adopted cultures are reflected in the organization. The article concludes that founder leaders’ culture needs a better framework in order to see its effects on the organization. Hofstede’s model does not show the relationship between different layers of the culture. Hence, the model seems inadequate to be applied to analyse founder leaders.
Relation between grip and pinch strength and pitch type in high school pitchers with and without elbow symptoms
Authors: Tajika Tsuyoshi , Oya Noboru , Ichinose Tsuyoshi , Shimoyama Daisuke , Sasaki Tsuyoshi , Hamano Takanori , Shitara Hitoshi , Yamamoto Atsushi , Sakamoto Masaaki , Takagishi Kenji , Chikuda Hirotaka 
Published: January 2020

Objective: Gripping and pinching a ball is a fundamentally important part of the kinetic chain for throwing baseball pitches of various types. This study of high school pitchers was conducted to assess the association between grip and pinch strength, the pitch type, and the history of elbow symptoms. Methods: We examined 133 high school baseball pitchers, all of whom had completed a self-administered questionnaire including items related to pitch type throwing ratios, the age at starting each pitch type, and throwing-related elbow joint pain sustained during the prior 3 years. We measured grip strength and the bilateral side tip, key, and palmar pinch strengths. Comparisons were made between the participants with and without an elbow symptom history to assess the grip and each pinch strength, throwing ratio of pitch type, and the age at starting to throw each pitch type. Results: Pitchers with an elbow symptom history exhibited less difference between the grip strength on the throwing side than those with no elbow symptom history ( p = 0.04). No difference was found between participants with and without an elbow symptom history in terms of pinch strength, the throwing ratios of pitch types, or the age at starting to throw pitches of each type. Positive significant association was found between pinch strength on the pitching side and the forkball and screwball throwing ratio ( r = 0.27, p = 0.002). Conclusion: Grip strength might influence high school baseball pitcher elbow conditions. The frequency of certain pitch types might develop pinch strength in high school baseball pitchers.
Justice Education: A Desired Destination of The Menon Model
Authors: Poddar Debasis 
Published: January 2020

Since inception of the new-generation experiment in legal education with the National Law School of India University Bangalore (NLSIU), contemporary history of professional education rolls on toward excellence and the ordeal is on with the proliferation of similar institutional entrepreneurship. In the anxiety of competitive edge, few—too few—follow legacy of a model school in Bangalore; invented by N.R. Madhava Menon: the legacy vis-a-vis experiments with discipline, leadership, pedagogy, and the like. Minute prospect and consequence of (t)his model apart, Menon redefined the philosophy of professional education at NLSIU. What went spread over far and wide as trendsetter for the contemporary legal education is the letters of institutionalism, more so for ‘National’. Spirit of the NLSIU legacy but lies elsewhere. A practising lawyer-turned-educator, Madhava Menon has introduced a model to prepare well-baked product for the bench and the bar alike. At the same time, however, he brought in sense of social responsibility otherwise getting dwindled in the contemporary professional lifeworld. Not without reason that there is emphasis upon clinical legal education and legal aid clinic alike. In its essence, the author advances arguendo with the reasoning of his own, that pedagogy thereby initiated has had a teleological end to offer legal education en route to justice education; thereby spearhead progressive social transformation. The Menon Model is meant to raise human resource for professional service to the court and the people; instead of tertiary service to the market. After his model, the market ought to approach qualified professionals; not vice versa. The sooner such internal legacy of the (Menon) model earns appreciation is the better for prospect of professional education.
Treatment of Acute Proximal Anterior Cruciate Ligament Tears—Part 2: The Role of Internal Bracing on Gap Formation and Stabilization of Repair Techniques
Authors: Bachmaier Samuel , DiFelice Gregory S. , Sonnery-Cottet Bertrand , Douoguih Wiemi A. , Smith Patrick A. , Pace Lee J. , Ritter Daniel , Wijdicks Coen A. 
Published: January 2020

Background: The latest biomechanical studies on some form of internal bracing have shown improved stabilization for anterior cruciate ligament (ACL) repair, but gap formation and load-sharing function have not yet been reported. Hypothesis: Internal bracing of an adjustable ACL repair construct provides improved stabilization with reduced gap formation and higher residual loading on the ACL. Study Design: Controlled laboratory study. Methods: Internally braced ACL repair constructs with single– and double–cinch loop (CL) cortical buttons, a knotless suture anchor, and a single-CL cortical button with adjustable loop fixation (CLS-ALD) were tested (n = 20 each) in a porcine model at 4 different loads (n = 5 each) over 4000 cycles at 0.75 Hz (n = 80 total). The CLS-ALD technique allowed for additional preconditioning (10 cycles at 0.5 Hz). Test results of the isolated internal brace groups served as a baseline for comparison. Lastly, specimens were pulled to failure (50 mm/min) with a cut internal brace. Final loading and gap formation on the ACL repair construct as well as ultimate strength were analyzed. Results: A statistical significance for peak loads over peak elongation was found between the CLS-ALD and all other reinforced groups (analysis of covariance, P < .001). Accordingly, the adjustable repair technique showed improved load-bearing capability with the internal brace compared with all other fixed repair groups and revealed significantly higher loads than the knotted single-CL group. Also, significantly reduced gap formation was found for the CLS-ALD compared with all other groups ( P < .001), with no gap formation up to 150 N with a final gap of 0.85 ± 0.31 mm at 350 N. A significantly higher ultimate failure load (866.2 ± 104.0 N; P < .001) was found for the button-fixed internal brace group compared with all other groups. Conclusion: Internal bracing had a crucial role in improving the stabilization potential of ACL repair at loads occurring during normal daily activity. The added strength of the internal brace allowed for reducing peak loads on the ACL repair construct as well as restricting gap formation to below 3 mm at loads up to 350 N. Clinical Relevance: Improvements in the mechanical characteristics of current ACL repair techniques that enable reduced gap formation and allow for early range of motion and accelerated rehabilitation may strengthen the self-healing response with the formation of stable scar tissue.
Characteristics of Diabetes Self-Care Agency in Japan Based on Statistical Cluster Analysis
Authors: Umeda Eiko , Shimizu Yasuko , Uchiumi Kyoko , Murakado Naoko , Kuroda Kumiko , Masaki Harue , Seto Natsuko , Ishii Hidetoki 
Published: January 2020

Introduction Considering the situation where the number of people with diabetes is increasing, we need to find ways to support more efficient and effective outpatient clinics. Therefore, it is necessary to develop effective support methods and to elaborate a strategy as a system for support after grasping the characteristics of the entire population of people with diabetes. Objective The purpose of this study was to identify the characteristics of the diabetes population in outpatient settings by differences in self-care agency and to examine how to support them based on the recognized characteristics. Methods Participants were 261 people with diabetes under outpatient care in Japanese institutions from whom demographic data on age, gender, HbA1c, and treatment method were collected as well as self-care agency data based on the Instrument of Diabetes Self-Care Agency consisting of 40 items. The data were analyzed using cluster analysis to compare age, gender, HbA1c, duration of diabetes, type of diabetes, and insulin therapy between clusters. Results The analysis identified six clusters, including a group with favorable HbA1c but low total self-care agency scores that were likely to affect their blood glucose control in the future, although accounting for as small a portion as 3% of the total. In addition, a cluster with poor HbA1c and generally low self-care agency was also identified accounting for about a quarter of the total population. These clusters were considered to require further support. Clusters having markedly low self-care agency items, stress-coping ability, or the ability to make the most of the support available were also identified. Conclusion The six clusters need to be assisted in focusing on mental or social support. Accordingly, consideration of the support system for people with diabetes based on an understanding of the cluster characteristics seemed to enable more efficient and effective support.
Improving economic evaluations in stroke: A report from the ESO Health Economics Working Group
Authors: Cadilhac Dominique A , Kim Joosup , Wilson Alastair , Berge Eivind , Patel Anita , Ali Myzoon , Saver Jeffrey , Christensen Hanne , Cuche Matthieu , Crews Sean , Wu Olivia , Provoyeur Marine , McMeekin Peter , Durand-Zaleski Isabelle , Ford Gary A , Muhlemann Natalia , Bath Philip M , Abdul-Rahim Azmil H , Sunnerhagen Katharina , Meretoja Atte , Thijs Vincent , Weimar Christian , Massaro Ayrton , Ranta Annemarei , Lees Kennedy R ,   on behalf of the ESO Health Economics Working group
Published: January 2020

Introduction Approaches to economic evaluations of stroke therapies are varied and inconsistently described. An objective of the European Stroke Organisation (ESO) Health Economics Working Group is to standardise and improve the economic evaluations of interventions for stroke. Methods The ESO Health Economics Working Group and additional experts were contacted to develop a protocol and a guidance document for data collection for economic evaluations of stroke therapies. A modified Delphi approach, including a survey and consensus processes, was used to agree on content. We also asked the participants about resources that could be shared to improve economic evaluations of interventions for stroke. Results Of 28 experts invited, 16 (57%) completed the initial survey, with representation from universities, government, and industry. More than half of the survey respondents endorsed 13 specific items to include in a standard resource use questionnaire. Preferred functional/quality of life outcome measures to use for economic evaluations were the modified Rankin Scale (14 respondents, 88%) and the EQ-5D instrument (11 respondents, 69%). Of the 12 respondents who had access to data used in economic evaluations, 10 (83%) indicated a willingness to share data. A protocol template and a guidance document for data collection were developed and are presented in this article. Conclusion The protocol template and guidance document for data collection will support a more standardised and transparent approach for economic evaluations of stroke care.
The influence of airborne N,N-dimethylformamide on liver toxicity measured in industry workers: A systematic review and meta-analysis
Authors: Antoniou Evangelia E , Gelbke Heinz-Peter , Ballach Jochen , Zeegers Maurice P 
Published: January 2020

Background: Modern industry is developing and so is the consumption of N, N-dimethylformamide (DMF) and the occupational population exposed to DMF. However, chronic occupational and experimental exposure to DMF has been especially linked to liver and gastrointestinal disturbances. Aims: This study aims to systematically review and evaluate with a meta-analysis the influence of DMF exposure on human liver toxicity. Methods: The PubMed/Medline, the ECHA restriction dossier and the Web of Science were searched. Midpoint DMF exposure levels were calculated, and the association between DMF exposure and liver toxicity was investigated. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: Of 92 screened articles, 19 articles were included in the review and of them, 10 articles were included in the meta-analysis. No association was observed when the midpoint DMF exposure was less than 20 mg/m3 (OR: 1.58, 95% CIs: 0.68–3.65). A positive association between DMF exposure and liver toxicity was observed when the midpoint DMF exposure was between 21 mg/m3 and 25 mg/m3 (OR: 3.26, 95% CIs: 1.38–7.73). Conclusions: Higher exposure DMF levels are associated with liver toxicity. However, these results tend to overestimate potential risks because the use of midpoint exposures includes and gives weight to populations at the upper end of the exposure distributions and because liver toxicity was defined as a statistical significant difference in liver enzyme levels compared to control groups, which is not identical to biologically relevant effects and adverse health effects.
Flexural behavior of bamboo–concrete composite beams with perforated steel plate connections
Authors: Wang Zhiyuan , Wei Yang , Li Ning , Zhao Kang , Ding Mingmin 
Published: January 2020

AbstractA new type of bamboo–concrete composite structure using perforated steel plates as connectors was proposed. To study the composite effect of this new type of composite structure, the slip behavior of bamboo–concrete shear connectors was first studied through push-out tests. Subsequently, four-point bending tests of ten bamboo–concrete composite beams were carried out. The results show that the failure of bamboo–concrete shear connectors occurred between the perforated steel plate and the concrete, and there was no obvious damage between the perforated steel plate and the bamboo. The load carrying capacity of perforated steel plate connectors was relatively stable. The failure mode was moderate failure. Considering the three stages of the load–slip curve, an exponential function is proposed to describe the load–slip curve. The failure modes of composite beams can be summarized as two types. In the first type, the bamboo beam ruptures on the bottom and the concrete dose not suffer significant damage; in the second type, the top surface of the concrete first exhibits longitudinal cracks, and finally, the bamboo beam ruptures. Compared with bamboo beams, the ultimate load of composite beams increased by 1.2–1.5 times, and the sectional stiffness of composite beams increased by 2.9–4.2 times. The equivalent section stiffness was obtained after determining the connection coefficient, and the connection coefficient γb ranged between 0.50 and 0.80 and decreased as the center spacing of the perforated steel plate increased. The equivalent cross-section stiffness obtained by different load stages of the shear slip stiffness was calculated to predict the mid-span displacement. The calculation results show that the effect of slip stiffness on the equivalent stiffness of cross section is not sensitive, and a 35% increase in slip stiffness results in a maximum increase in equivalent section stiffness of only 6%.
Measuring the placebo effect in carpal tunnel syndrome
Authors: Faig-Martí Jordi , Martínez-Catassús Adriana 
Published: January 2020

Abstract
Background
The placebo effect can account for part of the improvement seen in patients undergoing any type of treatment, be it surgical or pharmacological. The objective of this study is to quantify the placebo effect in carpal tunnel syndrome treatment.

Materials and methods
A double-blinded randomized trial was performed with 68 patients suffering from mild to moderate carpal tunnel syndrome, divided into two groups with no statistically significant differences regarding age, weight, or degree of nerve compression. The patients were evaluated clinically and electromyographically before and after 2 months of treatment with either palmitoylethanolamide (PEA) or placebo.

Results
The results, comparing the two groups, showed an improvement in both groups on a visual analogue scale (VAS) and Levine’s questionnaire, which have been reported to show statistical differences in only a few items. In the placebo group, the mean age was 53.32 years (±13.43) and the BMI was 28.85 kg/m2 (±4.84). Before treatment, the average symptom severity score (SSS) on the Levine questionnaire was 2.57 (±0.74) and the functional status score (FSS) was 2.24 (±0.66). After treatment, these decreased to 2.11 (±0.81) and 1.96 (±0.77), being statistically nonsignificant for SSS (p = 0.0865) but significant for FSS (p = 0.0028). VAS showed a statistically nonsignificant decrease from 4.06 to 3.25 (p = 0.3407). After placebo treatment, SSS, FSS, and VAS improved by 0.46, 0.28, and 0.81 points or 17.89%, 12.5%, and 19.95%, respectively.

Conclusions
These results show an improvement in the studied parameters by up to 20%, but when compared with those published in literature, these show great variability due to the wide variety of factors involved in the placebo effect. Several factors that affect the placebo effect are discussed, and the present work tries to quantify it in carpal tunnel syndrome.

Level of Evidence
Level 2 of evidence according to “The Oxford 2011 Level of Evidence.”
Cost-Constrained feature selection in binary classification: adaptations for greedy forward selection and genetic algorithms
Authors: Jagdhuber Rudolf , Lang Michel , Stenzl Arnulf , Neuhaus Jochen , Rahnenführer Jörg 
Published: January 2020

Abstract
Background
With modern methods in biotechnology, the search for biomarkers has advanced to a challenging statistical task exploring high dimensional data sets. Feature selection is a widely researched preprocessing step to handle huge numbers of biomarker candidates and has special importance for the analysis of biomedical data. Such data sets often include many input features not related to the diagnostic or therapeutic target variable. A less researched, but also relevant aspect for medical applications are costs of different biomarker candidates. These costs are often financial costs, but can also refer to other aspects, for example the decision between a painful biopsy marker and a simple urine test. In this paper, we propose extensions to two feature selection methods to control the total amount of such costs: greedy forward selection and genetic algorithms. In comprehensive simulation studies of binary classification tasks, we compare the predictive performance, the run-time and the detection rate of relevant features for the new proposed methods and five baseline alternatives to handle budget constraints.

Results
In simulations with a predefined budget constraint, our proposed methods outperform the baseline alternatives, with just minor differences between them. Only in the scenario without an actual budget constraint, our adapted greedy forward selection approach showed a clear drop in performance compared to the other methods. However, introducing a hyperparameter to adapt the benefit-cost trade-off in this method could overcome this weakness.

Conclusions
In feature cost scenarios, where a total budget has to be met, common feature selection algorithms are often not suitable to identify well performing subsets for a modelling task. Adaptations of these algorithms such as the ones proposed in this paper can help to tackle this problem.