bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Gesture-Based Interaction on Driving Behavior: A Driving Simulator Study Using the Projection-Based Vehicle-in-the-Loop
Authors: Graichen Lisa , Graichen Matthias , Krems Josef F. 
Published: August 2020

Objective We observe the driving performance effects of gesture-based interaction (GBI) versus touch-based interaction (TBI) for in-vehicle information systems (IVISs). Background As a contributing factor to a number of traffic accidents, driver distraction is a significant problem for traffic safety. More specifically, visual distraction has a strong negative impact on driving performance and risk perception. Thus, the implementation of new interaction systems that use midair gestures to encourage glance-free interactions could reduce visual distraction among drivers. Methods In this experiment, participants drove a projection-based Vehicle-in-the-Loop. The projection-based technology combines a visual simulation with kinesthetic, vestibular, and auditory feedback from a car on a test track. While driving, participants used GBI or TBI to perform IVIS tasks. To investigate driving behavior related to critical driving situations and car-following maneuvers, vehicle data based upon longitudinal and lateral driving were collected. Results Participants reacted faster to critical driving situations when using GBI compared to TBI. For drivers using TBI, steering performance decreased and time headway to a preceding vehicle was higher. Conclusion Gestures provide a safe alternative to in-vehicle interactions. Moreover, GBI has fewer effects on driver distraction than TBI. Application Potential applications of this research include all in-vehicle interaction systems used by drivers.
Searching for Meaning with Victor Frankl and Walker Percy
Authors: Schimmoeller Ethan M. , Rothhaar Timothy W. 
Published: August 2020

Patients present to physicians searching for more than scientific names to call their maladies. They rather enter examination rooms with value-laden narratives of illness, suffering, hopes, and worries. One potentially helpful paradigm, inspired in part by existentialism, is to see patients on a search for meaning. This perspective is particularly important in the seemingly meaningless ruins of modernity. Here, we will summarize Victor Frankl’s account of logotherapy found in his much-circulated book Man’s Search for Meaning and assess the limitations imposed by his religious agnosticism. At best he can offer patients a finite, impersonal meaning this side of the grave. Following Kierkegaard’s depiction of the religious sphere of existence, American novelist Walker Percy will be shown to supplement logotherapy with a theological mooring. The spiritual crisis of the modern world is treatable only by Christian faith supplying ultimate meaning. Taken together, Frankl and Percy show how Catholic physicians can be guides in their patients’ personal searches for meaning. This paradigm may prove chiefly beneficial in goals of care conversations, encountering “aesthetic” patients living only for pleasure, and engaging patients amidst tragedy-ridden circumstances. Although only Christian faith will ultimately satisfy the search for meaning, we first of all need encouragement to take responsibility for seeking meaning, and confidence that even the most hopeless situation can become meaningful. Summary: Victor Frankl’s Man’s Search for Meaning can enlighten clinical encounters for physicians to see patients on a search for meaning, particularly amidst suffering and tragedy in a post-modern world lacking transcendence. As shown in Walker Percy’s literature, however, ultimate meaning can only be found in Christian faith where the Word became flesh and continues to dwell among us.
Rational Design of Conformationally Flexible Drugs
Authors: Robson B. , Finn P.W. 
Published: August 2020

Synopsis The rational design of conformationally flexible drugs is briefly reviewed and conformational flexibility is identified as a major stumbling block in the application of QSAR-type methods. With a worked example for thyroid stimulating hormone releasing factor (TRH) and analogues, an approach with several new features is described which leads to quantitative structure-function relationships for the analogues studied so far. With the advantage of hindsight, it appears that with proper treatment good structure-activity relationships might be expected even in the usual case of a receptor of unknown structure, and the reasons for this are described.
In Vitro Techniques for the Detection of Chemicals Capable of Inducing Mitotic Chromosome Aneuploidy
Authors: Parry James M. , Danford Natalie , Parry Elizabeth M. 
Published: August 2020

Summary Three related assay systems have been developed for the detection and evaluation of chemicals capable of inducing mitotic chromosome aneuploidy. These assays, which involve the use of yeast and mammalian cell cultures, have been evaluated for their potential utility by the study of the aneugenic (aneuploidy-inducing) potential of a series of eight carcinogenic and two non-carcinogenic chemicals. The results of this study indicate that the assay of the potential of chemicals for their ability to induce cellular lesions which may lead to changes in chromosome number provides a valuable complement to the available in vitro assay systems for genotoxicity in that they are capable of detecting carcinogens that give negative results in bacterial mutagenicity assays.
The Use of Computers to Simulate Animal Preparations in the Teaching of Practical Pharmacology
Authors: Hughes I.E. 
Published: August 2020

Summary The teaching objectives of practical pharmacology classes are defined as being: 1. illustration and exemplification of drug effects; 2. acquisition of general laboratory skills and manual dexterity; 3. acquisition of specific skills required in practical pharmacology, and 4. development of a flexible and self-reliant approach to practical work. The properties of a typical computer simulation of an animal preparation are described and the ability of simulations to help students attain the above teaching objectives is discussed. It is concluded that simulations can help students achieve some of these teaching objectives and could be used extensively instead of animals for some, but not all, groups of students. Lack of cost-effectiveness and the restricted availability of suitable computer programs are major reasons why simulations are not used widely in areas where they could help students attain appropriate teaching objectives.
Concomitant continuous pain in patients with trigeminal neuralgia is associated with trigeminal nerve root atrophy
Authors: Di Stefano Giulia , De Stefano Gianfranco , Leone Caterina , Cruccu Giorgio , Tardioli Stefano , Cartocci Gaia , Fiorelli Marco , Truini Andrea , Caramia Francesca 
Published: August 2020

Introduction Trigeminal neuralgia is an exemplary neuropathic pain condition characterized by paroxysmal electric-shock-like pain. However, up to 50% of patients also experiences concomitant continuous pain. In this neuroimaging study, we aimed to identify the specific anatomical features of trigeminal nerve root in patients with concomitant continuous pain. Methods We enrolled 73 patients with a definitive diagnosis of classical and idiopathic trigeminal neuralgia and 40 healthy participants. The diagnosis of trigeminal neuralgia was independently confirmed by two clinicians. Patients were grouped as patients with purely paroxysmal pain (45 patients) and patients also with concomitant continuous pain (28 patients). All participants underwent a structured clinical examination and a 3T MRI with sequences dedicated to the anatomical study of the trigeminal nerve root, including volumetric study. Images analysis was independently performed by two investigators, blinded to any clinical data. Results In most patients with concomitant continuous pain, this type of pain, described as burning, throbbing or aching, manifested at the disease onset. Demographic and clinical variables did not differ between the two groups of patients; the frequency of neurovascular compression and nerve dislocation were similar. Conversely, trigeminal nerve root atrophy was more severe in patients with concomitant continuous pain than in those with purely paroxysmal pain ( p = 0.006). Conclusions Our clinical and neuroimaging study found that in patients with trigeminal neuralgia, concomitant continuous pain was associated with trigeminal nerve root atrophy, therefore suggesting that this type of pain is likely related to axonal loss and abnormal activity in denervated trigeminal second-order neurons.
Evaluation of belimumab treatment in patients with systemic lupus erythematosus in a clinical practice setting: Results from a 24-month OBSErve study in Argentina
Authors: Babini A , Cappuccio A M , Caprarulo C , Casado G , Eimon A , Figueredo H , García M A , Magri S , Mannucci P , Perez Rodriguez S , Pons-Estel B A , Velozo E J , Iglesias-Rodriguez M , Streger G 
Published: August 2020

Objective To describe clinical effectiveness of belimumab for systemic lupus erythematosus (SLE) in real-world practice in Argentina. Methods This retrospective, observational study analysed medical record data of patients with SLE treated with belimumab in 15 centres in Argentina. Primary endpoint: overall clinical response (assessed on a scale similar to the 6-point Physician Global Assessment) at months 6, 12, 18 and 24, all versus index (belimumab initiation). Secondary endpoints: improvement in disease activity (SELENA-SLEDAI), SLE manifestations, and corticosteroid dose change. Results Records for 81 patients (91% female) were analysed. Clinical improvements were reported for 95%, 95%, 98% and 100% patients at 6, 12, 18, and 24 months post index, respectively. Mean SELENA-SLEDAI score decreased from 11.21 at index to 4.76, 3.77, 3.86 and 2.17 at 6, 12, 18, and 24 months post index, respectively. Number of flares decreased from 1.05 at index to 0.21, 0.09, 0.22 and 0.30 at 6, 12, 18, and 24 months post index, respectively. Mean corticosteroid dose was 14.59 mg/day at index, and 6.45, 5.18, 5.17 and 4.78 mg/day at 6, 12, 18, and 24 months post index, respectively. Conclusions Real-world patients with SLE treated with belimumab in Argentina demonstrated clinical improvements and reductions in corticosteroid dose.
Sensitivity and specificity of artificial intelligence with Microsoft Azure in detecting pneumothorax in emergency department: A pilot study
Authors: Lai Kwok Hung Alastair , Ma Shu Kai 
Published: August 2020

Background: Artificial intelligence is becoming an increasingly important tool in different medical fields. This article aims to evaluate the sensitivity and specificity of artificial intelligence trained with Microsoft Azure in detecting pneumothorax. Methods: A supervised learning artificial intelligence is trained with a collection of X-ray images of pneumothorax from National Institutes of Health chest X-ray dataset online. A subset of the image dataset focused on pneumothorax is used in training. Two artificial intelligence programs are trained with different numbers of training images. After the training, a collection of pneumothorax X-ray images from patient attending emergency department is retrieved through the Clinical Data Analysis & Reporting System. In total, 115 pneumothorax patients and 60 normal inpatients are recruited. The pneumothorax chest X-ray and the resolution chest X-ray of the above patient group and a collection of normal chest X-ray from inpatients without pneumothorax will be retrieved, and these three sets of images will then undergo testing by artificial intelligence programs to give a probability of being a pneumothorax X-ray. Results: The sensitivity of artificial intelligence-one is 33.04%, and the specificity is at least 61.74%. The sensitivity of artificial intelligence-two is 46.09%, and the specificity is at least 71.30%. The dramatic improvement of 46.09% in sensitivity and improvement of 15.48% in specificity by addition of around 1000 X-ray images is encouraging. The mean improvement of AI-two over AI-one is 19.7% increase in probability difference. Conclusions: We should not rely on artificial intelligence in diagnosing pneumothorax X-ray solely by our models and more training should be expected to explore its full function.
Promotion of Advance Care Planning Among Young Adults: A Pilot Study of Health Engagement Workshop Feasibility, Implementation, and Efficacy
Authors: Barrison Philip , Davidson Lindy Grief 
Published: August 2020

Objective: This pilot study set out to evaluate the feasibility and efficacy of an interactive, peer-led, health engagement workshop to improve confidence and comprehension related to advance care planning (ACP) among young adults. Secondarily, this study evaluated if such workshops could promote ACP related behavior changes within this population. Methods: This observational cohort study utilized a repeated measures, mixed-method design. Six hour-long, in-person workshops were conducted with undergraduate students during meetings of university student organizations. Participants were evaluated across 3 mixed-method surveys, evaluating confidence, knowledge, and behaviors related to ACP prior to participation, directly after, and during a 2-week follow-up. Results: Workshop participation improved the average participant confidence and knowledge related to ACP as well as encouraged some participants to engage in discussions related to end-of-life care with friends and family. Alongside the impact of the workshops on knowledge and confidence, participants positively evaluated the design of the workshops through collected qualitative feedback. Conclusion: These results are encouraging in assessing this population’s willingness to learn about end-of-life care planning. The tools developed and the corresponding results should be used for further exploration of engaging the young adult population in ACP to promote improved healthcare outcomes.
Effect of Age on Complication Rates and Outcomes Following First Metatarsophalangeal Arthrodesis for Hallux Rigidus
Authors: Lunati Matthew P. , Manz Wesley J. , Maidman Samuel D. , Kukowski Nathan R. , Mignemi Danielle , Bariteau Jason T. 
Published: August 2020

Background: Hallux rigidus is one of the most common toe pathologies in patients greater than 50 years old. Although metatarsophalangeal (MTP) arthrodesis is used to improve pain and function, older patients are often considered to be higher-risk operative candidates. There are minimal data on outcomes of MTP fusion and no studies comparing outcomes between geriatric and younger patients. Methods: This is a single-center, prospective study of all patients who underwent MTP fusion between August 1, 2015, and July 1, 2018. Patient-reported outcomes were assessed using the Short Form Health Survey (SF-36), Life-Space Assessment survey (LSA), and visual analog scale (VAS) for pain administered preoperatively as well as 6 months and 1 year postoperatively. Baseline characteristics and operative outcomes were collected from the electronic medical record. Clinical and patient-reported outcomes were compared between patients <65 years old and ≥65 years old. Of 143 included patients, 79 were in the younger group (mean of 56.5 years) and 64 were in the older group (mean of 72.0 years). Results: Compared with the younger group, the older group was more predominantly female (95.3% older group, 77.2% younger group, P = .002). More patients in the older group had hypertension (73.4% older group, 50.6% younger group, P = .005) and coronary artery disease (9.4% older group, 0.0% younger group, P = .005). Both age groups had similar rates of postoperative wound complications requiring operative irrigation and debridement, deep vein thrombosis, deformity recurrence, and revision surgery. No differences were detected in SF-36, LSA, and VAS surveys administered at baseline, 6 months postoperation, or 1 year postoperation between younger and older patients. Conclusion: Despite more comorbidities, older patients had similar rates of postoperative complications and reported similar outcomes for pain, function, and mobility following MTP fusion. These findings support increased implementation of MTP fusion surgery for older patients with hallux rigidus. Level of Evidence: Level II, prospective cohort.
Characteristics of uveitic glaucoma in Turkish patients
Authors: Tekeli Oya , Elgin Ufuk , Takmaz Tamer , Ekşioğlu Ümit , Baş Zeynep , Yarangümeli Alper , Karakurt Ahmet , Evren Kemer Özlem , Mumcuoğlu Tarkan , Aktaş Zeynep , Akman Ahmet , Bayer Atilla 
Published: August 2020

Purpose: To evaluate the prevalence of uveitic glaucoma (UG) in the Turkish population and investigate the primary underlying diseases. Methods: This multicenter, cross-sectional, prospective study included patients who presented to the glaucoma units of 10 tertiary ophthalmology departments in Ankara, Turkey from 15th March to 16th May 2015 and fulfilled the criteria of UG. Patients were inspected for age, sex, medical history, best corrected visual acuity, biomicroscopic findings, intraocular pressure values, and visual field results. Results: During the study period, 4604 eyes of 2541 patients with glaucoma were screened and 145 eyes of 104 patients (4.1%) were identified as having UG. One hundred and thirty-four eyes (92.4%) had open-angle glaucoma and 11 eyes (7.6%) had closed-angle glaucoma. The mean patient age was 47 ± 16 (6–90) years. Idiopathic uveitis (54 eyes), Behçet’s disease (26 eyes), Fuchs heterochromic cyclitis (21 eyes), Herpes Simplex virus infectious uveitis (14 eyes), and ankylosing spondylitis (six eyes) were the leading types of uveitis associated with glaucoma. Acute anterior uveitis was the most common type of uveitis diagnosed in 72 patients (105 eyes), whereas 21 patients (27 eyes) had panuveitis, eight patients (nine eyes) had intermediate uveitis, and three patients (four eyes) had posterior uveitis. The need for surgical intervention was 37.2% among all cases and the most common surgery was trabeculectomy in 45 eyes. Conclusion: UG is a vision-threatening complication commonly seen in patients with uveitis. This study demonstrates the epidemiological features and underlying etiologies of UG in the Turkish population. The most common primary causes of UG were Behçet’s disease and Fuchs heterochromic cyclitis.
Novel technique of percutaneous bypass in a brachiocephalic arteriovenous fistula with cephalic arch occlusion: A case report
Authors: Tan Hiang Jin , Shi Lew Pei , Meng Lai Yu , Chunyin Ho Derek , Pitumpe Harsha , Kum Steven , Lim Darryl 
Published: August 2020

Objective: Arteriovenous fistulas are a principal mainstay of long-term dialysis access for patients with end stage renal failure. However, the patency of arteriovenous fistulas is limited, often requiring percutaneous transluminal angioplasty as a salvage procedure. We report a case of percutaneous method of arteriovenous fistula salvage. Methods: A gentleman with brachiocephalic arteriovenous fistula created in 2015 was admitted under us for dialysis access issue. His fistula history was notable for recurrent and refractory venous outflow stenosis of the cephalic vein and the cephalic arch with multiple previous interventions. Ultrasound showed cephalic arch occlusion with high venous pressures. He underwent left brachicephalic fistula percutaneous bypass. We describe the percutaneous creation of a brachial–subclavian arteriovenous fistula via a bypass graft from a worsening brachial-cephalic fistula with cephalic arch occlusion that is not amendable to angioplasty. Results: Final angiogram showed smooth flow to central vein. He is 2 years post procedure, and his fistula remained patent with no interventions required. Conclusion: Percutaneously created jump bypass grafts can reliably produce sustained long-term patency.
Patient-Level Factors Associated with Oncology Provider-Delivered Brief Tobacco Treatment Among Recently Diagnosed Cancer Patients
Authors: Neil JM , Price SN , Friedman ER , Ponzani C , Ostroff JS , Muzikansky A , Park ER 
Published: August 2020

Background: A cancer diagnosis is seen as a “teachable moment” for patients to consider changing their behavioral risk factors, such as smoking. It also offers an opportunity for oncology providers to engage in a dialogue about how they can support patients changing their smoking behaviors. Brief, evidence-based tobacco cessation treatment delivered by oncology providers through the 5As (Ask, Advise, Assess, Assist Arrange) model is recommended, but provision to cancer patients remains suboptimal. Aim: Explore patient-level factors associated with 5As receipt among current smokers with a newly diagnosed cancer. Method: A total of 303 patients self-reported whether they received each of the 5As during their most recent oncology care visit. Multivariable regression analyses were conducted to identify patient-level factors associated with 5As receipt. Results: Oncology provider-delivered 5As rates ranged from 81.5% (Ask) to 30.7% (Arrange). 5As receipt was associated with: reporting lower illness-related stigma, diagnosis of a comorbid smoking-related disease, diagnosis of a smoking-related cancer, and diagnosis of a non-advanced cancer. Conclusion: Findings support previous literature in which smoking-related diagnoses were associated with greater receipt of 5As; however, disparities in the receipt of 5As existed for patients with more advanced cancer diagnoses and illness-related stigma. Inequities in the provision of quit assistance may further decrease treatment effectiveness and survival expectancy among certain patient populations. These findings are, therefore, important as they identify specific patient-level factors associated with lower 5As receipt among newly diagnosed cancer patients.