bluuebunny/crossref_metadata_2025_split huggingface dataset:
Have FDI, Globalisation and Energy Security Addressed the Malaise in the Nigerian Economy? A Quantile Analysis
Authors: Musibau Hammed Oluwaseyi , Adenekan Tobiloba Adedoyin , Shittu Waliu Olawale 
Published: September 2021

Nigeria, among other developing countries, faces a lot of challenges on growth and global competitiveness as a result of low foreign capital and energy insecurity, among others. Using a quantile-on-quantile regression technique on Nigeria’s data covering 1980–2017, this article examines the impacts of foreign direct investment (FDI), energy security and globalisation on economic growth. Our empirical findings suggest the following: (a) the net impact of energy security on economic growth is negative—implying that energy security impedes growth in Nigeria; (b) globalisation stimulates economic growth across all quantiles, but only significant at the third quantile; (c) as expected, each of labour and capital produces a positive effect on growth; and (d) there exists an adverse, non-significant effect of FDI on economic growth across all quantiles. Similarly, there is evidence of a bidirectional causality between economic growth and FDI; economic growth and energy security; economic growth and globalisation; FDI and globalisation; as well as between energy security and globalisation. There is, however, a uni-directional causality running from energy security through FDI. The policy recommendations of these findings are also explained in the concluding section. JEL: Q43, Q56
Performance of peripheral catheters inserted with ultrasound guidance versus landmark technique after a simulation-based mastery learning intervention
Authors: Feinsmith Sarah E , Amick Ashley E , Feinglass Joseph M , Sell Jordan , Davis Evan M , Spencer Timothy R , Koepke Lydia , Pastoral Jeffrey , Wayne Diane B , Barsuk Jeffrey H 
Published: September 2021

Problem: Ultrasound-guided peripheral intravenous catheter (USGPIV) insertion is an effective method to gain vascular access in patients with difficult intravenous access (DIVA). While USGPIV success rates are reported to be high, some studies have reported a concerning incidence of USGPIV premature failures. Aims: The purpose of this study was to compare differences in USGPIV and landmark peripheral intravenous catheter (PIV) utilization and failure following a hospital-wide USGPIV training program for nurses. Methods: The authors performed a retrospective, electronic medical record review of all USGPIVs and PIVs inserted at a tertiary, urban, academic medical center from September 1, 2018, through September 30, 2019. The primary outcome was differences between USGPIV and PIV time to failure. Results: A total of 43,470 short peripheral intravenous catheters (PIVCs) were inserted in 23,713 patients. Of these, 7972 (16.8%) were USGPIV. At 30 days of follow-up, for PIVCs with an indication for removal documented, USGPIVs had higher Kaplan–Meier survival probabilities than PIVs ( p < 0.001). Conclusions: The use of simulation-based mastery associated with USGPIVs, demonstrated lower failure rates than standard PIVs after 2 days and USGPIVs exhibited improved survival rates in patients with DIVA. These findings suggest that rigorous simulation-based insertion training demonstrates improved USGPIV survival when compared to traditional PIVCs. SBML is an extremely useful tool to ensure appropriately trained clinicians acquire the necessary knowledge and skillset to improve USGPIV outcomes.
Quantitative physical examination indicators to detect patients with stenosis at a high risk of thrombosis at hemodialysis vascular access sites: A retrospective case–control study
Authors: Chen Matt Chiung-Yu , Weng Mei-Jui , Chao Lee-Hua , Wu Misoso Yi-Wen , Liu Yi-Chun , Chi Wen-Che 
Published: September 2021

Background: Quantitative physical examination (PE) indicators, including palpable pulsatility length and outflow scores, can be used to quantify stenosis severity at hemodialysis vascular access sites. It is known that the risk of high-shear-related thrombosis is increased when the minimal luminal diameter (MLD) of stenosis decreases. At present, MLD is measured using sonography or angiography. This study sought to determine the relationship between quantitative PE indicators and MLD and report their diagnostic performance in detecting patients with stenosis at a high risk of thrombosis. Methods: We performed a retrospective case–control study using routinely collected data. We used the post-stenosis palpable pulsatility length (sPPL) and pulse-and-thrill based outflow score to assess the severity of AVF inflow and outflow stenosis, respectively. We recorded paired quantitative PE indicators and MLD before and after angioplasty in patients enrolled over a 4-month period. Results: A total of 249 paired PE indicators and MLD measurements were obtained from 163 patients. A receiver operating characteristic curve analysis showed that an MLD cutoff value of <1.55 mm and an MLD of <1.95 mm discriminated sPPL = 0 and PESOS (physical examination significant outflow stenosis)/1− of the outflow score, respectively, from all other measurements, with the area under the curve values of 0.8922 and 0.9618, respectively. With sPPL = 0 and PESOS/1− of the outflow score as diagnostic tools to detect inflow stenosis with an MLD of ⩽1.5 mm and outflow stenosis with an MLD of ⩽1.9 mm at vascular access sites, sensitivity = 86.00% and 88.46%; specificity = 97.67% and 92.11%; positive predictive values of 97.73% and 92.00% and negative predictive values of 85.71% and 88.61%, respectively, were observed. Conclusions: Our preliminary results showed that physical examination can potentially be a diagnostic tool in detecting patients with stenosis who are at a high risk of thrombosis at hemodialysis vascular access sites with high diagnostic accuracy.
Stable incidence and survival of arteriovenous fistulas over 39 years: A long-term national cohort study
Authors: Lindhard Kristine , Hansen Ditte , Lindegaard Pedersen Brian , Rix Marianne , Hansen Henrik Post , Jensen Boye L. , Heaf James 
Published: September 2021

Introduction: The age and number of comorbidities in the hemodialysis population has increased over time. This may influence the construction and survival of the arteriovenous fistula (AVF). The present study explored the incidence and survival of AVFs over a period of 39 years. Methods: A retrospective cohort study was conducted based on Danish registries. Incident hemodialysis patients between 1977 and 2015 were included. The incidence of AVF and factors associated with the construction of an AVF were described. Risk factors for AVF survival and repair were explored by Kaplan Meier and Cox proportional hazard analysis. Results: The total number of arteriovenous accesses (AVF and arteriovenous grafts) were 10,187 and there were 4201 central venous catheters (CVC). No significant difference in the proportion of AVFs during the 39 years was seen. Age and renal diagnosis did not influence the proportion of AVFs. Patients with CVCs were found to have a significantly higher prevalence of comorbidities ( p < 0.01). AVF survival remained stable during the 39 years. The first constructed AVF had the best survival, 35% still functioning after 15 years. Factors such as brachiocephalic AVF, female sex, and diabetic nephropathy increased the risk of AVF failure (Odds Ratio (OR): 2.46, 95% Confidence Interval (CI) (2.29–2.65), 1.17 (1.10–1.25), and 1.21 (1.12–1.3)), respectively. Conclusion: Despite an older dialysis population, the proportion and survival of the AVF in the Danish dialysis population has not changed, probably because of increased awareness of AVF as the first choice of vascular access and improved surveillance, surgery, and repair.
Differences in management of telemedicine alerts on weekdays and public holidays: Results from the OptiLink heart failure trial
Authors: Wintrich Jan , Pavlicek Valerie , Brachmann Johannes , Bosch Ralph , Butter Christian , Oswald Hanno , Rybak Karin , Millenaar Dominic , Mahfoud Felix , Böhm Michael , Ukena Christian 
Published: September 2021

Background In the OptiLink heart failure study, timely and appropriate reactions to telemedicine alerts improved clinical outcomes in heart failure patients. This analysis investigates the relation between the weekday of alert transmission and the subsequent patient contact. Methods In patients enrolled in the intervention arm of the OptiLink heart failure study ( n = 505, age 66.1 ± 10.1, 77.2% male, left-ventricular ejection fraction 26.7% ± 6.1%), fluid index threshold crossing alerts were analysed according to the weekday of the transmission. Transmissions on Mondays–Thursdays were categorized as TD1, Fridays–Sundays as well as public holidays as TD2. Results Of 1365 transmitted alerts, 867 (63.5%) were categorized as TD1 and 498 (36.5%) as TD2. Same day telephone contacts were more frequent in TD1 (46.2%) than in TD2 (18.3%; p < 0.001). Accordingly, the median time to contact was significantly longer in TD2 compared with TD1 (2(1–3) vs 0(0–1) days; p < 0.001). Rates of no telephone contact were no different between the groups (12.1% vs 12.4%; p = 0.866). Although signs of worsening heart failure were prevalent in 32.4% in TD1 versus 32.1% in TD2 ( p = 0.996), initiation of a pharmacological intervention occurred more likely in TD1 compared with TD2 (27.9% vs 22.9%; p = 0.041). No differences existed concerning hospitalization for heart failure within 30 days after alert transmission (3.9% vs 3.4%; p = 0.636). Conclusion Alert transmissions during weekends and public holidays were less likely associated with timely patient contacts and initiation of pharmacological interventions than during the week. Telemedical centres providing 24/7 remote monitoring service and specific education programmes for physicians might help to optimize patient care.
Early Results of a Novel Gutter-Free Chimney Stent-Graft System to Treat Aortic Arch Dissection: Single-Center Data from a Prospective Clinical Trial
Authors: Shu Chang , Li Xin , Dardik Alan , Li Quanming , He Hao , Li Ming , Fang Kun , Luo Mingyao , Wang Tun , Yang Chenzi , Wang Mo 
Published: September 2021

Aims: Discuss the clinical value, technique characteristics, and early follow-up results of a newly designed gutter-free chimney stent-graft system for aortic arch pathology. Methods and Results: About 13 patients with aortic arch dissection were enrolled in a clinical trial testing a novel gutter-free stent-graft between February 2019 and December 2020. All 13 patients were male, age 52.6±10.4 years. The implantation time was 14.0±6.9 minutes; total procedure time was 89.5±19.8 minutes. The volume of contrast was 79.6±7.2 ml. And 15 aortic stent-grafts were implanted, and all 13 patients had chimney branch stent-grafts implanted into the left subclavian artery (LSA). There were 3 (23.1%) cases of immediate type Ιa endoleak after thoracic endovascular aortic repair (TEVAR), and 7.7% type Ιa endoleaks occurred in delayed fashion. Survival at 2 years was 100%, and the 2-year patency of chimney stent-grafts was 100%. Conclusions: This study reports early success with good freedom from endoleak using a novel stent-graft designed for chimney TEVAR to treat aortic arch dissection. Postoperative survival and patency of the branch stent-grafts were excellent. Additional data from this multicenter clinical trial will be forthcoming.
Efficacy of pinaverium bromide in the treatment of irritable bowel syndrome: a systematic review and meta-analysis
Authors: Bor Serhat , Lehert Philippe , Chalbaud Adriana , Tack Jan 
Published: September 2021

Background: Spasmolytic agents are an attractive first line treatment option for irritable bowel syndrome (IBS). Pinaverium bromide (pinaverium) has antispasmodic effects on gastrointestinal smooth muscle and can relieve major IBS symptoms, but an up-to-date meta-analysis comparing the efficacy of pinaverium with placebo is lacking. The aim is to perform a systematic review and meta-analysis to assess the efficacy of pinaverium compared with placebo for IBS treatment. Methods: All placebo-controlled trials evaluating pinaverium for IBS treatment were included, up to October 2019. Treatment efficacy was evaluated by overall patient IBS symptoms. Individual symptoms were also evaluated. The effect of pinaverium versus placebo was expressed as standardized mean difference (SMD) and risk ratio (RR). Odds ratio (OR) and number needed to treat (NNT) were also calculated. Results: Eight studies were included for analysis. Pinaverium treatment had a beneficial effect on overall IBS symptom relief with a positive SMD of 0.64 [95% confidence interval (CI) 0.45–0.82, p < 0.0001] and a positive RR of 1.75 (1.26–2.43, p < 0.0008). No significant difference was found by publication year, gender, age, methodological quality score (MQS), or sample size. No publication bias was detected. OR was 3.43 (2.00–5.88, p < 0.0001), and NNT was 4. Pinaverium also demonstrated a beneficial treatment effect for abdominal pain, stool change, and bloating improvement or resolution. Conclusion: Pinaverium is superior to placebo for the treatment of IBS symptoms, irrespective of patient age or gender, study publication year, sample size, or MQS. The NNT in this meta-analysis is amongst the lowest for studies and meta-analyses of antispasmodics versus placebo in IBS.
High Return to Sport in Patients Over 45 Years of Age Undergoing Osteochondral Allograft Transplantation for Isolated Chondral Defects in the Knee
Authors: Markus Danielle H. , Hurley Eoghan T. , Haskel Jonathan D. , Manjunath Amit K. , Campbell Kirk A. , Gonzalez-Lomas Guillem , Strauss Eric J. , Alaia Michael J. 
Published: September 2021

Objective: The purpose of this study was to evaluate the efficacy of osteochondral allograft (OCA) in patients older than 45 years of age, particularly with respect to return to sport. Design: A retrospective review was performed to evaluate patients greater than 45 who underwent an OCA for a symptomatic osteochondral defect of the knee between June 2011 and January 2019. Results: Overall, there were 18 patients (76% male) that met our inclusion and exclusion criteria. Follow-up was attained in 14 of these patients (78%). The mean age of patients included was 52.6 years (48-57) with a mean of 37 months of follow-up (18-60). Visual Analogue Scale scores decreased significantly from the preoperative baseline to final follow-up (7.7 ± 1.7 vs. 2.0 ± 2.0, P < 0.01). Furthermore, the mean Visual Analogue Scale while playing sport was 3.4 ± 3.2, and the mean Knee Injury and Osteoarthritis Outcome Score was 77.5 ± 12.7 at final follow-up. Overall, 11 patients (78.6%) were able to return to their desired sport. No clinical failures were identified during the follow-up period. Conclusion: In our series of patients 45 years and older who were treated with OCA for focal osteochondral injuries of the knee, we found a significant improvement in clinical outcome scores at a midterm follow-up of 37 months with no revision OCA procedures or conversion to any form of knee arthroplasty. In addition, a high percentage of patients were able to return to their preferred level of athletic activity.
Assessment of TOC and TPM in Indian SME Auto Manufacturing Industries
Authors: Tarte Nagesh , Doke Sunil 
Published: September 2021

The purpose of this article is to investigate the impact of theory of constraints (TOC) and total productive maintenance (TPM) practices on operational performance, and their interlinkage between each other. Constructs that are critical to auto manufacturer’s operational performance have been identified with the help of literature and experts from industry. The impact of TOC and TPM on operational performance has been evaluated. Similarly, impact of competitiveness on operational performance has been evaluated. Further, alternate models are tested and evaluated through structural equation model. It was observed during testing of alternate models that TOC and TPM have a direct impact on operational performance. However, TOC and TPM practices also directly impact overall operational performance, which in turn, influences competitiveness. In comparison of alternate models, the model in which TOC and TPM affect overall equipment efficiency (OEE), human total participation and commitment (HTPC), throughput (T), inventory (I), and operating expense (OE) practices and these further affect the operational performance, is found most appropriate. This study provides some useful implications from industry point of view. TOC and TPM practices are crucial to auto manufacturing industries. TOC and TPM are the core of attaining sustenance in crucial factors, which will have greater impact to achieve operational performance. Overall equipment efficiency, Human total participation, T, I, and operating expense practices are driven by TOC and TPM practices. This crucial factor linkage helps to achieve the desired operation performance. There are very limited studies that have considered both the continuous improvement practices together to achieve better operational performance. In auto manufacturing industry, both TOC and TPM are crucial continuous improvement practices for any organization to drive its growth.
The selection of variable regions affects effector mechanisms of IgA antibodies against CD20
Authors: Evers Mitchell , Rösner Thies , Dünkel Anna , Jansen J. H. Marco , Baumann Niklas , ten Broeke Toine , Nederend Maaike , Eichholz Klara , Klausz Katja , Reiding Karli , Schewe Denis M. , Kellner Christian , Peipp Matthias , Leusen Jeanette H. W. , Valerius Thomas 
Published: September 2021

Abstract
Blockade of the CD47-SIRPα axis improves lymphoma cell killing by myeloid effector cells, which is an important effector mechanism for CD20 antibodies in vivo. The approved CD20 antibodies rituximab, ofatumumab, and obinutuzumab are of human immunoglobulin G1 (IgG1) isotype. We investigated the impact of the variable regions of these 3 CD20 antibodies when expressed as human IgA2 isotype variants. All 3 IgA2 antibodies mediated antibody-dependent cellular phagocytosis (ADCP) by macrophages and antibody-dependent cellular cytotoxicity (ADCC) by polymorphonuclear cells. Both effector mechanisms were significantly enhanced in the presence of a CD47-blocking antibody or by glutaminyl cyclase inhibition to interfere with CD47-SIRPα interactions. Interestingly, an IgA2 variant of obinutuzumab (OBI-IgA2) was consistently more potent than an IgA2 variant of rituximab (RTX-IgA2) or an IgA2 variant of ofatumumab (OFA-IgA2) in triggering ADCC. Furthermore, we observed more effective direct tumor cell killing by OBI-IgA2 compared with RTX-IgA2 and OFA-IgA2, which was caspase independent and required a functional cytoskeleton. IgA2 variants of all 3 antibodies triggered complement-dependent cytotoxicity, with OBI-IgA2 being less effective than RTX-IgA2 and OFA-IgA2. When we investigated the therapeutic efficacy of the CD20 IgA2 antibodies in different in vivo models, OBI-IgA2 was therapeutically more effective than RTX-IgA2 or OFA-IgA2. In vivo efficacy required the presence of a functional IgA receptor on effector cells and was independent of complement activation or direct lymphoma cell killing. These data characterize the functional activities of human IgA2 antibodies against CD20, which were affected by the selection of the respective variable regions. OBI-IgA2 proved particularly effective in vitro and in vivo, which may be relevant in the context of CD47-SIRPα blockade.
Portable medical orders and end-of-life measures in acute myeloid leukemia and myelodysplastic syndromes
Authors: LoCastro Marissa , Baran Andrea M. , Liesveld Jane L. , Huselton Eric , Becker Michael W. , O’Dwyer Kristen Marie , Aljitawi Omar S. , Baumgart Megan , Snyder Eric , Kluger Benzi , Loh Kah Poh , Mendler Jason H. 
Published: September 2021

Abstract
Patients with acute myeloid leukemia (AML) or a myelodysplastic syndrome (MDS) experience high rates of hospitalization, intensive care unit (ICU) admission, and in-hospital death at the end of life. Early goals-of-care (GOC) discussions may reduce the intensity of end-of-life (EOL) care. Portable Medical Order forms, known as Medical Orders for Life-Sustaining Treatment (MOLST) forms in New York state, assist patients in translating GOC discussions into specific medical orders that communicate their wishes during a medical emergency. To determine whether the timing of completion of a MOLST form is associated with EOL care in patients with AML or MDS, we conducted a retrospective study of 358 adult patients with AML or MDS treated at a single academic center and its affiliated sites, who died during a 5-year period. One-third of patients completed at least 1 MOLST form &gt;30 days before death. Compared with patients who completed a MOLST form within 30 days of death or never, those who completed a MOLST form &gt;30 days before death were less likely to receive transfusion (adjusted odds ratio [AOR], 0.39; P &lt; .01), chemotherapy (AOR, 0.24; P &lt; .01), or life-sustaining treatments (AOR, 0.21; P &lt; .01) or to be admitted to the ICU (AOR, 0.21; P &lt; .01) at EOL. They were also more likely to use hospice services (AOR, 2.72; P &lt; .01). Earlier MOLST form completion was associated with lower intensity of care near EOL in patients with MDS or AML.
Minute ventilation/carbon dioxide production in congenital heart disease
Authors: Hager Alfred 
Published: September 2021

This review summarises various applications of how ventilatory equivalent (ventilatory efficiency or better still ventilatory inefficiency) and the minute ventilation (VʹE)/carbon dioxide production (VʹCO2) slope obtained from cardiopulmonary exercise testing (CPET) can be used in the diagnostic or prognostic workup of patients with congenital heart disease.The field of congenital heart disease comprises not only a very heterogeneous patient group with various heart diseases, but also various conditions in different stages of repair, as well as the different residuals seen in long-term follow-up. As such, various physiologic disarrangements must be considered in the analysis of increasedVʹE/VʹCO2slope from CPET in patients with congenital heart disease. In addition to congestive heart failure (CHF), cyanosis, unilateral pulmonary stenosis and pulmonary hypertension (PH) provide the background for this finding. The predictive value of increasedVʹE/VʹCO2slope on prognosis seems to be more important in conditions where circulatory failure is associated with failure of the systemic ventricle. In cyanotic patients, those with Fontan circulation, or those with substantial mortality from arrhythmia, the impact ofVʹE/VʹCO2on prognosis is not that important.