bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recovery education for people experiencing housing instability: An evaluation protocol
Authors: Durbin Anna , Kapustianyk Grace , Nisenbaum Rosane , Wang Ri , Aratangy Tatiana , Khan Bushra , Stergiopoulos Vicky 
Published: June 2019

Background: Recovery education centers (RECs) offer recovery supports through education rather than traditional health services. The Supporting Transitions and Recovery Learning Centre (STAR) in Toronto, Canada, is among the few that are internationally focused on individuals with histories of homelessness. Although research suggests that RECs positively impact participants, there is a paucity of rigorous studies and none address the engagement and impacts on homeless individuals. Aims: This protocol describes a realist-informed evaluation of STAR, specifically examining (1) if STAR participation is more effective in promoting 12-month recovery outcomes than participation in usual services for individuals experiencing housing instability and mental health challenges and (2) how STAR participation promotes recovery and other positive outcomes. Methods: This study uses a quasi-experimental mixed methods design. Personal empowerment (primary outcome) and recovery, housing stability, social functioning, health service use and quality of life (secondary outcomes) data were collected at baseline, and 6 and 12 months. Intervention group participants were recruited at the time of STAR registration while control group participants were recruited from community agencies serving this population after screening for age and histories of housing instability. Interviews and focus groups with service users and providers will identify the key intervention ingredients that support the process of recovery. Results: From January 2017 to July 2018, 92 individuals were recruited to each of the intervention and control groups. The groups were mostly similar at baseline; the intervention group’s total empowerment score was slightly higher than the control group’s ( M ( SD): 2.94 (0.23) vs 2.84 (0.28), p = .02), and so was the level of education. A subset of STAR participants ( n = 20) and nine service providers participated in the qualitative interviews and focus groups. Conclusion: This study will offer important new insights into the effectiveness of RECs, and expose how key REC ingredients support the process of recovery for people experiencing housing instability.
Lessons from Experience: A New Look at Performance Management Systems
Authors: Rao T V 
Published: June 2019

The concept of performance appraisal has changed over the years. Performance has been usually equated with annual appraisals which measure the entire year's effort of an employee in terms of numbers. This paper points out the flaws in this system and suggests its replacement with the Performance Management Systems (PMS), offering a set of changes to make PMS more effective. Drawing from his own experiences of designing Integrated HRD systems for various companies, the author stresses upon the importance of understanding the nature, potential, and complexities of performance management systems (PMS). Evaluating an employee�s performance on the basis of numbers assigned by another appraiser without an awareness of the context in which the ratings are assigned could inflict serious injustice to the performer. The outlook has to shift from an annual exercise to the on-going activities. Appraisal focuses on ratings while improvements focus on work, stakeholders, service levels, productivity, motivation effort and all such performance-related variables. Following changes are suggested in order to improve PMS as a system: Change from ‘Appraisal’ to ‘Management’ and focus on “Contributions and Improvement” Recognize the comprehensiveness of PMS as a system Recognize the complexities of the multi-dimensional PMS Allocate adequate time and legislate the same and if required plan it into the company calendar Take HR managers out of PMS, decentralize and shift PMS to Performance Managers developed from line jobs Make PMS a part of the budgeting process and integrate with other systems of the company Create a new Index—“Performance Index”—for each employee and make it quarterly and annual Use technology to support your work Implement PMS rigorously and give it the seriousness it deserves. A questionnaire survey on a number of managers from three organizations: an MNC, a family- owned business, and a professionally managed company from abroad clearly indicated the potential use of PMS for performance enhancements and a similarity in the implementation of PMS in all these organizations. The author discusses how these insights helped him in designing the programme, popularly known as “Invest Twenty and Direct 2,000 to 20,000™.” The line managers and top management are being told that their managers can learn to direct 2,000 hours of their performance time to 20,000 hours of their junior�s performance time by merely investing 20 hours of their time for planning their own and their juniors' work. PMS can be a great tool if designed comprehensively and implemented in all earnestness, the author affirms.
Outcomes and Patient Satisfaction With Arthroscopic Partial Meniscectomy for Degenerative and Traumatic Tears in Middle-Aged Patients With No or Mild Osteoarthritis
Authors: Lizaur-Utrilla Alejandro , Miralles-Muñoz Francisco A. , Gonzalez-Parreño Santiago , Lopez-Prats Fernando A. 
Published: June 2019

Background: There is controversy about the benefit of arthroscopic partial meniscectomy (APM) for degenerative lesions in middle-aged patients. Purpose: To compare satisfaction with APM between middle-aged patients with no or mild knee osteoarthritis (OA) and a degenerative meniscal tear and those with a traumatic tear. Study Design: Cohort study; Level of evidence, 2. Methods: A comparative prospective study at 5 years of middle-aged patients (45-60 years old) with no or mild OA undergoing APM for degenerative (n = 115) or traumatic (n = 143) tears was conducted. Patient satisfaction was measured by a 5-point Likert scale and functional outcomes by the Knee injury and Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Univariate and multivariate regression analyses were used to identify factors correlating with patient-reported satisfaction at 5 years postoperatively. Results: Baseline patient characteristics were not different between groups. At the 5-year evaluation, the satisfaction rate in the traumatic and degenerative groups was 68.5% versus 71.3%, respectively ( P = .365). Patient satisfaction was significantly associated with functional outcomes ( r = 0.69; P = .024). In the degenerative group, 43 patients (37.4%) had OA progression to Kellgren-Lawrence (K-L) grade 2 or 3, but only 24 patients (20.8%) had a symptomatic knee at final follow-up. Multivariate regression analysis for patient dissatisfaction at 5-year follow-up showed the following significant independent factors: female sex (odds ratio [OR], 1.6 [95% CI, 1.1-2.3]; P = .018), body mass index >30 kg/m2 (OR, 2.6 [95% CI, 1.7-4.9]; P = .035), lateral meniscal tears (OR, 0.6 [95% CI, 0.1-0.9]; P = .039), and OA progression to K-L grade ≥2 at final follow-up (OR, 1.4 [95% CI, 1.2-2.6]; P = .014). At the final evaluation, there were no significant differences between groups in pain scores ( P = .648), WOMAC scores ( P = .083), or KOOS-4 scores ( P = .187). Likewise, there were no significant differences in the KOOS subscores for Pain ( P = .144), Symptoms ( P = .097), or Sports/Recreation ( P = .150). Although the degenerative group had significantly higher subscores for Activities of Daily Living ( P = .001) and Quality of Life ( P = .004), the differences were considered not clinically meaningful. Conclusion: There were no meaningful differences in patient satisfaction or clinical outcomes between patients with traumatic and degenerative tears and no or mild OA. Predictors of dissatisfaction with APM were female sex, obesity, and lateral meniscal tears. Our findings suggested that APM was an effective medium-term option to relieve pain and recover function in middle-aged patients with degenerative meniscal tears, without obvious OA, and with failed prior physical therapy.
Lateral Meniscal Allograft Transplantation With Bone Block and Suture-Only Techniques Partially Restores Knee Kinematics and Forces
Authors: Novaretti João V. , Lian Jayson , Sheean Andrew J. , Chan Calvin K. , Wang Joon H. , Cohen Moises , Debski Richard E. , Musahl Volker 
Published: June 2019

Background: The ability of lateral meniscal allograft transplantation (MAT) to improve knee stability and the meniscal load-bearing function in patients after meniscectomy is critical for surgical success. Purpose: To compare the effects of 2 lateral MAT fixation techniques—bone block and suture only—on knee kinematics and forces. Study Design: Controlled laboratory study. Methods: With a robotic testing system, loads were applied during flexion on 10 fresh-frozen cadaveric knees: 134-N anterior tibial load + 200-N axial compression, 5-N·m internal tibial + 5-N·m valgus torques, and 5-N·m external tibial + 5-N·m valgus torques. Kinematic data were recorded for 4 knee states: intact, total lateral meniscectomy, lateral MAT bone block, and lateral MAT suture-only fixation. In situ force in the anterior cruciate ligament and resultant forces in the lateral meniscus and in the meniscal allograft were quantified via the principle of superposition. A repeated measures analysis of variance was used to analyze variations in kinematics and forces at 0°, 30°, 60°, and 90° of knee flexion. Significance was set at P < .05. Results: When anterior loads were applied, a decrease in medial translation of the tibia that was increased after total lateral meniscectomy was observed at 30°, 60°, and 90° of knee flexion for both the lateral MAT bone block (54.2%, 48.0%, and 50.0%) and the MAT suture-only (50.0%, 40.0%, and 34.6%) fixation techniques ( P < .05). Yet, most of the increases in knee kinematics after lateral meniscectomy were not significantly reduced by either lateral MAT technique ( P > .05 for each MAT technique vs the total lateral meniscectomy state). Resultant forces in the meniscal allograft were 50% to 60% of the resultant forces in the intact lateral meniscus in response to all loading conditions at all flexion angles ( P < .05). Overall, no significant differences between lateral MAT techniques were observed regarding kinematics and forces ( P > .05). Conclusion: Lateral MAT partially restored medial translation of the tibia, and the resultant forces in the meniscal allograft were only 50% to 60% of the intact lateral meniscus forces in the cadaver model. In the majority of testing conditions, no significant changes of the in situ force in the anterior cruciate ligament were observed. Surgeons should consider the potential benefits of lateral MAT when deciding the appropriate treatment for symptomatic patients after lateral meniscectomies. Both lateral MAT techniques functioned similarly. Clinical Relevance: The load-bearing function of the meniscal allograft observed in this study may be beneficial in ameliorating the short- and long-term disability associated with lateral meniscal deficiency.
China’s Policy on Science and Technology: Implications for the Next Industrial Transition
Authors: Agarwala Nitin , Chaudhary Rana Divyank 
Published: June 2019

Since the formation of the People’s Republic of China in 1949, Science and Technology (S&T) has been the focus area for Chinese economic development. However, little was known about China’s scientific mission, working and policies till the end of 1978. Based on the studies and the developments made, one can say that China’s S&T policy has evolved through four phases. The first phase (1949–1959) supported the development of heavy industries along the Soviet lines; the second phase (1959–1976) witnessed economic stagnation and ideological domination of technology projects; the third phase (1976–2001) focused on market-driven and product-driven research and now in her fourth phase of S&T development, since 2002, China has aimed to develop high technology industries and the nascent clean-energy or green technology with a focus on innovation. These policy changes entirely reformed the way China’s industrial enterprises are being managed today as compared to earlier years. However, some thinkers do not consider these reforms as sweeping or successful. In order to better appreciate the implications of the S&T policy in China’s industrial transition, the article analyses the role and effects of the policy that has assisted in enhancing the country’s S&T strength and improving the competitiveness, while supporting its economic and social development.
Post-Traumatic Growth, Dissociation, and Sexual Revictimization in Female Childhood Sexual Abuse Survivors
Authors: Lahav Yael , Ginzburg Karni , Spiegel David 
Published: June 2019

Background: Childhood sexual abuse (CSA) survivors are at high risk of sexual revictimization. At the same time, some survivors report positive transformations resulting from the traumatic experience, a phenomenon known as post-traumatic growth (PTG). Although one might expect PTG to be related to reduced risk of revictimization, the link between PTG and revictimization has not been investigated. Furthermore, mixed findings regarding the associations between PTG and distress imply that the effects of PTG are multifaceted. One potential explanation may be that dissociation shapes the implications of PTG, making it more like denial than adaptive processing of traumatic experience. This longitudinal study explores (a) the associations between PTG and sexual revictimization and (b) the moderating role of dissociation within the associations between PTG and revictimization. Method: Participants were 111 female CSA survivors who participated in a 6-month efficacy trial evaluating the effectiveness of group psychotherapy for CSA survivors with HIV risk factors. Results: Dissociation moderated the associations between PTG and revictimization: Whereas PTG had nonsignificant effects on revictimization in participants with low dissociation, it predicted elevated levels of revictimization in participants with high dissociation. Conclusions: Reports of PTG among some CSA survivors might mirror dissociative beliefs that increase their risk of revictimization.
Anti-thrombogenic coatings for devices in neurointerventional surgery: Case report and review of the literature
Authors: Henkes Hans , Bhogal Pervinder , Aguilar Pérez Marta , Lenz-Habijan Tim , Bannewitz Catrin , Peters Marcus , Sengstock Christina , Ganslandt Oliver , Lylyk Pedro , Monstadt Hermann 
Published: June 2019

Background: Stent-assisted coiling and extra-saccular flow diversion require dual anti-platelet therapy due to the thrombogenic properties of the implants. While both methods are widely accepted, thromboembolic complications and the detrimental effects of dual anti-platelet therapy remain a concern. Anti-thrombogenic surface coatings aim to solve both of these issues. Current developments are discussed within the framework of an actual clinical case. Case description: A 33-year-old male patient lost consciousness while doing sport and was administered 500 mg acetylsalicylic acid on site. Computed tomography revealed a massive subarachnoid haemorrhage, and digital subtraction angiography showed an aneurysm of the right middle cerebral artery. Stent-assisted coiling using a neck bridging device with a hydrophilic coating (pCONUS_HPC) was considered as an appropriate approach. Another 500 mg acetylsalicylic acid IV was given. After the single anti-platelet therapy was seen to be effective, a pCONUS_HPC was implanted, and the aneurysm sac subsequently fully occluded using coils. No thrombus formation was encountered. During the following days, 2 × 500 mg acetylsalicylic acid IV daily were required to maintain single anti-platelet therapy, monitored by frequent response testing. Follow-up digital subtraction angiography after 13 days confirmed the occlusion of the aneurysm and the patency of the middle cerebral artery. Conclusion: A variety of ways to reduce the thrombogenicity of neurovascular stents is discussed. Hydrophilic surface coatings are a valid concept to improve the haemocompatibility of neurovascular implants while avoiding the use of dual anti-platelet therapy. Phosphorylcholine and phenox hydrophilic polymer coating are currently the most promising candidates. This concept is supported by anecdotal experience. However, formalised registries and randomised trials are currently being established.
Cuboid Edema Syndrome Following Fixation of Proximal Fifth Metatarsal Fractures in Professional Athletes
Authors: Roberts Lauren , Bernasconi Alessio , Netto Cesar de Cesar , Elliott Andrew , Hamilton William , O’Malley Martin 
Published: June 2019

Stress fractures of the proximal fifth metatarsal are common injuries in elite athletes. Fixation using an intramedullary screw represents the most popular surgery performed for treating these injuries, with excellent results in most cases. However, multiple reports in the literature highlight the possibility of painful hardware, usually related to the presence of the screw head, following intramedullary fixation In this case report, we outline 4 cases of professional athletes who developed lateral-based foot symptoms following complete healing of their surgically treated proximal fifth metatarsal fractures and were found to have significant cuboid edema on magnetic resonance images. We also outline recommendations regarding specific surgical technique considerations aiming to minimize this possible complication. Level of Evidence: Level V: Case report.
Lipoprotein Glomerulopathy in a Hispanic Female: A Case Report and Literature Review
Authors: Majeed Nasma K. , McLaughlin Jeanette , Gonzalez Miguel 
Published: June 2019

Rationale: Lipoprotein glomerulopathy (LPG) is a rare renal disorder that features glomerular capillary lipoprotein thrombi, proteinuria, and progressive renal failure. Although most reported cases describe involvement in Asian patients, occurrence in Caucasian and other ethnicities has also been reported. Presenting concern: A 28-year-old Hispanic female with a past medical history of hypertension, high cholesterol, gastritis, and a strong family history of renal disease presented with abdominal pain. On admission, her blood pressure was elevated. A computed tomography scan was unremarkable. Her laboratory studies showed proteinuria, high creatinine level, and an abnormal lipid profile. Diagnosis: The kidney biopsy showed glomerular capillary lipoprotein thrombi that stained positively for Oil-Red-O, confirming the lipid nature of the material consistent with LPG. Intervention: After stabilizing her blood pressure, the patient was started on fenofibrate to treat her high cholesterol and improve her renal function. Outcome: Her lipid profile and renal function were initially improved. However, after one year of treatment, her renal function started to decline and the patient was referred to a transplant center for further management. Novel finding: To the best of our knowledge, this the first reported incidence of LPG in a Hispanic female.
Impact of Predialysis Psychosocial Conditions on Kidney Transplant Recipient Survival: Evidence Using Propensity Score Matching
Authors: Fu Rui , Coyte Peter C. 
Published: June 2019

Background: An increased number of end-stage renal disease patients suffer psychosocial conditions and may experience delayed access to transplantation due to listing restrictions. However, it remains to be shown whether preexisting psychosocial conditions confer an independent risk factor of poor posttransplant outcomes. Objective: We addressed this gap in knowledge by conducting a retrospective cohort study to investigate an independent association between the risk of death after transplant and having a diagnosis of psychosocial conditions 1 year prior to starting dialysis. Methods: All cases of adult deceased-donor kidney transplantation performed in Ontario, Canada, between April 1, 2002, and March 31, 2013, were used. Propensity score matching was applied to adjust for potential endogenous bias of using predialysis psychosocial status to predict posttransplant mortality. Survival analysis techniques, including Kaplan-Meier curves and Cox proportional hazards modeling, were also used. Results: Our results indicate a 49.4% (hazard ratio [HR] = 1.494 [95% confidence interval (CI) = 1.168-1.913]) increased relative risk of posttransplant death to be associated with predialysis psychosocial conditions, when other factors are held constant. The effect is significant ( P = .001) and is independent of other known predictors of death including advanced age. Conclusions: Findings from this study offered strong support for the development of psychosocial evaluation to screen candidates prior to transplant listing and early interventions for transplant candidates with psychosocial concerns.
How do you ‘know’ a tribal when you see one? How do you ‘see’ a tribal when you know one?
Authors: Pandya Vishvajit 
Published: June 2019

This article considers the formation of anthropological knowledge and ethnographic implications in the course of understanding and framing the category of ‘tribe’ on Andaman Nicobar Islands. Considering events from colonial and post-colonial histories of the Andaman and Nicobar Islands, the article argues that the process of classification and reclassification, motivated by anthropological knowledge and the drive for welfare, creates a discourse that tends to deny cultural and social differentiation or diversity among the various tribal communities that inhabit different parts of the Island archipelago. Statist definitions in other words serve to reduce the conditions and identities of tribal groups into categories of the ‘primitive’, ‘particularly vulnerable’ or presently as just ‘vulnerable’. While such categorisations may have its uses in the allocation of welfare budgets, the sole focus on the category of ‘vulnerability’ obfuscates a more nuanced understanding of the conditions of life and well being among such communities. The article asks if our ‘categorising impulse’ restrains us from thinking of and problematising questions of ‘agency’ in the self-description and assertion of tribal identities. Why is it that the state or the non-tribal outsider remains indifferent to the deconstruction of the statist category of the ‘vulnerable’? Could the discourse of the ‘changeless de- historicised’ Andaman islander suit the ‘non- tribal’ status quo in the Islands?
Interesting overlooked findings in melanocytic nevi
Authors: Xavier-Júnior José Cândido Caldeira , Ocanha-Xavier Juliana Polizel , Camilo-Júnior Deolino João , D’ávilla Solange Correa Garcia Pires , Mattar Neivio José 
Published: June 2019

AbstractSince histological analysis is the gold standard for melanoma diagnose, to understand possible findings in nevi is the first step to avoid diagnostic errors. The aim of this paper is to describe several histological features that can be found in nevi and may be misunderstood or overlooked. Histological findings were organized into two groups: 1- adaptive findings (neurotization, sebaceous alteration, adipose metaplasia, amyloid deposition and calcifications, pseudovascular lacunae), 2- findings that can occasionally be associated with malignancy (suspicious for angiolymphatic invasion, perineural infiltration, deep mitosis, muscle infiltration). Each finding by itself does not mean that lesion is malignant. We have selected 13 cases of benign intradermal or compound melanocytic nevi excised for aesthetical purposes from our collection to illustrate possible overlooked findings in melanocytic nevi.