Postoperative Fever Evaluation Following Lumbar Fusion Procedures

Benjamin C. Mayo,Brittany E. Haws,Daniel D. Bohl,Philip K. Louie,Fady Y. Hijji,Ankur S. Narain,Dustin H. Massel,Benjamin Khechen,Kern Singh 대한척추신경외과학회 2018 Neurospine Vol.15 No.2

Objective: This study aimed to determine the incidence of postoperative fever, the workup conducted for postoperative fever, the rate of subsequent fever-related diagnoses or complications, and the risk factors associated with fever following lumbar fusion. Methods: A retrospective review of patients undergoing lumbar fusion was performed. For patients in whom fever (≥38.6°C) was documented, charts were reviewed for any fever workup or diagnosis. Multivariate regression was used to identify independent risk factors for the development of postoperative fever. Results: A total of 868 patients met the inclusion criteria, of whom 105 exhibited at least 1 episode of fever during hospitalization. The first documentation of fever occurred during the first 24 hours in 43.8% of cases, during postoperative hours 24–48 in 53.3%, and later than 48 hours postoperatively in 2.9%. At least 1 component of a fever workup was conducted in 47 of the 105 patients who had fever, resulting in fever-associated diagnoses in 4 patients prior to discharge. Three patients who had fever during the inpatient stay developed complications after discharge. On multivariate analysis, operations longer than 150 minutes (relative risk [RR], 1.66; p=0.015) and narcotic consumption greater than 85 oral morphine equivalents on postoperative day 0 (RR, 1.53; p=0.038) were independently associated with an increased risk of developing postoperative fever. Conclusion: The results of this study suggest that inpatient fever occurred in roughly 1 in 8 patients following lumbar fusion surgery. In most cases where a fever workup was performed, no cause of fever was detected. Longer operative time and increased early postoperative narcotic use may increase the risk of developing postoperative fever.

Review on the comparison of effectiveness between denosumab and bisphosphonates in post-menopausal osteoporosis

Biju Benjamin,Mridula Ambwani Benjamin,Myint Swe,Sandheep Sugathan 대한골다공증학회 2016 Osteoporosis and Sarcopenia Vol.2 No.2

Objective: Osteoporosis is a rapidly rising cause of concern for elderly patients. Various classes of drugs are available in the market. Bisphosphonates are considered as a first-line therapy for the prevention and treatment. Denosumab is an antiresorptive agent which is a RANK ligand inhibitor. There is a scarcity of comparison between these two classes of drugs. The aim of this study is to compare efficacy of Bisphosphonates and Denosumab in various parameters. Materials and methods: Literature search was done for randomized controlled trials (RCTs) comparing bisphosphonates with denosumab. RCTs with a treatment period of at least one year with a baseline bone mineral density (BMD) and bone turnover markers (BTM) and follow up values at one year were included in the study. All included studies were also analysed for complications. The study has also been registered in PROSPERO International prospective register of systematic reviews. Results: A total of five RCTs were identified providing data on 3751 participants. In all five studies, the BMD changes at both hip and spine were statistically significant in favour of denosumab. Result was similar in three studies that studied BMD changes at the wrist. Denosumab also produced significant reduction in BTM as early as one month, but at one year there was no difference compared to the bisphosphonates. There was no statistically significant differences in the complication rates. Conclusion: Though both bisphosphonates and denosumab were effective with similar side effects, the latter was statistically superior in increasing the BMD and reducing the BTM. © 2016 The Korean Society of Osteoporosis. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

How Americans Feel About Asian Countries and Why

Benjamin I. Page,Julia Rabinovich,David G. Tully 동아시아연구원 2008 Journal of East Asian Studies Vol.8 No.1

Americans feelings about foreign countries are embedded in foreign policy belief systems and affect policy preferences. The analysis of nine surveys of the U.S. general public conducted between 1978 and 2006 indicates that on average Americans have had rather lukewarm or slightly cool, nearly neutral feelings toward China, India, South Korea, Taiwan and Indonesia; warm feelings toward Japan and Australia; and cold feelings toward North Korea and (at least since 2001) toward Pakistan and Afghanistan.Individuals feelings are affected by certain personal and social characteristics. High levels of formal education tend to make people feel considerably warmer toward most of these countries especially Pakistan, Afghanistan, and India. Education has part of its effect through increased information: those who know more about the world generally express warmer feelings. But most important are internationalist attitudes, especially putting a relatively low priority on U.S. domestic threats and concerns, embracing capitalism and world markets, and espousing world antipoverty goals. National security considerations play only a limited part. Policy implications are discussed.

Everyday Life in the North Korean Revolution, 1945-1950

Benjamin Young(서평자) 고려대학교 한국사연구소 2015 International Journal of Korean History Vol.20 No.2

Contact Tools in Japanese Acupuncture: An Ethnography of Acupuncture Practitioners in Japan

Benjamin CW. Chant,Jeanne Madison,Paul Coop,Gudrun Dieberg 사단법인약침학회 2017 Journal of Acupuncture & Meridian Studies Vol.10 No.5

This study aimed to identify procedural elements of Japanese acupuncture, describe these elements in detail, and explain them in terms of the key thematic category of treatment principles. Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. In total, 38 participants were recruited by chain referral and emergent sampling. Data was collected through participant observation, interviews, and by analyzing documents. A total of 22 participants agreed to clinical observation; 221 treatments were observed with 172 patients. Seventeen consented to formal interviews and 28 to informal interviews. Thematic analysis was used to critically evaluate data. One especially interesting theme was interpreted from the data: a variety of contact tools were applied in treatment and these were manipulated by adjusting elements of form, speed, repetition, and pressure. Tapping, holding, pressing/pushing, and stroking were the most important ways contact tools were used on patients. Contact tools are noninvasive, painless, can be applied in almost any environment, and may be easily accepted by patients worldwide. Contact tool theory and practice may be successfully integrated into acupuncture curricula outside of Japan, used to inform clinical trials, and contribute to an expanded repertoire of methods for practitioners to benefit individual patients in international contexts.

Quantitation of meloxicam in the plasma of koalas (Phascolarctos cinereus) by improved high performance liquid chromatography

Benjamin Kimble,Kong Ming Li,Merran Govendir 대한수의학회 2013 JOURNAL OF VETERINARY SCIENCE Vol.14 No.1

An improved method to determine meloxicam (MEL)concentrations in koala plasma using reversed phase high performance liquid chromatography equipped with a photo diode array detector was developed and validated. A plasma sample clean-up step was carried out with hydrophilic- lipophilic copolymer solid phase extraction cartridges. MEL was separated from an endogenous interference using an isocratic mobile phase [acetonitrile and 50 mM potassium phosphate buffer (pH 2.15), 45:55(v:v)] on a Nova-Pak C18 4-μm (300 × 3.9 mm) column. Retention times for MEL and piroxicam were 8.03 and 5.56min, respectively. Peak area ratios of MEL to the internal standard (IS) were used for regression analysis of the calibration curve, which was linear from 10 to 1,000 ng/mL (r2 > 0.9998). Average absolute recovery rates were 91%and 96% for MEL and the IS, respectively. This method had sufficient sensitivity (lower quantitation limit of 10ng/mL), precision, accuracy, and selectivity for routine analysis of MEL in koala plasma using 250-μL sample volumes. Our technique clearly resolved the MEL peak from the complex koala plasma matrix and accurately measured MEL concentrations in small plasma volumes.

The confirmation of treatment effects in Japanese acupuncture

Benjamin Chant,Jeanne Madison,Paul Coop,Gudrun Dieberg 한국한의학연구원 2019 Integrative Medicine Research Vol.8 No.1

Background: Japanese acupuncture is gaining international recognition. However, previous research has failed to comprehensively describe the characteristics of Japanese acupuncture by not investigating it within the Japanese clinical environment. This qualitative ethnographic study aimed to identify unique and routine elements of Japanese acupuncture, describe these in detail and examine how they related to treatment principles. Methods: Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. Participants were recruited by chain referral and emergent sampling. Data were collected through participant observation and interviews as well as by analyzing documents. A total of 38 participants were recruited. A total of 22 agreed to clinical observation; 221 treatments were observed with 172 patients. Seventeen participants consented to participate in formal interviews and 28 to informal interviews. Thematic analysis was used to evaluate data. Results: That practitioners tended to confirm perceived effects of interventions during treatment, was a major theme interpreted from the data. Confirmation was performed continually throughout treatment and at three different levels of timing and anatomical areas (micro, meso and macro). Many markers signified treatment effects which were in general, perceived by observing and/or palpating body tissue. Belief in the instantaneous effects of treatment and the value of effect through technique exemplify the philosophical foundations of confirmation. Continually monitoring treatment results at a range of time and body location increments is an important element of Japanese acupuncture. Conclusion: This effect confirmation practice model promotes a system of constant feedback gained by repeated intervention and confirmation. This may be a unique feature of Japanese acupuncture.

Scope and Enforcement of European Competition Law by the Commission, European Courts and the Member States

Benjamin Raue 강원대학교 비교법학연구소 2013 江原法學 Vol.38 No.-

경쟁법은 일반 시장의 핵심적인 요소들 중에 하나이다. 경쟁 법은 세가지 특징들로 구성되어 있다. 카르텔의 금지, 남용의 통제 그리고 흡수합병의 통제, 처음 두 가지 특징들은 각각 Article 101, 102 TFEU와 시행에 관한 규정 1/2003에 규정되어 있고 세번째 특징은 ECMR과 법원의 고유한 판례들에 규정되어 있다. 국제적인 조약들과는 다르게 경쟁에 관한 규정들은 각각의 EU회원국들에게 직접적으로 적용할 수 있는 법이다. 이 규정들은 집행위원회와 회원국의 법원과 당국들에 의해 적용되고 시행된다. 유일하게 회원국들에 의해서 고려되는 몇몇 예외규정을 가진 기본적인 자유들과 다르게 TFEU의 경쟁 규정들은 회사들에도 적용된다. 복수의 주소를 가지는 결과, 책임있게 활동하고 있는 단체는 적당한 구제책들 뿐 만 아니라 효력이 있는 실체법과 절차법에 상당한 영향력을 가지고 있음에도 불구하고 시행책임과 밀접한 관련이 있는 그리고 변화하고 있는 시스템은 발달했다. 유럽연합은 유럽 경쟁법을 시행하기 위한 경쟁적인 시스템을 도입했다. 각국의 당국자들은 경쟁법 위반에 대해 벌금을 부과할 수 있고 상거래 참가자들은 그 규정들을 위반하지 않고 그 권리를 주장하면서 그 자신의 이익을 추구하는 것이 허락된다. 전체적으로 그것은 매우 효과적인 시스템이다. 그러나 공적 그리고 사적인 시행의 종합적인 결과물들이 대부분의 기업들에게 너무 가혹하게 부여되는지 아닌지를 지켜보아야 한다. 기업들이 상당한 공적 벌금과 고객들 또는 차별받는 경쟁자들로부터 매우 큰 위험 청구에 직면할 수 있다. 그런 경우가 거의 없다 하더라도 이것은 관련 기업이 파산을 하게 할 수 있다. 적정한 벌금? Competition law is one of the core elements of the common market. It comprises three pillars : the prohibition of cartels, abuse control and merger control. The first two pillars are regulated in art. 101 resp. 102 TFEU and their enforcement in Regulation 1/2003, the third pillaris laid down in the Merger Regulation(ECMR) and in the appropriate rules of court. Different from other international treaties these rules of competition are directly applicable law in every Member State of the EU without needing another act of transposition (principle of direct effect). The competition rules are applied and enforced both by the Commission and by the authorities and the courts of the Member States. Different from the fundamental freedoms, which-with few exceptions ?are addressed to the Member States only, the competition rules of the TFEU are also directed at companies. As a result of the multiple addressees, a system of changing and inter twined enforcement responsibilities has evolved although the responsible and/or acting body has substantial influence on the applicable substantive and procedural law as well as the available remedies. The European Union has established a competitive system to enforce European competition law. There are many players having a vital self-interest to support the Commission in stopping distortion of competition and punishing the offenders. National competition authorities may impose, collect and keep fines for competition law infringements, private players are allowed to pursue their own interests by stopping infringements and claiming damages with the support of national courts. Altogether, it is a fairly effective system. But it has to be observed whether the aggregated consequences of public and private enforcement will not render too severe for most undertakings. They do not only face substantial public fines but also high damages claims from customers or discriminated competitors. In not so little cases this may force the concerned undertaking to file for insolvency. A proportional fine?

Beliefs and values in Japanese acupuncture: an ethnography of Japanese trained acupuncture practitioners in Japan

Benjamin Chant,Jeanne Madison,Paul Coop,Gudrun Dieberg 한국한의학연구원 2017 Integrative Medicine Research Vol.6 No.3

Background: Japanese acupuncture is gaining international recognition. However, previous research has failed to comprehensively describe the characteristics of Japanese acupuncture by not investigating it within the Japanese clinical environment. This study aimed to identify unique and routine elements of Japanese acupuncture, describe these elements in detail, and examine how the current beliefs and attitudes of Japanese acupuncture practitioners related to philosophical concepts in their practice. Methods: Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. Japanese trained acupuncture practitioners were recruited by chain referral and emergent sampling. Data were collected through participant observation, interviews, and by analyzing documents. Thematic analysis was used to critically evaluate the data. Results: Thirty-eight participants were recruited. Of these participants, 22 agreed to clinical observation; 221 treatments were observed with 172 patients. Additionally, 17 participants consented to participate in formal semistructured interviews and 28 to informal unstructured interviews (fieldwork discussion). Besides “knowledge,” “beliefs and values” was a major theme interpreted from the data. Subthemes—including Zen Buddhism, effect through technique, instant effects of treatment, anatomical areas of significance, resolution of abnormalities, minimal stimulation, and patient comfort and customer service—were identified. Conclusion: Beliefs and values are an underrepresented, yet extremely important aspect of philosophical concepts influencing acupuncture practice in Japan. Uniquely Japanese beliefs and values that do not rely on a commitment to any spiritual or religious affiliations or proprietary knowledge of traditional or biomedicine may be successfully exported from Japan to advance acupuncture education, research and practice in international contexts.

Endovascular, treatment for complex aortic pathology

Benjamin Chua 대한외과학회 2014 대한외과학회 학술대회 초록집 Vol.2014 No.11