bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Evolving Impact of COVID-19 on Medical Student Orthopedic Education: Perspectives From Medical Students in Different Phases of the Curriculum
Authors: Richardson Michelle A. , Islam Wasif , Magruder Matthew 
Published: September 2020

Introduction: The world-wide lockdown caused by Coronavirus Disease 2019 (COVID-19) has upended the trajectories of lives everywhere. The medical profession has been on the front lines of this rapidly developing situation, which in turn has called for unprecedented changes in the medical school curriculum. These changes have severe implications for medical students interested in applying to competitive surgical specialties like orthopedics. Methods: As medical students in 3 different class years pursuing orthopedic surgery, we provide our perspectives on the impact that COVID-19 has had on medical student orthopedic education. Results: With the removal of away rotations and a shift to virtual interviews, rising fourth year medical students are arguably the most impacted as they prepare for the orthopedic residency application process. Third year students, who are in the exploratory phase of choosing a specialty, also face uncertainties in the shift to a “new” clerkship experience that may (1) be of shorter duration, (2) implement shifts to limit overcrowding of clinical space, and (3) increase the use of telehealth over direct patient contact. Discussion: The COVID-19 pandemic has altered the course of medical students’ orthopedic education in unprecedented ways. We believe the following suggestions may be helpful for students seeking alternative, supplemental ways of learning: (1) read up on major orthopedic journals, (2) reach out to orthopedic surgeons in areas of interest, (3) reach out to program directors/medical clerkship directors/program coordinators for opportunities to attend their educational curriculum virtually, (4) attend online lectures and hospital grand rounds, and (5) practice suturing technique with a practice kit. Conclusions: While the medical education landscape remains uncertain amid the evolving conditions of COVID-19, as medical students we strive to learn from this pandemic and respond to future unforeseen challenges with resilience, dedication, and compassion: all qualities we admire in orthopedic surgeons.
Total Thyroidectomy as an Ambulatory Procedure in Community Practice
Authors: Compton Rebecca A. , Simmonds Jonathan C. , Dhingra Jagdish K. 
Published: September 2020

ObjectiveIncreasingly, total thyroidectomy is offered as an ambulatory procedure. Most of the relevant outcomes research derives from academic centers, but most thyroid surgeries are performed in the community. The goal of this study is to evaluate the safety of total thyroidectomy performed as an ambulatory procedure in a community otolaryngology practice.Study DesignRetrospective review and national database analysis.SettingA single community otolaryngology practice.MethodsAdult patients undergoing total thyroidectomy by a single otolaryngologist between 2013 and 2019 were divided into 2 cohorts: planned ambulatory and planned admission. Charts were reviewed for demographics and surgical outcomes in the 2 groups. The Healthcare Cost and Utilization Project databases for New York and Florida between 2015 and 2016 were also analyzed to compare outcomes of thyroidectomy as an ambulatory surgery between different practice settings.ResultsA total of 99 total thyroidectomies were performed during the study time period; 66 of 99 (67%) were planned as ambulatory procedures and 33 of 99 (33%) were planned admissions. Five of the 66 (8%) planned outpatient surgeries required admission. Complications of vocal fold dysfunction, symptomatic hypocalcemia, and seroma formation were more commonly seen in the inpatient cohort. Only 2 ambulatory patients required admission after discharge. Nationally, odds of complication were higher for ambulatory total thyroidectomy at nonteaching practice sites, which is not duplicated in our study.ConclusionsAmbulatory total thyroidectomy can be undertaken safely in the community in carefully selected cases.
Reduced immunogenicity of the adjuvanted recombinant zoster vaccine after hematopoietic cell transplant: a pilot study
Authors: Camargo Jose F. , Lin Rick Y. , Natori Yoichiro , Anderson Anthony D. , Alencar Maritza C. , Wang Trent P. , Morris Michele I. , Komanduri Krishna V. 
Published: September 2020

Key Points
Shingrix is poorly immunogenic following allogeneic hematopoietic cell transplantation independent of age, CD4, and B-cell recovery. In hematopoietic cell transplantation recipients with antibody response to the vaccine, varicella zoster virus reactivation risk is not null.
Prebiotics protect against acute graft-versus-host disease and preserve the gut microbiota in stem cell transplantation
Authors: Yoshifuji Kota , Inamoto Kyoko , Kiridoshi Yuko , Takeshita Kozue , Sasajima Satoshi , Shiraishi Yukiko , Yamashita Yuko , Nisaka Yuko , Ogura Yukari , Takeuchi Rie , Toya Takashi , Igarashi Aiko , Najima Yuho , Doki Noriko , Kobayashi Takeshi , Ohashi Kazuteru , Suda Wataru , Atarashi Koji , Shiota Atsushi , Hattori Masahira , Honda Kenya , Kakihana Kazuhiko 
Published: September 2020

Abstract
Acute graft-versus-host disease (aGVHD) is a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Therefore, management of aGVHD is important for successful transplantation. Mucosal damage and alteration of the gut microbiota after allo-HSCT are key factors in the development of aGVHD. We conducted a prospective study to evaluate the ability of prebiotics, which can alleviate mucosal damage and manipulate the gut microbiota, to mitigate posttransplantation complications, including aGVHD. Resistant starch (RS) and a commercially available prebiotics mixture, GFO, were administered to allo-HSCT recipients from pretransplantation conditioning to day 28 after allo-HSCT. Prebiotic intake mitigated mucosal injury and reduced the incidence of all aGVHD grades combined and of aGVHD grades 2 to 4. The cumulative incidence of skin aGVHD was markedly decreased by prebiotics intake. Furthermore, the gut microbial diversity was well maintained and butyrate-producing bacterial population were preserved by prebiotics intake. In addition, the posttransplantation fecal butyrate concentration was maintained or increased more frequently in the prebiotics group. These observations indicate that prebiotic intake may be an effective strategy for preventing aGVHD in allo-HSCT, thereby improving treatment outcomes and the clinical utility of stem cell transplantation approaches. This study was registered on the University Hospital Medical Information Network (UMIN) clinical trials registry (https://www.umin.ac.jp/ctr/index.htm) as #UMIN000027563.
Review and Analysis of Key Techniques in Marine Sediment Sampling
Authors: He Shudong , Peng Youduo , Jin Yongping , Wan Buyan , Liu Guangping 
Published: September 2020

AbstractDeep-sea sediment is extremely important in marine scientific research, such as that concerning marine geology and microbial communities. The research findings are closely related to the in-situ information of the sediment. One prerequisite for investigations of deep-sea sediment is providing sampling techniques capable of preventing distortion during recovery. As the fruit of such sampling techniques, samplers designed for obtaining sediment have become indispensable equipment, owing to their low cost, light weight, compactness, easy operation, and high adaptability to sea conditions. This paper introduces the research and application of typical deep-sea sediment samplers. Then, a representative sampler recently developed in China is analyzed. On this basis, a review and analysis is conducted regarding the key techniques of various deep-sea sediment samplers, including sealing, pressure and temperature retaining, low-disturbance sampling, and no-pressure drop transfer. Then, the shortcomings in the key techniques for deep-sea sediment sampling are identified. Finally, prospects for the future development of key techniques for deep-sea sediment sampling are proposed, from the perspectives of structural diversification, functional integration, intelligent operation, and high-fidelity samples. This paper summarizes the existing samplers in the context of the key techniques mentioned above, and can provide reference for the optimized design of samplers and development of key sampling techniques.
Flow deformation characteristics of African blackwood, Dalbergia melanoxylon
Authors: Nakai Kazushi , Tanaka Soichi , Kanayama Kozo , Yoshimura Tsuyoshi 
Published: September 2020

AbstractAfrican blackwood (ABW: Dalbergia melanoxylon) is a valuable tree in Tanzanian local community forests, and heartwood has been mainly utilized as an irreplaceable material in musical instruments, e.g., clarinet, oboe and piccolo. Since its use is generally for the production of musical instruments only, most of the harvested volume is wasted due to defects that would affect the quality of final products. Wood flow forming can transform bulk woods into materials in temperature/pressure-controlled mold via plastic flow deformation. The main object of this study was to evaluate the deformation characteristics of ABW heartwood in developing the potential of wasted ABW parts in terms of the effective material use. The deformation characteristics of heartwood were examined by free compression tests. Specimens were compressed along the radial direction at 120 °C, and air-dried heartwood was dramatically deformed in the tangential direction. The plastic flow deformation of ABW was amplified by the presence of both extractives and moisture. In particular, the ethanol/benzene (1:2, v/v) soluble extractives in heartwood may have contributed to flow deformation. The results of the dynamic mechanical analysis showed that the air-dried heartwood exhibited softening in a temperature range over 50 °C. The ethanol/benzene-soluble extractives contributed to the softening behavior. The clarified deformation characteristics of ABW can contribute to more efficient material use of local forests.
Determination of color-changing effects of bleaching chemicals on some heat-treated woods
Authors: Akkuş Memiş , Budakçı Mehmet 
Published: September 2020

AbstractThe aim of this study was to use bleaching chemicals to remove the discoloration occurring on the surface of wood after heat treatment in order to restore the natural color of the wood. For this purpose, samples prepared from Scots pine (Pinus sylvestrisL.), sessile oak (Quercus petraeaL.), Eastern beech (Fagus orientalisL.), and Uludağ fir (Abies bornmuellerianaMattf.) were exposed to heat treatment at temperatures of 140 and 160 °C for time periods of 3, 5, and 7 h. Bleaching solutions S1 (NaOH + H2O2), S2 (NaSiO3 + H2O2), and S3 (H2C2O4) at a concentration of 18% were then applied to the surface of the materials and the color change was determined according to ASTM D 2244 standard. Depending on the heat treatment temperature and duration, an increase in total color change values was detected on the surfaces of the materials and the color of the samples became darker. The total color change values decreased after bleaching with the S2 solution in the heat-treated Scots pine and fir samples, with the S3 solution in the beech samples, and with the S1, S2, and S3 solutions in the oak samples. The findings showed that by using bleaching chemicals to lighten wood materials darkened after heat treatment, it is possible to obtain results close to the natural color values.
HIV knowledge and associated factors among young Ethiopians: application of multilevel order logistic regression using the 2016 EDHS
Authors: Dadi Teshome Kabeta , Feyasa Merga Belina , Gebre Mamo Nigatu 
Published: September 2020

Abstract
Background
Human Immunodeficiency virus continues to be a major global health problem infecting 75 million and killing 32 million people since the beginning of the epidemic. It badly hit Sub Saharan Africa than any country in the world and youths are sharing the greatest burden. The study aims to assess the level of HIV-knowledge and its determinants among Ethiopian youths using the 2016 Ethiopia Demographic and Health Survey data.

Methods
A nationally representative 2016 Ethiopian Demographic and Health Survey data were used. A total of 10,903 youths comprising 6401 females and 4502 males were included in the study. Descriptive statistics and multilevel order logistic regression were used and confidence interval was used to declare statistical significance in the final model.

Results
The mean age and SD of youths included in this study was 19.10 (±2.82). Among Ethiopian youths, 20.92% (95% CI: 18.91, 23.09%) had low knowledge of HIV whereas, 48.76% (95% CI: 47.12, 50.41%) and 30.31% (95% CI: 28.51, 32.18%) of them had moderate and comprehensive HIV knowledge respectively. Being male, access to TV and radio, ever tested for HIV/AIDS, owning a mobile telephone, and attending primary school and above compared to non-attendants were associated with having higher HIV knowledge. But, dwelling in rural Ethiopia, being in the Protestant and Muslim religious groups as compared to those of Orthodox followers and being in married groups were associated with having lower HIV knowledge. Approximately, 12% of the variation in knowledge of HIV was due to regions.

Conclusion
Only one-third of Ethiopian youths have deep insight into the disease, whereas, nearly one-fifth of them have lower HIV-knowledge. There is a significant disparity in HIV-related knowledge among Ethiopian youths living in different regions. Rural residents, less educated, female, and married youths have less knowledge of HIV as compared to their counterparts. Youths who do not have a mobile phone, who lack health insurance coverage, and who have limited access to media have less knowledge about HIV. Therefore, the due focus should be given to the aforementioned factors to minimize the disparities between regions and to enhance Ethiopian youths’ HIV-knowledge.
Association between circulating microRNAs 486, 146b and 15b and serum betatrophin levels in obese; type 2 diabetic and non-diabetic children
Authors: Mohany Khalid M. , Al rugaie Osamah , Al-wutayd Osama , Al-Nafeesah Abdullah , Saleem Tahia H. 
Published: September 2020

Abstract
Background
This study tested the association between serum levels of microRNA-486, −146b and -15b and betatrophin in normal and obese children with/without type 2 diabetes mellitus (T2DM).

Methods
the study included 120 children; divided into three groups: G1 (50 healthy), G2 (35 obese) and G3 (35 obese with T2DM). The levels of microRNA-486, 146b and 15b and serum betatrophin were measured by their corresponding methods.

Results
serum microRNA-486, −146b, −15b and betatrophin levels were significantly high in G3 followed by G2 then G1 (p = 0.002, > 0.001, > 0.001, and > 0.001, respectively). Especially in G3, these levels correlated positively with the BMI percentile (r = 0.44, 0.58, 0.38, and 0.46, p = 0.007, > 0.001, 0.021, and 0.005, respectively), serum glucose (r = 0.56, 0.49, 0.82, 0.60, and 0.42, p > 0.001, 0.003, > 0.001, and > 0.001, respectively) and HbA1c% (r = 0.56, 0.39, 0.66, and 0.42, p > 0.001, 0.019, > 0.001, and 0.032, respectively) while, showed negative correlations with correlated with serum insulin levels (r = − 0.37, − 0.42, − 0.58, and − 0.41, p = 0.021, 0.012, > 0.001 and 0.013, respectively) and with serum C-peptide levels (r = − 0.76, − 0.50, − 0.35 and − 0.42, p > 0.001, 0.002, 0.036 and 0.011, respectively). Serum betatrophin levels correlated positively with microRNA-486, −146b and -15b levels in G2 (r = 0.35, 0.80, and 0.67, p = 0.036, > 0.001, and,> 0.001, respectively), and in G3 (r = 0.57, 0.36, and 0.38, p > 0.001, 0.029 and, 0.023, respectively).

Conclusions
Circulating microRNA-486, 146b and 15b increase significantly in obese children with T2DM and these levels correlate positively with serum betatrophin levels. Further studies are required to test the role of targeting of these microRNAs and betatrophin in the timely management of obesity and/or T2DM in children.
Exploring patient-centered aspects of home care communication: a cross-sectional study
Authors: Höglander Jessica , Eklund Jakob Håkansson , Spreeuwenberg Peter , Eide Hilde , Sundler Annelie J. , Roter Debra , Holmström Inger K. 
Published: September 2020

Abstract
Background
Communication is a cornerstone in nursing and aims at both information exchange and relationship building. To date, little is known about the naturally occurring communication between older persons and nurses in home care. Communication might heal through different pathways and a patient- or person-centered communication could be important for health and well-being of older persons. However, the delivery of individualized home care is challenged by routines and organizational demands such as time constraints. Therefore, the aim of this study was to explore the patient-centered aspects of home care communication between older persons and registered nurses.

Methods
In total 37 older persons (aged 65 years or older) and eleven RNs participated in 50 audio-recorded home care visits. Roter Interaction Analysis System (RIAS) was used to code verbal communication. A ratio from these codes, establishing the degree of patient-centeredness, was analyzed using a Generalized Linear Mixed Model.

Results
The present home care communication contained more socio-emotional than task-oriented communication and the emotional tone was largely positive. The global affect ratings reflected an overall positive tone (m = 39.88, sd = 7.65), with higher ratings on dimensions of, for example, responsiveness/engagement and interactivity or interest were more frequent than those that may be considered as less-positive emotions (m = 15.56, sd = 3.91), e.g. hurried, dominance or anger. The ratio of the degree of patient-centered communication in the home care visits was an average of 1.53, revealing that the communication could be considered as patient-centered. The length of the visits was the only characteristic significantly associated with the degree of patient-centeredness in the communication, with a peak in patient-centeredness in visits 8–9 min long. Sex, age or procedural focus showed no significant effects on the degree of patient-centeredness.

Conclusion
Overall, the degree of patient-centeredness and a positive emotional tone, which might have a positive outcome on older persons’ health, was high. Longer visits provided a higher degree of patient-centeredness, but no linear increase in patient-centeredness due to length of visit could be observed. The findings can be used for education and training of nurses, and for providing individualized care, e.g. patient- or person-centered care.
Investigating prevalence job stress and illness among hospital staff providing health tourism services (HSPHTS) in Iran
Authors: Hemmati Farhad , Dabbaghi Fatemeh , Mahmoudi Ghahraman 
Published: September 2020

Abstract
Background
Health tourism or treatment tourism is one of threatening fields that causes (added s) increase in prevalence of job stress and illnesses among hospital staff of providing health tourism services (HSPHT). The aim of this study is to determine the prevalence of job stress and illnesses among hospitals staff of providing health tourism services in touristic cities as Tehran and Shiraz in Iran.

Methods
This cross-sectional, descriptive-analytical study was carried out among the staff of 10 hospitals providing health tourism services in cities of Tehran and Shiraz, Iran, in 2019. In these hospitals, 1250 staff were chosen by cluster sampling method from each job task as doctor, nurse, office worker, and paramedical and cleaner worker. Also, 1100 staff working in other general hospitals (non-HSPHTS) were selected as the control sample. Then, the demographic information and prevalence of job stress were gathered by Osipow job stress questionnaire and the illnesses were accumulated by self-reporting questionnaire. Finally, data were analyzed in SPSS 20 software. Chi-square and Pearson’s parametric tests were used in the study.

Results
Prevalence of illnesses among HSPHTS was more than that in general hospitals (Pvalue < 0.05). The most prevalent illnesses were respiratory (11.08%), digestive (9.2%), and cutaneous (9.04%), respectively. Also, the prevalence of job stress among HSPHTS was more than that in general hospitals (Pvalue < 0.05). There was a significant relationship between prevalence of illnesses and job stress among the staff of hospitals and the increase in the number of visited tourists in the hospitals providing health tourism services.

Conclusion
Results of the study showed that the prevalence of job stress (%33.76) and illnesses (%43.66) among the HSPHTS was respectively 2 and 2.6 times more than that among the staff of general hospitals. Thus, it is necessary to observe sanitary actions and considerations more seriously in these hospitals.
Comorbidity between depression and anxiety: assessing the role of bridge mental states in dynamic psychological networks
Authors: Groen Robin N. , Ryan Oisín , Wigman Johanna T. W. , Riese Harriëtte , Penninx Brenda W. J. H. , Giltay Erik J. , Wichers Marieke , Hartman Catharina A. 
Published: September 2020

Abstract
Background
Comorbidity between depressive and anxiety disorders is common. A hypothesis of the network perspective on psychopathology is that comorbidity arises due to the interplay of symptoms shared by both disorders, with overlapping symptoms acting as so-called bridges, funneling symptom activation between symptom clusters of each disorder. This study investigated this hypothesis by testing whether (i) two overlapping mental states “worrying” and “feeling irritated” functioned as bridges in dynamic mental state networks of individuals with both depression and anxiety as compared to individuals with either disorder alone, and (ii) overlapping or non-overlapping mental states functioned as stronger bridges.

Methods
Data come from the Netherlands Study of Depression and Anxiety (NESDA). A total of 143 participants met criteria for comorbid depression and anxiety (65%), 40 participants for depression-only (18.2%), and 37 for anxiety-only (16.8%) during any NESDA wave. Participants completed momentary assessments of symptoms (i.e., mental states) of depression and anxiety, five times a day, for 2 weeks (14,185 assessments). First, dynamics between mental states were modeled with a multilevel vector autoregressive model, using Bayesian estimation. Summed average lagged indirect effects through the hypothesized bridge mental states were compared between groups. Second, we evaluated the role of all mental states as potential bridge mental states.

Results
While the summed indirect effect for the bridge mental state “worrying” was larger in the comorbid group compared to the single disorder groups, differences between groups were not statistically significant. The difference between groups became more pronounced when only examining individuals with recent diagnoses (< 6 months). However, the credible intervals of the difference scores remained wide. In the second analysis, a non-overlapping item (“feeling down”) acted as the strongest bridge mental state in both the comorbid and anxiety-only groups.

Conclusions
This study empirically examined a prominent network-approach hypothesis for the first time using longitudinal data. No support was found for overlapping mental states “worrying” and “feeling irritable” functioning as bridge mental states in individuals vulnerable for comorbid depression and anxiety. Potentially, bridge mental state activity can only be observed during acute symptomatology. If so, these may present as interesting targets in treatment, but not prevention. This requires further investigation.