bluuebunny/crossref_metadata_2025_split huggingface dataset:
Explicating Practice Norms and Tensions Between Values in Resident Training in Family Medicine
Authors: Achkar Morhaf Al 
Published: April 2020

Abstract
Background. Residency programs have the intricate and complex role of training health care providers. But little is known about what residents and attendings consider norms of practice or the tensions among different values residents are expected to uphold. Thus, dialogical and reflective frameworks are being explored for resident learning.Methods. This study examined the use of facilitated conversations with groups of residents and attending physicians while reviewing video-recorded resident–patient interactions. The conversations were recorded, transcribed, and qualitatively analyzed.Results. A total of 24 residents and 10 attendings participated in conversations while separately and in parallel groups reviewing 15 resident sessions. Residents explicated the norms of practice and evaluated their performance, which often agreed with those of attending physicians in calling out important learning opportunities. When disagreement occurred, residents’ explications of their reasoning were often relevant and, via reflection and dialogue, helped clarify intentions that were not apparent in the videos. Residents and attendings often judged actions on more than one domain of value. For instance, if a resident addressed problems, built relationships in a timely manner, and acted autonomously without jeopardizing the quality of care, she satisfactorily performed her duty.Conclusions. Practice norms and value struggles were addressed by participants during reviews, which provided a promising framework for learning and assessment. Also, the non-hierarchical structure opened space to acknowledge a diversity of positions and for tensions among values to be explicated.
Resources Utilisation and Economic Burden of Percutaneous Vertebroplasty or Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures in China: A Retrospective Claim Database Study
Authors: Yang Dehong , Zhang Yanlei , Ma Xiao , Huo Li , Li Liran , Gao Yue 
Published: April 2020

Abstract
Background: Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF. Objective: To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective. Methods: A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate and re-surgery rate. Results: Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; females accounted for 79.54% of all cases. The median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference in re-surgery rate between PVP and PKP (p=0.3897). The median time to the re-surgery was 139 days. Mean costs per PVP/PKP-related hospitalisation were 35,906 CNY/5,122 USD (34,195 CNY/4,878USD for PVP, 44,414 CNY/6,336 USD for PKP, p<0.01). The overall costs of hospitalisation averaged 186.61 million CNY (26.62 million USD) per year in this metropolitan city. Conclusion: From 2015 to 2017, nearly one-third of OVCF inpatients received PVP/PKP and the re-surgery rate was 7.95%. PVP/PKP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis are critical in China.
Application of Loop-Mediated Isothermal Amplification combined with colorimetric and lateral flow dipstick visualization as the potential point-of-care testing for Corynebacterium diphtheriae
Authors: Zasada Aleksandra Anna , Wiatrzyk Aldona , Czajka Urszula , Brodzik Klaudia , Formińska Kamila , Mosiej Ewa , Prygiel Marta , Krysztopa-Grzybowska Katarzyna , Wdowiak Karol 
Published: April 2020

Abstract
Background Diphtheria outbreaks occurred in endemic areas and imported and indigenous cases are reported in UE/EEA. Because of the high infectiveness and severity of the disease, early and accurate diagnosis of each suspected case is essential for the treatment and management of the case and close contacts.The aim of the study was to establish simple and rapid testing methods based on Loop-Mediated Isothermal Amplification (LAMP) assay for the detection of Corynebacterium diphtheriae and differentiation between toxigenic and non-toxigenic strains.Methods Corynebacterium diphtheriae and Corynebacterium ulcerans isolates from the National Institute of Public Health-National Institute of Hygiene collection were used for the development of LAMP assay for the diagnosis of diphtheria and nontoxigenic C. diphtheriae infections. Various colorimetric methods for visualization of results were investigated. Sensitivity and specificity of the assay were examined using a collection of DNA samples from various gram-positive and gram-negative bacteria.Results The LAMP assay for tox and dtxR genes was developed. The sensitivity and specificity of the assay were calculated as 100%. The detection limit was estimated as 1.42 pg/µl concentration of DNA template when the reaction was conducted for 60 min. However, the detection limit was lowered 10 times for every 10 minutes of reduction in the time of incubation during the reaction. Positive results were successfully detected colorimetrically using hydroxynaphthol blue, calcein, QuantiFluor, and lateral flow Milenia HybriDetect dipsticks.Conclusion The assay developed in the study might be applied for point-of-care testing of diphtheria and other C. diphtheriae infections as well as for other infections caused by diphtheria-toxin producing Corynebacterium species. It is highly sensitive, specific, inexpensive, easy to use, and suitable for low-resource settings.
Glistening formation in a new hydrophobic acrylic intraocular lens
Authors: Yildirim Timur M. , Fang Hui , Schickhardt Sonja K. , Wang Qiang , Merz Patrick R. , Auffarth Gerd U. 
Published: April 2020

Abstract
Background: The formation of fluid-filled microvacuoles, termed glistenings, is a common complication of intraocular lenses (IOLs) made from hydrophobic acrylate. Using our well-established in-vitro laboratory method, we evaluated a new IOL material’s resistance to glistening formation.Methods: An in-vitro stress test for glistening induction was performed on twenty samples of hydrophobic acrylic IOLs: ten of the new Eyecryl ASHFY600 (Biotech Vision Care, Ahmedabad, India) compared with ten samples of AcrySof IQ SN60WF (Alcon, Fort Worth, USA). The number of microvacuoles per square millimetre (MV/mm2) was evaluated in five sections of each IOL. The results for each model were compared and rated on the Miyata Scale for grading glistening severity.Results: In all cases, glistening number was higher in the central section of the IOL optic than in the periphery. Mean number of MV/mm2 was highest in the central part of the AcrySof IQ SN60WF, with 41.84 (±27.67) MVs/mm². The lowest number of glistenings was found in the five sections of the Eyecryl ASHFY600 with 0.52 (±0.24) MVs/mm². Mean value of the Eyecryl ASHFY600 IOL, using the Miyata Scale, was Zero.Conclusion: In this in-vitro laboratory study, the new hydrophobic acrylic IOL showed a high resistance to microvacuole formation. Results from this in-vitro study suggest that glistening numbers will be low in clinical use in the Eyecryl ASHFY600.
The etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation
Authors: Wang Hongwei , Qin Xiuhong , Ji Jiali , Lu Yang , Xu Li , Guo Tao , Xiao Caiwen , Zhang Zhenzhen 
Published: April 2020

Abstract
Background: To evaluate the etiology of lacrimal canalicular laceration and explore possible risk factors influencing prognosis. Methods: A total of 142 patients (142 eyes) with lacrimal canalicular laceration were reviewed and surgically repaired using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018. The analyzed data contained demographic information, types of trauma, injury location, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and the complications of surgery.Results: The mean patient age was 42.07 years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 patients (78.87%), respectively, and both canalicular lacerations were found in 16 patients (11.27%). Electric bike accidents were the leading cause of injury with 76 patients (53.52%). There were 100 (70.42%) patients who had lid laceration without tarsal plate fracture and 42 (29.58%) patients who had lid laceration with tarsal plate fracture. Anatomic success rate was 98.59%, and functional success rate was 83.8%. Functional reconstruction failure rates were higher in patients with indirect injuries, lid laceration with tarsal plate fracture, and with punctum splitting(P<0.05). Surgical Complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, stent extrusion and loss in 2 (1.41%) patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. The indirect injuries, lid laceration with tarsal plate fracture and with punctum splitting, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.
Medication Discrepancies Involving Hospitalized Children At A High-Complexity Public Hospital
Authors: Lyra Divaldo Pereira de , Alcântara Thaciana dos Santos , Neto Fernando Castro de Araújo , Lima Helena Ferreira , Araújo Dyego Carlos S. Anacleto de , Sanchez Júlia Mirão , Junior Divaldo P. de Lyra 
Published: April 2020

Abstract

The authors have withdrawn this preprint due to author disagreement.
Phosphate starvation enhances phagocytosis of Mycobacterium bovis/BCG by macrophages.
Authors: Espinosa-Cueto Patricia , Magallanes-Puebla Alejandro , Mancilla Raul 
Published: April 2020

AbstractBackground:Tuberculosis is an important health problem worldwide. The only available vaccine isM. bovis/BCG, an attenuated mycobacterium that activates the innate and the acquired immune system after being phagocytosed by macrophages and dendritic cells. Vaccination fails to prevent adult pulmonary tuberculosis although it may have a protective effect in childhood infection. Understanding how BCG interacts with macrophages and other immunocompetent cells is crucial to develop new vaccines.Results:In this study we showed that macrophages phagocytoseM. bovis/BCG bacilli with higher efficiency when they are cultured without phosphate. We isolated mycobacterial membranes to search for mycobacterial molecules that could be involved in these processes; by immunoblot, it was found that the plasma membranes of phosphate-deprived bacilli express the adhesins PstS-1, LpqH, LprG, and the APA antigen. These proteins are not detected in membranes of bacilli grown with usual amounts of phosphate.Conclusions:The interest of our observations is to show that under the metabolic stress implied in phosphate deprivation, mycobacteria respond upregulating adhesins that could improve their capacity to infect macrophages. These observations are relevant to understand howM. bovis/BCGinduces protective immunity.
WITHDRAWN: High Failure Rate after Beta-tricalcium Phosphate Grafting for the Treatment of Femoral Head Osteonecrosis: a Retrospective Analysis
Authors: Liu Pei , Mu Xiao-hong , Yu Hua-chen , Jian-lei Guan , Liu Zhao-hui , Wang Wei-guo , Zhang Qi-dong , Guo Wanshou 
Published: April 2020

Abstract

Background: Non-vascularized bone grafting is a promising head-preserving technique for younger patients diagnosed as non-traumatic osteonecrosis of the femoral head (NONFH). Among the various types of bone grafting techniques, “light-bulb” procedure grafting with synthetic bone substitute is an attractive option. We aimed to assess the effectiveness of using beta-tricalcium phosphate (β-TCP) for the treatment of pre-collapse and early post-collapse lesions NONFH. Methods: From April 2010 to June 2014, 33 patients (47 hips) with NONFH were treated using the afore-mentioned technique. The clinical and radiological outcomes were recorded and compared statistically between pre- and post-operation. Harris hip score (HHS) was used to evaluate the clinical results, and Association Research Circulation Osseous (ARCO) stage was applied to assess the radiological outcomes. Results: The 5-years survival rate of using β-TCP grafting was accounting for 25.5%. HHS was decreased from 78.47 to 52.87 points, and a very significant worsening of radiological results were revealed ( P < 0.05). 2 hips collapsed more than 2 mm were awaiting for THA, and 33 of the 47 hips had converted to THAs in an average time to failure of 24.24 months postoperatively. Meanwhile, only 4 hips survived without collapse, and 8 hips collapsed less than 2 mm. After surgery, the time onset of head collapse was 3.65 months on average, and the first conversion to THA was performed at 5 months postoperative. Conclusions: Our results suggest that “light-bulb” procedure grafting with β-TCP sticks presented with a high failure rate in the early postoperative period. It is not proposed for the treatment of pre-collapse and early post-collapse lesions NONFH.
Effect of acupuncture and its influence on cerebral activity in patients with persistent asthma: study protocol for a randomized controlled clinical trial
Authors: Yu Siyi , Dong Xiaohui , Sun Ruirui , He Zhaoxuan , Zhang Chuantao , Chen Mei , Hong Xiaojuan , Lan Lei , Zeng Fang 
Published: April 2020

Abstract
BackgroundPrevious studies suggested that acupuncture was a promising adjunct treatment for asthma. However, the underlying mechanism of acupuncture for asthma remains unclear. The present trial aimed to explore whether and how specific meridian acupuncture works in quality of life and symptomatic improvement by modulating brain function in asthma patients.Methods: A randomized controlled functional brain imaging trial is currently being conducted in Sichuan, China. In total 48 patients with mild to moderate, persistent asthma will be recruited randomly allocated to two acupuncture groups: acupuncturing at Lung Meridian and acupuncturing at Heart Meridian. The treatment period will last for 4 weeks. The Asthma quality of life questionnaire (AQLQ) is the primary outcome. Asthma control test (ACT), the rate of Peak expiratory flow (PEFR), Forced expiratory volume in 1 second (FEV1), Montreal cognitive assessment (MoCA), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) will also assess the clinical efficacy of different interventions. Functional magnetic resonance imaging (fMRI) scans will be performed to detect cerebral activity changes in each group. The clinical data and fMRI data will be analyzed, respectively. Pearson correlation analysis will be used to assess the association between the changes of cerebral activity features and the improvement of clinical outcomes in each group.Discussion: The present study has been established on the “meridians-viscera relationship” theory of traditional Chinese medicine and modern central mechanism of acupuncture. The results of this trial would be useful to identify the efficiency of the specific meridian acupuncture for asthma. The investigation of its central mechanism would further expand our knowledge of the acupuncture for asthma. Trial registration: Chinese Clinical Trial Registry, ChiCTR1900027478. Registered on 15 November 2019.
Is it necessary to use tobramycin-dexamethasone eye ointment prophylactically in eyes at the end of intraocular surgery?
Authors: Zhang Wei , Han Han , Feng Kang , Wang Xiaohong , Du Mei , Meng Xiangda , Liu Yuanyuan , Huang Bo , Brant Rodrigo , Yan Hua 
Published: April 2020

Abstract
Background: There are no data available regarding the complications associated with using antibiotic ointment at the end of intraocular surgery. This study aimed to explore the necessity of using ocular tobramycin-dexamethasone prophylactically at the end of intraocular surgery.Methods: This was a retrospective cohort study of patients who received intraocular surgery at Tianjin Medical University General Hospital from January 2015 to December 2017. The patients were grouped according to whether they received tobramycin-dexamethasone eye ointment or not after surgery. The Tobramycin dexamethasone eye ointment was sampled to observe bacterial contamination pathogens at 0.5, 1, 1.5, 2, 2.5, 3, 6, 8, 24, 36, 48, 72, and 168 h after being opened.Results: A total of 3811 eyes in 3811 patients (mean age of 63±12 years) were included: 2397 eyes that received prophylactic tobramycin-dexamethasone eye ointment and 1414 eyes that did not. The overall rate of endophthalmitis was 0.08% (3/3811) in our study, all in the eye ointment group (0.12%, 3/2397); no patients developed endophthalmitis in the non-ointment group (0%, 0/1414)(P=0.184). The anterior chamber reactions 1 day after surgery were more serious in the eye ointment group compared with the non-ointment group (all P<0.05), but there were no statistically significant differences at 1 month postoperatively (all P>0.05). The contamination rate was 0% at all time points over 7 days.Conclusion: We did not observe a statistically significant difference in the incidence of endophthalmitis in patients with or without prophylactic tobramycin-dexamethasone eye ointment. And tobramycin-dexamethasone eye ointment seemed to increase some side effects such as eye secretions increasing and foreign body feeling.
Radiographic and clinical outcome of lumbar lateral interbody fusion for extreme lumbar spinal stenosis of Schizas grade D: a retrospective study
Authors: Li Jun , Li Hao , Ning Zhang , Wang Zhi-wei , Zhao Teng-fei , Chen Lin-wei , Chen Gang , Chen Qi-xin , LI Fang-cai 
Published: April 2020

Abstract
Background: Extreme lumbar spinal stenosis was thought to be a relative contraindication for lumbar lateral interbody fusion (LLIF) and was excluded in most studies. This is a retrospective study to analyze the radiographic and clinical outcome of LLIF for extreme lumbar spinal stenosis of Schizas grade D. Methods: For radiographic analysis, we included 181 segments from 110 patients who underwent LLIF between June 2017 and December 2018. Lumbar spinal stenosis was graded according to Schizas’ classification. Anterior and posterior disc heights, disc angle, foramen height, spinal canal diameter and central canal area were measured on CT and MRI. For clinical analysis, 18 patients with at least one segment of grade D were included. Visual analogue scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate clinical outcome. Continuous variables were compared using Student's t-test, with P- values < 0.05 considered to indicate statistically significant differences. Results: Among the 181 segments included for radiological evaluation, there were 23 grade A segments, 37 grade B segments, 103 grade C segments and 18 grade D segments. Postoperatively, the average change of midsagittal canal diameter of grade D was significantly greater than that of grade A, and not significantly different compared to grades B and C. As to the average change of disc height, bilateral foraminal height, disc angle and central canal area (CCA), grade D was not significantly different from the others. The average postoperative CCA of grade D was significantly smaller than the average preoperative CCA of grade C. Eighteen patients with grade D stenosis were followed up for an average of 19.61 ± 6.32 months. Clinical evaluation revealed an average improvement in the ODI and VAS scores for back and leg pain by 20.77%, 3.67 and 4.15 points, respectively. Sixteen of 18 segments with grade D underwent posterior decompression. Conclusion: The radiographic decompression effect of LLIF for Schizas grade D segments was comparable with that of other grades. Posterior decompression was necessary for LLIF to achieve a satisfactory clinical outcome for extreme lumbar spinal stenosis of Schizas grade D.