bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resolving Disagreement: A Multi-Jurisdictional Comparative Analysis of Disputes About Children’s Medical Care
Authors: Auckland Cressida , Goold Imogen 
Published: July 2020

Abstract
Recently, the English courts have dealt with a number high-profile, emotive disputes over the care of very ill children, including Charlie Gard, Alfie Evans, and Tafida Raqeeb. It is perhaps fair to say such cases have become a regular feature of the courts in England. But is the situation similar in other jurisdictions? If not, are there lessons to be learned from these jurisdictions that do not seem to need to call on judges to resolve these otherwise intractable disputes? We argue that many of the differences we see between jurisdictions derive from cultural and social differences manifesting in both the legal rules in place, and how the various parties interact with, and defer to, one another. We further argue that while recourse to the courts is undesirable in many ways, it is also indicative of a society that permits difference of views and provides for these differences to be considered in a public manner following clear procedural and precedential rules. These are the hallmarks of a liberal democracy that allows for pluralism of values, while still remaining committed to protecting the most vulnerable parties in these disputes—children facing life-limiting conditions.
Going beyond the minimal texture of quark mass matrices in the era of precision measurements
Authors: Bagai Aakriti , Kaundal Shivali , Ahuja Gulsheen , Gupta Manmohan 
Published: July 2020

Abstract
An attempt has been made to carry out a detailed analysis of quark mass matrices having structure beyond the minimal texture. In particular, keeping in mind precision measurements of Cabibbo–Kobayashi–Maskawa parameters as well as refinements in the ranges of light quark masses, we have examined the viability of all possible combinations of Hermitian texture 5 zero quark mass matrices. Interestingly, one finds that all these possibilities are now excluded by the present quark mixing data, thereby having important implications for model building.
Sleep problems, internalizing and externalizing symptoms, and domains of health-related quality of life: bidirectional associations from early childhood to early adolescence
Authors: Williamson Ariel A , Zendarski Nardia , Lange Katherine , Quach Jon , Molloy Carly , Clifford Susan A , Mulraney Melissa 
Published: July 2020

Abstract

Study Objectives
To examine longitudinal, bidirectional associations among behavioral sleep problems, internalizing and externalizing symptoms, and domains of health-related quality of life (HRQoL) from early childhood to adolescence in a population sample of Australian children.

Method
Data were drawn from the Longitudinal Study of Australian Children, a national prospective cohort study with 4983 children participating in the Kindergarten cohort. Data were collected when children were aged 4–5, 6–7, 8–9, 10–11, and 12–13 years. At each study wave, the primary parent (97% mothers) reported on behavioral child sleep problems, internalizing and externalizing symptoms, and HRQoL domains (psychosocial and physical). Cross-lagged structural equation models were used to evaluate bidirectional associations.

Results
At nearly every age, behavioral sleep problems were associated with worse subsequent psychosocial and physical HRQoL. Despite bidirectional associations between mental health and HRQoL at many waves, HRQoL domains more strongly predicted later internalizing symptoms, while externalizing symptoms more strongly predicted later HRQoL. Many of the bidirectional associations among sleep, mental health, and HRQoL were found earlier in childhood.

Conclusions
Behavioral sleep problems may forecast later HRQoL psychosocial and physical impairments. Attending to both sleep problems and HRQoL could prevent the progression of internalizing conditions, while a focus on externalizing concerns could prevent the worsening of these symptoms, sleep problems, and HRQoL, particularly during the transition to school.
Associations of loneliness and social isolation with actigraph and self-reported sleep quality in a national sample of older adults
Authors: Benson Jade A , McSorley V Eloesa , Hawkley Louise C , Lauderdale Diane S 
Published: July 2020

Abstract

Study Objectives
To examine associations of social isolation and loneliness with sleep in older adults and whether associations differ for survey and actigraph sleep measures.

Methods
This study used data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative study of community-dwelling older adults born 1920–1947. A random one-third of participants in 2010–2011 were invited to participate in a sleep study (N = 759) that included survey questions, 72 hours of wrist actigraphy, and a sleep log. Perceived loneliness was measured using three questions from the UCLA Loneliness Scale. An index of social isolation was constructed from nine items that queried social network characteristics and social interactions. We used ordinary least squares and ordinal logistic regression to examine whether sleep measures were associated with loneliness and social isolation adjusted for potential sociodemographic confounders.

Results
Social isolation and loneliness had a low correlation (Spearman’s correlation = 0.20). Both loneliness and social isolation were associated with actigraphy measures of more disrupted sleep: wake after sleep onset and percent sleep. Neither was associated with actigraph total sleep time. Increased loneliness was strongly associated with more insomnia symptoms and with shorter sleep duration assessed by a single question, but social isolation was not. More isolated individuals spent a longer time in bed.

Conclusions
We found that both loneliness and social isolation were associated with worse actigraph sleep quality, but their associations with self-reported sleep differed. Only loneliness was associated with worse and shorter self-reported sleep.
Shoelace Technique Plus Negative-Pressure Wound Therapy Closure in Fasciotomy Wounds
Authors: Eceviz Engin , Çevik Hüseyin Bilgehan 
Published: July 2020

ABSTRACT

BACKGROUND
Fasciotomy incision closure is often performed with skin grafts that can lead to cosmetic and functional complications after surgical intervention. Because fasciotomy incisions do not result in skin loss, the authors hypothesized that better closure can be achieved by reducing tissue edema with negative-pressure wound therapy (NPWT) and reducing stress on the skin with the shoelace surgical technique.

METHODS
This 1-year prospective study included eight patients with acute compartment syndrome after extremity fractures and/or blunt injuries. Patients were treated with fasciotomies closed with the shoelace technique and NPWT for wound margin approximation. The NPWT device was changed every second day; the shoelace traction tension was tightened at the same time.

MAIN RESULTS
The mean time from fasciotomy to wound closure was 11.8 days (range, 5–30 days). There was no need for a skin graft or flap in any patient.

CONCLUSIONS
The shoelace technique plus NPWT may be successful in closing skin fasciotomies after acute compartment syndrome without causing additional morbidity.
Pathologic Scarring after Eyebrow Micropigmentation: A Case Report and Systematic Review
Authors: Motoki Thamy Harumi Cardoso , Isoldi Felipe Contoli , Ferreira Lydia Masako 
Published: July 2020

ABSTRACT

BACKGROUND
Skin tattooing and cosmetic eyebrow definition and reshaping (micropigmentation) have been growing exponentially in popularity. The pigment used in these procedures can activate the skin’s inflammatory response, promoting the formation of pathologic scars.

OBJECTIVE
To carry out a systematic review of the literature on this topic and report a case of pathologic scarring on the eyebrows after micropigmentation.

METHODS
A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline in the MEDLINE, Lilacs, and SciELO databases using the keywords “scar; scar, hypertrophic; eyebrows; pigmentation; skin pigmentation; coloring agents; tattooing” and their synonyms.

RESULTS
The systematic literature review did not identify any study reporting pathologic scarring on eyebrows after micropigmentation. This is likely because eyebrow pathology is uncommon, although these results are limited by the comprehensiveness of the systematic review. The case of a 50-year-old woman undergoing eyebrow micropigmentation who presented with hypertrophic scarring after the procedure is also reported.

CONCLUSIONS
Eyebrow micropigmentation may be a risk factor for pathologic scarring, but further research is needed.
Functional Benefits of Fitness Boxing for Survivors Diagnosed With Breast or Ovarian Cancer: A Pilot Study
Authors: Doherty Deborah , Felisky Paige , Morton Kaitlyn , Sumner Kaitlyn 
Published: July 2020

Background and Purpose:
Fitness boxing has been shown to improve strength, balance, endurance, and quality of life (QOL) in persons diagnosed with Parkinson disease and multiple sclerosis. The purpose of this pilot study was to explore the functional benefits of an upper extremity (UE) fitness boxing program for women diagnosed with breast and ovarian cancer.

Methods Design:
Prospective pilot study. Participants: Ten women diagnosed with breast or ovarian cancer. Pre/Postintervention Measurements: 6-Minute Walk Test (6MWT), 30-second chair stand, 4-step balance, scapular strength, hand grip, B-tracks balance, and Functional Assessment Chronic Illness Therapy–Fatigue specific (FACIT-F) survey. Intervention/Setting: Instructor-led 8-week UE fitness boxing program (3 times per week). Descriptive statistics completed.

Results:
Nine participants (breast cancer, n = 6; ovarian cancer, n = 3) completed 8 weeks of UE fitness boxing. In total, 77% of participants increased 6MWT distance, 55% improved in 30-second chair stand, 66% improved in bilateral middle and left lower trapezius strength, and 55% (right hand) and 66% (left hand) improved in grip strength. FACIT-F: Twenty-two percent reported decreased pain from “a little bit/somewhat” to “not at all”; 44% reported a decrease in being bothered by the side effects of treatment from “a little bit” to “not at all”; 44% reported an improvement in sleeping well from “somewhat/quite a bit” to “very much”; and 44% reported decrease in fatigue from “a little bit/somewhat” to “not at all.”

Limitations:
Small sample size, only female participants, and not being able to generalize to other cancer groups.

Conclusion:
UE fitness boxing has the potential to be a safe and effective option to improve strength, endurance, and QOL for women diagnosed with breast or ovarian cancer.
A matched-cohort study comparing outpatient total knee arthroplasty in an ambulatory surgery center with inpatient total knee arthroplasty in a hospital
Authors: Littleton Travis W. , Mascioli Anthony A. , Throckmorton Thomas W. , Mihalko William M. , Toy Patrick C. 
Published: July 2020

Background:
The authors compared a matched cohort of outpatient total knee arthroplasties (TKA) performed in a free-standing ambulatory surgery center (ASC) with those performed in a standard inpatient hospital setting to determine the safety, efficacy, and expense associated with both locations.

Methods:
Retrospective review identified 82 patients who had TKA, 41 at an ASC and 41 in an inpatient hospital. The cohorts were matched according to age and American Society of Anesthesiologists (ASA) physical status classification.

Results:
There were no statistically significant differences in age, gender, body mass index, or ASA scores. There were no readmissions or major complications, including deep infection, periprosthetic fracture, or venous thromboembolism, in either cohort. Minor wound issues occurred in four (9.8%) hospital patients and one (2.4%) ASC patient. All ASC patients were discharged the day of surgery without an overnight stay. The average length of stay for the hospital group was 2.5 days. The average total facility charge for ASC patients was $26,800.00 compared to the national average of $31,124.

Conclusions:
No significant differences were noted between TKA performed in an ASC and a hospital for major complications or hospital readmissions at 90 days. The average length of stay in the hospital was 2.5 days, however, which might indicate a higher cost than day surgery. Although not statistically significant, the ASC cohort had fewer minor complications than the inpatient cohort. In select patients TKA performed outpatient in an ASC appears to be as effective and safe as that performed in a hospital, with the caveat that some patients may not be candidates. Careful patient selection, preoperative screening and counseling, and the use of multimodal pain regimens are critical to minimizing complications and reducing costs.

Level of Evidence:
Level III.
External Fixator–Assisted Reduction of Distal Femur Fractures: A Technical Trick
Authors: Shymon Stephen J. , Ulitto Joseph , Barei David P. , Sirkin Michael S. , Reilly Mark C. , Adams Mark R. 
Published: July 2020

Summary:
Restoration of anatomical alignment while preserving the soft-tissue envelope around the fracture site remains a challenge during distal femur fracture fixation. Although the lateral distal femoral locking plate allows surgeons to achieve adequate bony stability, their application has been associated with malalignment leading to inferior outcomes. We propose a biologically friendly, percutaneous technique that sequentially reduces and aligns distal femur fractures with an anterior external fixator before definitive fixation with a lateral distal femoral locking plate.
Clinical and Radiologic Outcomes of Thoracolumbar Fusions Using Intraoperative CT Guidance and Stereotactic Navigation in a Spinal Trauma Population
Authors: Domino Joseph S. , Smith Kyle A. , Arnold Paul M. 
Published: July 2020

Study Design:
Retrospective review of prospectively collected single-institution database.

Objective:
To analyze the clinical and radiographic outcomes of posterior thoracolumbar fusions using intraoperative computed tomography (CT)-guidance and stereotactic navigation in thoracolumbar spinal trauma.

Summary of Background Data:
Pedicle screw instrumentation is utilized for stabilization in thoracolumbar fusions. Suboptimal placement may lead to neurovascular complications, pseudarthrosis, postoperative pain, and the need for revision surgery. Image-guided spinal surgery is commonly used to improve accuracy, particularly for complex anatomy such as encountered with traumatic fractures.

Methods:
We retrospectively identified 58 patients undergoing posterior thoracolumbar fusions using intraoperative CT and stereotactic navigation for traumatic fractures from 2010 to 2017 at a single institution. Pedicle screw accuracy, realignment, clinical outcomes, and ease of use were retrospectively reviewed. Accuracy was assessed on postplacement or postoperative CT. Breach grades included: grade 1 (<2 mm), grade 2 (2–4 mm), and grade 3 (>4 mm).

Results:
A total of 58 patients were identified having undergone 58 operations, which involved placement of 519 pedicle screws. Traumatic fracture patterns and levels of injury were varied. Accurate pedicle screw placement was found in 95.8% and was stable over time. Breach included: grade 1 in 19 screws, grade 2 in 2 screws, and grade 3 in 1 screw. No neurovascular complications were noted. No revision surgery was performed for misplacement. A subgroup of 6 ankylosing spondylitis patients were identified having undergone 6 operations with 63 pedicle screws. Accurate pedicle screw placement was found in 93.7%.

Conclusion:
Intraoperative CT-guidance and stereotactic navigation can overcome the difficulty associated with thoracolumbar trauma resulting in complex anatomy with malalignment and unpredictable trajectories. Intraoperative CT can be used with stereotactic guidance or for intraoperative verification of free-hand screw placement with repositioning as needed. CT-guidance maintains the benefit of reduced fluoroscopic exposure while improving accuracy of instrumentation and reducing reoperation for screw malposition.
Feasibility and Outcome of Routine Use of Concurrent Chemoradiation in HIV-positive Patients With Squamous Cell Anal Cancer
Authors: Leiker Andrew J. , Wang Chiachien J. , Sanford Nina N. , Aguilera Todd A. , Karri Sirisha , Beg Muhammad S. , Kazmi Syed A. , Olson Craig , Matthews Joselin A. , Abdelnaby Abier , Meyer Jeffrey J. , Folkert Michael R. 
Published: July 2020

Objectives:
Clinical concerns about hematologic toxicities in human immunodeficiency virus (HIV)+ patients with squamous cell anal cancer (SCAC) may lead to de-escalation of treatment intensity. The objective of this study is to evaluate clinical outcomes including toxicity following standard concurrent curative-intent chemoradiation for HIV+ and HIV− patients with SCAC.

Materials and Methods:
Among 97 evaluable patients treated between 2009 and 2016 (median age 52.2 y), 43 (44.3%) were HIV+ and 54 (55.7%) HIV−. The majority of the radiation was delivered using intensity-modulated radiation therapy and chemotherapy consisting primarily (93%) of 5-fluorouracil and mitomycin C. Clinical outcomes assessed included toxicity, locoregional control (LRC), distant metastasis (DM), progression-free survival (PFS), colostomy-free survival (CFS), overall survival (OS), and cause-specific survival (CSS).

Results:
With a median follow-up of 45 months, HIV+ patients exhibited a trend toward reduced OS compared with HIV− patients (4 y OS 61.2% vs. 78.3%; HR 2.09; 95% CI, 0.97-4.52; P=0.055) on univariable analysis, but HIV status was not significant after adjusting for additional parameters on multivariable analysis. Toxicity rates, LRC, CFS, PFS, freedom from DM, and CSS were similar between the 2 cohorts. On multivariable analysis, tumor size >5 cm impacted all clinical outcomes (trend for LRC) except CFS. Radiation treatment extension beyond 7 days was found to negatively impact LRC and CSS. Male sex was associated with worse CFS.

Conclusions:
Radiation therapy with concurrent 5-fluorouracil and mitomycin C chemotherapy is reasonably well-tolerated as curative treatment for HIV+ patients with SCAC, and no significant difference in outcomes was noted relative to HIV− patients.
Menopause and frailty: a scoping review
Authors: Ruan Haihui , Hu Junping , Zhao Jinzhu , Tao Hongxia , Chi Junting , Niu Xiaodan , Zhang Jing , Wang Yanhong 
Published: July 2020

Abstract

Importance and Objective:
Frailty refers to the decline in physiological reserve capacity caused by the deterioration of multiple physiological systems (brain, endocrine system, immune system, and skeletal muscle), leading to increased vulnerability and decreased stress capacity. Women have a higher prevalence of frailty than men, although the epidemiological factors underlying this phenomenon are not fully understood. Menopause and menopause-related characteristics may be among the contributing factors. Hence, the purpose of this scoping review was to explore the relationship between menopause and frailty. We attempted to summarize information such as the age that menopause occurs, years since menopause, types of menopause, and hormones and inflammatory markers of frailty among postmenopausal women.

Methods:
PubMed, EMBASE, The Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature and Web of Science, the China National Knowledge Infrastructure, the China Biomedical Literature Service System, Wanfang Database and the WeiPu (VIP) Database were searched from inception until April 3, 2019. Supplementary searches of the references, cited documents, and similar documents of the included literature were also carried out.

Discussion and Conclusions:
Of 762 papers identified, 15 articles matching the criteria were included. The prevalence of frailty among postmenopausal women ranged from 5.9% to 57.3%. Existing studies suggest that menopause is associated with frailty. Early menopause, hysterectomy, low-free testosterone levels, and high C-reactive protein levels may increase the likelihood of frailty among postmenopausal women. Few original studies have explored the relationship between estrogen and frailty and the results of these studies are conflicting. Changes in hormone and inflammatory cytokine levels may mediate frailty among postmenopausal women. More in-depth research would be required to better understand the physiological and etiological mechanisms of the occurrence of frailty among postmenopausal women.
Recent trends in acute myocardial infarction among the young
Authors: Wu Wanda Y. , Berman Adam N. , Biery David W. , Blankstein Ron 
Published: July 2020

Purpose of review
In recent decades, the incidence of myocardial infarction (MI) has declined among the general population. However, MI rates in the young have not decreased as much as has been observed among older individuals. This review will focus on recent trends of MI in young patients, factors that may account for these trends, and implications for future prevention.

Recent findings
MI rates in young patients, particularly in women, have not decreased in the same fashion as they have for their older counterparts, with some studies reporting an increase. The reasons for these findings include underestimation of cardiovascular risk, and accordingly treatment, in the young, as well as an increasing prevalence of risk factors such as obesity and diabetes.

Summary
Better recognition and treatment of cardiovascular risk factors among young adults may improve outcomes. There is a need for improved methods to assess and treat cardiovascular risk in young individuals.