bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Tubular Separation Surgery for Metastatic Spinal Cord Compression: 2-Dimensional Operative Video
Authors: De la Garza Ramos Rafael , Echt Murray , Gelfand Yaroslav , Yanamadala Vijay , Yassari Reza 
Published: December 2020

Abstract
Symptomatic cord compression affects approximately 20% of patients with spinal metastatic disease. Direct decompressive surgery followed by conventional radiation was shown to be superior to radiation alone in a landmark trial published in 2005.
1
For radioresistant tumors causing high-grade compression, however, “separation surgery” followed by stereotactic body radiation therapy was developed. The main goal of this newer technique is to decompress and create a distance between the spinal cord and tumor to allow for safe delivery of radiation.
2
This technique has shown to provide durable local tumor control, pain relief, and preservation of neurological function.
3,4
In this study, we describe a minimally invasive tubular separation surgery technique used to treat symptomatic cord compression in a 59-yr-old man with metastatic prostate adenocarcinoma to T9. The patient presented with acute motor weakness and sensory level. A tubular retraction system was used to dock over the pedicle at T9 bilaterally and a posterior decompression with ligamentectomy was first performed. This was followed by transpedicular decompression and ventral removal of the posterior longitudinal ligament. Space was created between the ventral tumor and spinal cord to allow for postoperative stereotactic body radiation. The patient had a significant improvement in his strength and gait postoperatively.
Patient consent was obtained for videotaping prior to surgical intervention.
A Two-Scale Analysis for a Spherical Pendulum with a Vertically Vibrating Pivot
Authors: Grundy R E 
Published: December 2020

Summary
In this article, we consider the behaviour of a simple undamped spherical pendulum subject to high-frequency small amplitude vertical oscillations of its pivot. We use the method of multiple scales to derive an autonomous ordinary differential equation describing the slow time behaviour of the polar angle which generalises the Kapitza equation for the plane problem. We analyse the phase plane structure of this equation and show that for a range of parameter values there are conical orbits which lie entirely above the horizontal. Going further, we identify a family of quasi-conical orbits some of which may lie entirely above the pivot and establish that initial conditions can be chosen so that precession is eliminated for these orbits. For the general initial value problem, we show that the leading order solutions for the polar and azimuthal angles diverge significantly from their exact counterparts. However, by consolidating the slow scale error term into the leading order structure we may construct extremely accurate solutions for the slow scale evolution of the system. These solutions, confirmed by exact numerical simulations, show that by suitable choice of initial data orbital precession can be eliminated.
Materiality, Quarantine and Contagion in the Early Modern Mediterranean
Authors: Inì Marina 
Published: December 2020

Summary
To fight the spread of the plague, early modern Mediterranean states commonly quarantined goods and people on the move inside complexes called lazzaretti. These institutions, managed by the health magistracies of different Mediterranean cities, formed a transnational plague-preventative system. Based on an exploration of both the early modern theory of contagion and the eighteenth-century quarantine procedures shared between Health Offices across the Mediterranean, this article demonstrates that goods were categorised into different levels of contagion depending on their materials. Different disinfection practices were followed according to the level of danger posed by different types of goods. Anxieties caused by the interaction between surfaces and the human body shaped the procedures, the architecture and the everyday routine inside lazzaretti. While analysing the materiality of quarantined goods, the regulations and the architecture of the lazzaretti, this article highlights the relevance of material culture to early modern medical preventative practices.
Knowledge, Observation and Practices Related to Neonatal Jaundice in a Rural Community in Kano, Nigeria
Authors: Farouk Zubaida L , Slusher Tina M , Danzomo Abba Ahmed , Slusher Ida L 
Published: December 2020

AbstractBackgroundNeonatal jaundice (NNJ) is a common condition and when not adequately treated leads to acute bilirubin encephalopathy/kernicterus. This largely preventable condition is an important cause of death and disability in low- and middle-income countries. Education, early detection and effective management are key for prevention and require an understanding of community knowledge and practices to foster appropriate behavior to prevent severe NNJ. Therefore, the aim of this study was to identify knowledge, observation for jaundice (both active and passive) and practices related to NNJ in northern Nigeria.MethodsThis descriptive, correlational and cross-sectional study enrolled 298 household members with an average age of 29.8 years in Kano, Nigeria. A structured questionnaire regarding knowledge of, potential sequelae and causes and local practices related to NNJ was administered and data were analyzed using descriptive and Chi-square statistics.ResultsParticipants reported: 85% NNJ to be a sign of illness; 3% understood that NNJ could cause brain damage; 94% did not actively observe for jaundice in their newborns; 56% did not know what causes NNJ; 88% would seek care if their newborn developed jaundice. Significant relationships between educational levels and what study participants would do if a newborn develops jaundice and between occupation, educational level and knowledge about causes of NNJ were noted, consistent with a difference in active jaundice observation between ethnic groups.ConclusionA public health approach to NNJ with a strong community education program is a crucial next step in the fight to eliminate severe NNJ.
Extensive Antibiotic and Antimalarial Prescription Rate among Children with Acute Febrile Diseases in the Lake Victoria Region, Tanzania
Authors: Huth Philipp Florian Brixius , Addo Marylyn , Daniel Tim , Groendahl Britta , Hokororo Adolfine , Koliopoulos Philip , Mshana Stephen , Pretsch Leah , Schmidt Christian , Zuechner Antke , Gehring Stephan , Kayange Neema 
Published: December 2020

Abstract

Objectives
Acute mosquito-borne febrile diseases pose a threat to children in the Sub-Saharan-Africa with ∼272 000 children dying worldwide from malaria in 2018. Although the awareness for malaria in this area has increased due to improved health education, the apparent decline of actual malaria cases has not affected clinical practice significantly. This study collected clinical and epidemiologic data of children presenting with acute febrile diseases in order delineate their diagnostic and therapeutic management.

Methods
A hospital-based cross-sectional clinical study was conducted at the Sekou Toure Regional Referral Hospital in Tanzania. Children between 1 month and 12 years of age with an axillary temperature ≥ 37.5°C were recruited from August 2016 to December 2016. Children received full clinical examination. In addition, file data about diagnostics and treatment were collected and malaria rapid diagnostic tests (mRDTs) were performed. Confirmatory malaria polymerase chain reaction was performed from dry blood spots.

Results
From 1381 children presented in the pediatric outpatient department, 133 met the inclusion criteria. Out of 133 febrile children, 10.5% were malaria positive. Treatment data indicate the prescription of antimalarials in 35.3% and antibiotics in 63.9% of the children with an overlap of 24.1% receiving both. Despite a negative mRDT, 36 patients received antimalarials.

Conclusions
The findings of this study confirm a significant decline of malaria cases in the Lake Victoria region. The discrepancy between the valuable results provided by mRDTs and the high prescription rates of antibiotics and antimalarials call for an enforced diagnostic and therapeutic algorithm.

LAY SUMMARY
The aim of the study was to take a closer look at reported cases of febrile diseases in the Lake Victoria region and assess the relationship between clinical as well as diagnostic findings and the resulting therapeutic concept. Based on these findings the prescription rate of antimalarial and antibiotic drugs was analyzed. The results showed an overall high prescription rate of antimalarials and antibiotics in both diagnosed malaria cases and cases with diagnosed bacterial infections.
Not only with regards to the possible side effects of these medications but also keeping in mind the apparent misuse of resources this practice poses a serious burden to the health care system in this low resource country.
Prevention of food allergy: can we stop the rise of IgE mediated food allergies?
Authors: Santos Alexandra F. 
Published: December 2020

Purpose of review
Food allergy has become more prevalent in recent decades. Without a curative treatment for food allergy, prevention is key. Can we intervene and halt the food allergy epidemic?

Recent findings
There are three main hypotheses to explain the rise in food allergy: the dual-allergen exposure hypothesis, the hygiene hypothesis and the vitamin D hypothesis. In a recent systematic review of randomized controlled trials, only introduction of allergenic foods, namely egg and peanut, in the diet at the time of weaning and avoidance of temporary supplementation with cow's milk formula in the first few days of life showed low to moderate evidence of a preventive effect.

Summary
For primary prevention, introduction of allergenic foods at the time of weaning and avoidance of temporary supplementation with cow's milk formula in the first few days of life has been recommended. Introduction of foods once allergy has been excluded may be beneficial for sensitized subjects (secondary prevention). Once food allergy has been established, it is important to minimise complications (tertiary prevention) through allergen avoidance, timely treatment of allergic reactions, control of atopic co-morbidities and dietetic and psychological support, as appropriate. Immunomodulatory treatments can potentially be disease-modifying and require further research.
Strategies From 11 U.S. Medical Schools for Integrating Basic Science Into Core Clerkships
Authors: Daniel Michelle , Morrison Gail , Hauer Karen E. , Pock Arnyce , Seibert Christine , Amiel Jonathan , Poag Molly , Ismail Nadia , Dalrymple John L. , Esposito Karin , Pettepher Cathleen , Santen Sally A. 
Published: December 2020

Calls for curricular reform in medical schools and enhanced integration of basic and clinical science have resulted in a shift toward preclerkship curricula that enhance the clinical relevance of foundational science instruction and provide students with earlier immersion in the clinical environment. These reforms have resulted in shortened preclerkship curricula, yet the promise of integrated basic science education into clerkships has not been sufficiently realized because of barriers such as the nature of clinical practice, time constraints, and limited faculty knowledge. As personalized medicine requires that physicians have a more nuanced understanding of basic science, this is cause for alarm. To address this problem, several schools have developed instructional and assessment strategies to better integrate basic science into the clinical curriculum.
In this article, faculty and deans from 11 U.S. medical schools discuss the strategies they implemented and the lessons they learned to provide guidance to other schools seeking to enhance basic science education during clerkships. The strategies include program-level interventions (e.g., longitudinal sessions dedicated to basic science during clerkships, weeks of lessons dedicated to basic science interspersed in clerkships), clerkship-level interventions (e.g., case-based learning with online modules, multidisciplinary clerkship dedicated to applied science), bedside-level interventions (e.g., basic science teaching scripts, self-directed learning), and changes to formative and summative assessments (e.g., spaced repetition/leveraging test-enhanced learning, developing customized examinations). The authors discovered that: interventions were more successful when buy-in from faculty and students was considered, central oversight by curricular committees collaborating with faculty was key, and some integration efforts may require schools to provide significant resources. All schools administered the United States Medical Licensing Examination Step 1 exam to students after clerkship, with positive outcomes. The authors have demonstrated that it is feasible to incorporate basic science into clinical clerkships, but certain challenges remain.
The Effect of Direct Health Education on the Uptake of Screening by First Degree Relatives of Glaucoma Patients in Nigeria
Authors: Ogunleye Olakunle , Olawoye Olusola , Sarimiye Tarela , Bekibele Charles , Ashaye Adeyinka 
Published: December 2020

Précis:
First degree relatives (FDRs) of glaucoma patients are more likely to present for screening when they are directly contacted and educated by health workers on the phone compared with when they are only invited by their relative with glaucoma.

Objective:
The aim was to determine the effect of direct health education by phone calls on the uptake of glaucoma screening among FDRs of primary open angle glaucoma patients as a glaucoma blindness control strategy in an asymptomatic high-risk African population.

Methods:
This was a randomized clinical trial in which 102 primary open angle glaucoma patients (probands) were randomized into control and intervention groups. Both proband groups were educated about glaucoma and requested by the investigator to invite their adult FDR to attend a screening clinic within 1 month. In addition, the FDRs in the intervention group were directly contacted, educated, and invited for examination by phone calls. A total of 560 FDRs were enumerated by the probands. The main outcome measure was proportion of FDR that presented for screening.

Results:
A total of 218 (38.9%) FDRs took up glaucoma screening services. Eighty-nine (30.1%) of the 296 FDRs in the control group and 129 (48.9%) of the 264 FDRs in the intervention group presented for examination. After multivariate analysis, FDRs in the phone call group were 2.506 times [95% confidence interval (CI): 1.695-3.706] more likely to present than FDRs in the no phone call group. Young FDRs were more likely to present [odds ratio (OR)=3.593; 95% CI: 1.613-8.007] than the elderly FDRs, while FDRs living within 200 km of the hospital were also more likely to present (OR=5.200; 95% CI: 2.860-9.456) than those living far (>200 km) away. Probands with moderate to severe visual impairment were significantly more likely (OR=3.073; 95% CI: 1.845-4.352) to have their FDRs present than probands with mild or no visual impairment.

Conclusion:
Direct contact and health education of FDRs through phone calls had a significant positive effect on the uptake of glaucoma screening by FDRs. We recommend direct contact and education of the FDRs of glaucoma patients.
Tenon Cyst Patch Graft for Ahmed Glaucoma Valve Tube Exposure: Case Series Report
Authors: Alvarez-Ascencio Daniela , Lazcano-Gomez Gabriel , Flores-Reyes Elsa , Dueñas-Angeles Karla , Jímenez-Roman Jesús , Kahook Malik Y. 
Published: December 2020

Purpose:
To report our experience using a Tenon cyst autograft in the management of tube exposure post Ahmed glaucoma valve (AGV) implantation.

Methods:
This is a retrospective case series.

Results:
Four patients who underwent tube exposure repair using Tenon cyst autograft were identified in our tertiary care center. The duration between initial AGV implantation and tube exposure ranged between 3 and 36 months with a mean of 16 months (±14.35 mo). All patients were followed postoperatively for a range of 4 to 24 months with a mean of 11.75 months (±9.03 o) and all remain exposure free at last follow-up.

Conclusion:
The use of a Tenon cyst autograft for the surgical repair of a tube exposure is valuable, as it involves using autologous scar tissue that is available in eyes that have undergone AGV implantation. The patch autograft is technically easy to harvest, and represents a significantly lower cost when compared with other available options.
Cumulative Efficacy of Longitudinal Repeat Salivary Gland OnabotulinumtoxinA Injection
Authors: Shoval Hannah , Friel Kathleen , Levin Jared , Kim Heakyung 
Published: December 2020

Aim
We hypothesized that repeat onabotulinumtoxinA (BTX-A) injections to salivary glands would have a cumulative effect on drooling, leading to prolonged efficacy duration.

Methods
We retrospectively reviewed medical records and conducted a telephone survey of individuals treated with BTX-A to the salivary glands to investigate ongoing efficacy or adverse effects. Outcome measures were duration of decrease in drooling and adverse events. The main independent variable was the number of injections. We identified 52 consecutive individuals (26 females) with cerebral palsy with an average age of 9 yrs, 3 mos ± 5 yrs 2 mos, who had received BTX-A for sialorrhea.

Results
Linear regression analysis showed that each additional injection resulted in the duration of efficacy being 0.68 mos longer (P < 0.001, R
2 = 0.47). Age, sex, Gross Motor Function Classification System level, presence of tube feeding, presence of tracheostomy, gastroesophageal reflex, seizures, and concurrent intramuscular injections seizures were not significant contributors to the association between injection number and efficacy duration (F (6, 45) = 1.01, P = 0.431).

Interpretation
There may be a cumulative effect of BTX-A injections to the salivary glands, resulting in longer periods of efficacy with consecutive injection.
External Devices Among Individuals With Spinal Cord Injury From a Developing Country
Authors: Kumprou Makamas , Thaweewannakij Thiwabhorn , Arayawichanon Preeda , Amatachaya Pipatana , Amatachaya Sugalya 
Published: December 2020

Objective
The aim of this study was to explore the proportion, number, and type of external devices (including mobility devices, ambulatory aides, and orthotics) possessed and used by individuals with spinal cord injury (SCI) from a developing country.

Design
This was a cross-sectional study.

Participants
A total of 163 participants with SCI from several rural communities in a developing country participated in the study from June 2018 to August 2019.

Methods
The participants were interviewed and assessed for their SCI characteristics and the external devices (i.e., mobility devices, ambulatory aides, and orthotics) they possessed and used in their daily living.

Results
Most participants (85%), who lived in rural communities with a family income of less than $3167 per year, possessed external devices (one to five types), and 80% of all participants actually used the devices (one to three types) in their daily living. Most participants with motor-complete SCI used a single device, especially a manual wheelchair, whereas those with mild lesion severity used multiple devices for their daily activities, particularly a standard walker.

Conclusion
Owing to budget and environmental constraints, the external devices used by individuals with SCI from a developing country are different from those reported in a developed country. The findings provide particular insights into the management of external devices for these individuals of a developing country.
Rehabilitation Protocol After Hip Arthroscopy
Authors: Bistolfi Alessandro , Guidotti Claudio , Aprato Alessandro , Sabatini Luigi , Artiaco Stefano , Massè Alessandro , Ferracini Riccardo 
Published: December 2020

Objective
Although many rehabilitation protocols after hip arthroscopy have been described, there is still significant variability about duration, goals, restrictions, and techniques to apply by the physical therapy after the surgical procedure. The aim of the study was to systematically review rehabilitation after hip arthroscopy.

Design
The data sources were PubMed, Scopus, and Cochrane Library. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used for the systematic review. Level I–IV evidence clinical studies and clinical reviews that focused on rehabilitation protocols after hip arthroscopy have been used as study eligibility criteria. Major limitations include the retrospective nature of most of the studies selected (level IV evidence) and the use of different clinical scores to report the outcomes.

Results
This review showed that although a standardized guideline on rehabilitation after hip arthroscopy is still missing, the most recent studies and clinical trials are focusing on a four-phase program, which includes goals, recommendations, and a progression of exercises.

Conclusions
Rehabilitation after hip arthroscopy is strongly suggested, but different authors recommended different rehabilitation programs. There is not a defined program, but as of today, the current standard of care is composed of phase-based programs.
Cancer Patients in the Era of Coronavirus: What to Fear Most?
Authors: Haddad Fady Gh , Kourie Hampig Raphael , Gebara Nicole , Matta Christian , Eid Roland , El Karak Fady , Nasr Fadi , Chahine Georges , Ghosn Marwan , Kattan Joseph 
Published: December 2020

Background
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic led to a worldwide medical crisis, affecting mostly immunocompromised patients, such as cancer patients. Various cancer societies have issued recommendations regarding patients care, but few studies addressed the perception of cancer patients regarding this pandemic.

Objective
The aim of the study was to assess the perception of cancer patients regarding their health risks during this pandemic and the preventive measures taken.

Materials and Methods
An anonymous survey was conducted among cancer patients presenting for their treatment, during 10 consecutive working days, at the one-day clinic of Hotel-Dieu de France University hospital in Beirut. We evaluated their state of disease, comorbidities, precautions taken, and their concerns regarding the virus spread.

Results
A total of 216 patients responded with a mean age of 60 years. The majority had a good performance status (performance status = 0–1 in 79.6%), 51.4% had metastatic disease, and chemotherapy was the main therapy used (65.7%). A total of 52.3% of patients considered themselves to be at increased risk of contracting the virus. A total of 55.1% were more worried about the coronavirus rather than their disease. The priority was for the treatment of their cancer in 47.7% of the total patients studied. Of note, only 2.8% of planned one-day clinic reservations were canceled or postponed to avoid COVID-19 exposure.

Conclusions
Although cancer is a disease with a high mortality rate, many patients are more concerned about the actual pandemic rather than their disease. Nevertheless, the absenteeism from their treatment sessions during the COVID-19 atmosphere was minimal.