bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Bruises of the Ankle and Mid-foot Often Associate with Ankle Sprain
Authors: Koiwai Hidefumi , Kamimura Mikio , Taguchi Akira , Tensho Keiji , Nakamura Yukio , Takahashi Jun 
Published: October 2020

Abstract
Background: Ankle sprains are one of the most common musculoskeletal injuries. However, they may be more serious than commonly believed since many patients reportedly experience chronic problems afterwards. It is necessary to improve the treatment, such as the method and duration of fixation, of sprained ankles.Methods: Magnetic resonance imaging of 70 patients with acute moderate or advanced ankle sprains presenting consecutively between November 2014 and December 2019 were reviewed for analysis of bone bruising associated with ankle sprains. The patients were treated conservatively with a solid splint or cast until walking pain could be resolved without external fixation. In cases with pain at the time of weight bearing after solid fixation, crutches were prescribed for pain relief. The fixation period ranged from 8 days to 72 days (mean: 29.5 days). Afterwards, 54.0% of patients had walking pain and required the use of crutches. The ankle joint pain disappeared after conservative treatment in all patients.Results: The incidence of bone bruises detected by magnetic resonance imaging in the ankle and midfoot associated with ankle sprain was 81.4%. Bone bruises of the midfoot, including the tarsal bone and Chopart joint, were found in 34.3% of ankle sprains. Bone bruises of the talus were the most common, being present in 60% of ankle sprains. Bone bruises were also evident in the tibia (44.3%), the calcaneus (21.4%), and the tarsal bone (25.7%). There was a significant association between bone bruises of the talocrural joint surface and use of the crutches after fixation (P=0.041). Multiple regression analysis adjusted for age and gender revealed that bone bruises of the talocrural joint surface of the talus was a significant independent predictor of crutch use (P=0.045), with an odds ratio (95% confidence interval) of 3.03 (1.03-8.94).Conclusion: Bone bruises of the ankle and midfoot are often present in ankle sprains. In moderate or advanced cases of ankle sprain, external solid fixation of both the ankle and midfoot should be performed. In cases with pain at weight bearing following solid fixation, crutches are advised for pain relief and proper ligament and bone healing.
Prostitution Among University Students: A Case Study of Four Public Universities in Ghana
Authors: Gbagbo Fred Yao , Gbagbo Josephine Akosua 
Published: October 2020

Abstract
Background Despite its criminalization in Ghana, prostitution dates back to ancient societies and occurs in various forms within communities. The authors examined prostitution in selected public Universities in Ghana. Methods The study was an exploratory- mixed-method design. Respondents were identified using purposive and snowballing techniques whiles semi-structure questionnaires and in-depth interviews were used for data collection between 2017and 2019. Quantitative data were analyzed using Statistical Package for Social Sciences version 23 and qualitative data analyzed thematically. ResultsFindings show that there is a proliferation of prostitution on university campuses in Ghana for financial, material and emotional gains. Student prostitutes have devised various strategies to combine academic work and prostitution. Prospective customers are solicited by hanging out in drinking bars and night clubs in and around university campuses at night and/or leaving contact details with pimps to be contacted for services. Brothels are also springing up in and around the university campuses in the form of movie houses and student prostitutes convert their hostel rooms into brothels. Price negotiation is based on the environment, duration and styles/positions adopted for sex. ConclusionThere is a need for a multi-sectoral approach for appropriate policy and program interventions to regulate the practice on campus.
Prevention of White Flocculate Precipitation with Simethicone During Upper Gastrointestinal Endoscopy: A Double‐Blinded, Multi‐Center, Randomized Study
Authors: Chen Xueqin , Dai Ning , Deng Yanyong , Sun Xin , Zhang Mingqing , Pan Jie , Huang Zhiming , Ye Guoliang , Si Jianmin , Wang Lan , Chen Shujie 
Published: October 2020

Abstract
Background: The reformulated simethicone emulsion from Berlin Chemical AG might develop white flocculate precipitation covering gastric mucosa when used before esophagogastroduodenoscopy (EGD). We aim to investigate whether combining reformulated simethicone emulsion with 5% NaHCO3 solution could prevent the development of white precipitation and improve visibility during EGD. Methods: Our study involved 523 patients. They were randomly assigned to two groups: In Group A patients received a warm mixed solution containing 30 ml 5% NaHCO3 solution and 15 ml reformulated simethicone emulsion. In Group B patients received 45 ml 40℃ lukewarm water. Visibility scores were recorded and analyzed. In addition, flush times, volume of flush water, overall time taken for EGD and complications during or after procedure were also recorded. Results: We found that no white precipitation was observed during EGD in Group A. Moreover, visibility scores in Group A were significantly lower (P < 0.01). Patients in Group A had fewer flush times (P < 0.01) and smaller volumes of flush water (P < 0.01). In addition, overall time taken for EGD procedure was significantly shorter in Group A (P < 0.01). The percentage of patients who had no adverse response is significantly higher in patients in Group A compared to Group B (P < 0.01). Conclusions: Premedication with mixed solution of 15ml reformulated simethicone emulsion and 30ml 5% NaHCO3 solution can prevent the development of white precipitation, substantially enhance mucosal visibility safely.Trial registration: The registered name of the trial is “Efficacy of using premedication with reformulated simethicone emulsion during upper gastrointestinal endoscopy examination”. Current Controlled Trials ChiCTR1900021689, as well as the date of registration is 11 September 2019. Retrospectively registered, http://www.medresman.org.cn/uc/sindex.aspx.
Comparison of Three Different Screw Trajectories in Osteoporotic Vertebrae: A Biomechanical Investigation
Authors: Jarvers Jan-Sven , Schleifenbaum Stefan , Pfeifle Christian , Oefner Christoph , Edel Melanie , Höh Nicolas von der , Heyde Christoph E. 
Published: October 2020

Abstract
Background: Pedicle screw insertion in osteoporotic patients is challenging. Achieving more screw-cortical bone purchase and invasiveness minimization, the cortical bone trajectory and the midline cortical techniques represent alternatives to traditional pedicle screws. This study compares the fatigue behavior and fixation strength of the cement-augmented traditional trajectory (TT), the cortical bone trajectory (CBT) and the midline cortical (MC). Methods: Ten human cadaveric spine specimens (L1 - L5) were examined. The average age was 86.3 ± 7.2 years. CT scans were provided for preoperative planning. CBT and MC were implanted by using the patient-specific 3D-printed placement guide (MySpine®, Medacta International), TT were implanted freehand. All 10 cadaveric specimens were randomized to group A (CBT vs. MC) or group B (MC vs. TT). Each screw was loaded for 10,000 cycles. The failure criterion was doubling of the initial screw displacement resulting from the compressive force (60 N) at the first cycle, the stop criterion as a doubling of the initial screw displacement. After dynamic testing, screws were pulled out axially at 5 mm/min to determine their remaining fixation strength. Results: The mean pull-out forces did not differ significantly. Concerning the fatigue performance, only one out of ten MC of group A failed prematurely due to loosening after 1,500 cycles (L3). Five CBT already loosened during the first 500 cycles. The mean displacement was always lower in the MC. In group B, all TT showed no signs of failure or loosening. Three MC failed already after 26 cycles, 1,510 cycles, and 2,144 cycles, respectively. The TT showed always a lower mean displacement. In the subsequent pull-out tests, the remaining mean fixation strength of the MC (449.6 ± 298.9 N) was slightly higher compared to the mean pull-out force of the CBT (401.2 ± 261.4 N). However, MC (714.5 ± 488.0 N) were inferior to TT (990.2 ± 451.9 N).Conclusion: The current study demonstrated that cement-augmented TT have best fatigue and pull-out characteristics in osteoporotic lumbar vertebrae, followed by the MC and CBT. MC represent a promising alternative in osteoporotic bone if cement augmentation should be avoided. Using the patient-specific guide contributes to improve screws’ biomechanical properties.
Low Agricultural Potential Exacerbates the Effect of Temperature on Civil Conflicts
Authors: Goyette Jonathan , Smaoui Maroua 
Published: October 2020

Abstract
Using data on 172 countries from 1946 until 2014, this paper examines how time-wise variations in temperature at the country level interacted with cross-country variations in agricultural potential impact the incidence of civil conflicts. In the analysis, countries exhibiting high agricultural potential act as a control group for countries with a lower agricultural potential and variations in temperature act as a treatment from one period to the next. This allows identifying the causal impact of the interaction on conflict incidence. We find that deviations in annual or decennial temperature are conducive to a higher probability of being in conflict in countries with lower agricultural potential. The findings have important policy implications to predict, avoid or mitigate conflicts related to climate change.
Comparing the Efficacy and Side Effects of PDLASTA® (Peg-Filgrastim) with PDGRASTIM® (Filgrastim) in Breast Cancer Patients; A Non-inferiority Randomized Clinical Trial
Authors: Najafi Safa , Ansari Maryam , Kaveh Vahid , Haghighat Shahpar 
Published: October 2020

Abstract
Background: The objective of this study was to compare the efficacy and side effects of to evaluate the efficacy and safety of a single dose (Peg-Filgrastim or PDL) or repeated six daily injections (Filgrastim or PDG) during chemotherapy courses in breast cancer patients in a non-inferiority clinical trial.Methods: In this randomized clinical trial, 80 patients recruited and allocated randomly in two equal arms. In one group, a single subcutaneous dose of 6 mg of PDL was injected the day after receiving a chemotherapy regimen in each cycle. The second arm received a subcutaneous injection of 300 micrograms per day for six consecutive days in each course of treatment. Side effects of GCF treatment and its effect on blood parameters were compared in each cycle and during eight courses of chemotherapy.Results: hematologic parameters showed no significant difference in each course of treatment between two groups of study. The comparison of the WBC (p=0.527), Hgb (p=0.075), Platelet (p=0.819), Neutrophil (p=0.575), Lymphocyte (p=705) and ANC (p=0.675) changes during eight courses of treatment identified no statistically significant difference between two study groups. Side effects including headache, injection site reaction and muscle pain had a lower frequency in patients receiving PDL drugs.Conclusion: Regarding our results, PDL is completely non- inferior in efficacy and also less toxic compared to PDG. Prescribing in single-dose and lower expenses of PDL introduces it as a cost-effective drug in the treatment of chemotherapy-induced neutropenia. Trial registration number, date of registration: IRCT20190504043465N1, May 2019https://www.irct.ir/search/result?query=IRCT20190504043465N1
Implant Breakage Risk for Modular Fluted Tapered Stems in Revision Total Hip Arthroplasty at 5-Year Follow-Up
Authors: Lucena Thibaut , Cavaignac Etienne , Chiron Philippe , Reina Nicolas 
Published: October 2020

Abstract
Background: Modular stems in revision total hip arthroplasties allow diaphyseal fixation and optimal restoration of the architecture of the proximal femur. Several studies report metaphyseal implant breakage in the mid- to long-term and therefore a huge impact on survivorship. We aimed to evaluate a specific design of uncemented modular fluted tapered stems (MFT) to analyze survivorship and clinical and radiological outcomes.Methods: In a retrospective study, we identified 99 patients who had surgery using the same design of MFT implant between 2012 and 2014. Patients were mainly male in 53% and mean age was 73 years. Indications were 33 aseptic loosening, 24 periprosthetic fractures, 23 periprosthetic joint infection, 1 instability and 18 were complex primary arthroplasties. Survivorship, complications and clinical outcomes, were assessed. Mean follow-up was 5 years.Results: There was no implant breakage. At 5-year follow-up, the survivorship free of revision for aseptic loosening and free of revision for any reason of the femoral stem were 100% and 99%, respectively. At last follow-up, they were 94% and 81%, respectively. Six implants were revised. A mean stem subsidence of 6 mm was noted in 9 cases; 1 was revised for aseptic loosening. The Harris hip score was 89. The risk of revision was significantly higher for shorter diaphyseal implants (p=0.026).Conclusion: At mid-term follow-up of 5 years, the MFT studied reported an excellent survivorship and clinical outcomes with no specific complications. Unlike literature reports, no specific complications occurred with this design. Satisfying clinical outcomes and limited subsidence are consistent with previous reports though.Level of evidence: IV – Case series
Clinical Outcomes of Physiotherapy for Patients with Acetabular Labral Tears: An Analysis According to Severity of Injury
Authors: Kawai Makoto , Tateda Kenji , Ikeda Yuma , Motomura Ryosuke , Kosukegawa Ima , Kaya Mitsunori , Nagoya Satoshi , Katayose Masaki 
Published: October 2020

Abstract
Background: Arthroscopic labral repair is an effective treatment for femoroacetabular impingement (FAI) and acetabular labral injury. However, the effectiveness of physiotherapy treatment is controversial. Previous studies that analyzed the outcome of physiotherapy for patients with FAI or acetabular labral tears did not consider damaged tissues or the severity of the acetabular labral tear. This study aimed to evaluate (1) the short-term outcome of physiotherapy in patients with acetabular labral tears confirmed by magnetic resonance imaging (MRI) and (2) the effectiveness of physiotherapy according to the severity of the labral tear.Methods: Thirty-five patients who underwent physiotherapy for symptomatic acetabular labral tears from August 2013 to July 2018 were enrolled. We evaluated the severity of the acetabular labral tears, which were classified based on the Czerny classification system using 3-T MRI. Clinical findings of microinstability and extra-articular pathologies of the hip joint were also examined. Outcome scores were evaluated using the International Hip Outcome Tool 12 (iHOT12) at pre- and post-intervention.Results: The mean iHOT12 score significantly improved from 44.0 to 73.5 in 4.7 months. The post-intervention iHOT12 scores were significantly higher than the pre-intervention scores at stages I (pre 51.0, post 74.4; P=0.004) and II (pre 44.8, post 81.2; P<0.001). However, there were no significant differences between the pre-intervention and post-intervention iHOT12 scores at stage III (pre 36.6, post 60.8; P=0.061). Furthermore, 7 patients (20.0%) had positive microinstability tests, and 22 (62.9%) had findings of extra-articular pathologies. Of 35 patients, 8 (22.9%) underwent surgical treatment after failure of conservative management, of whom 4 had Czerny stage III.Conclusions: Physiotherapy significantly improved the iHOT12 score of patients with acetabular labral tears in the short-term period. In patients with severe acetabular labral tear, improvement of clinical score by physiotherapy may be poor. Identifying the severity of acetabular labral tears can be useful in determining treatment strategies.
Preventing The Human Factor: Organisational Aspects Linked to Foetal Asphyxia.
Authors: AMADORI Roberta , GRANDIOSO Sara , OSELLA Elena , MELLUZZA Carmela , AQUINO Carmen Imma , STAMPINI Viviana , Pedrini Alberto De , TINELLI Raffaele , SURICO Daniela 
Published: October 2020

Abstract
Background: the aim of this study was to identify prepartum, intrapartum and organisational risk factors for foetal asphyxia. We focused on modifiable factors such as organisational factors, maternal Body Mass Index, Assisted Reproductive Technology pregnancies, smoking and number of clinical checks.Methods: This is a retrospective analytical observational study.It was carried out in a teaching hospital in Northern Italy. The data for this study was obtained from maternal and neonatal medical records,obstetric and neonatal hospital discharge summaries and birth assistance certificates.162 cases of mothers whose children experienced foetal asphyxia were compared to 162 controls where this condition did not occur. The different variables were analysed using the Fisher test, the Mann Whitney U test and logistic regression. The association probability was estimated by the odds ratio with a confidence interval of 95%. The alpha level of 0,05 was considered significant.Results: giving birth at night (p<0.001), lack of one to one assistance during labour (p <0.001), birth on a day of high volume activity(p<0.001), Assisted Reproductive Technology obtained pregnancies (p<0.001), number of clinical checks during pregnancy (p <0.001 ), smoking during pregnancy (p<0.001), high maternal body mass index (p<0.001 ), as well as other traditionally associated risk factors like shoulder distocia (p<0.001) or age>35 (p <0.001) all increased the risk in a statistically significant way.Conclusions: giving birth on a high activity day, at night or without one-to one care are organisational factors that statistically increase the risk of foetal asphxia.Our paper proposes strategies to try and modify these risk factors and therefore limit the incidence of foetal asphyxia and of its life changing consequences like cerebral palsy.
Association Between Media Use and Poor Sleep Quality Among Senior High School Students in Ratchaburi Province, Thailand: A Cross-Sectional Study
Authors: Chaveepojnkamjorn Wisit , Srik Jutiporn , Satitvipawee Pratana , Pitikultang Supachai , Khampeng Soontaree 
Published: October 2020

Abstract
Background: Poor sleep quality (PSQ) is an increasing health problem and adolescents also constitute risk groups. Portable mobile and media devices have become a part of children’s lives and may affect their sleep duration and quality. This study aimed to explore the prevalence of PSQ and identify the association between media use and PSQ among adolescents studying in high school grades 10-12.Methods: This cross-sectional study was conducted in Ratchaburi Province. A multi-stage sampling technique was used to enroll 777 adolescents from 8 schools from August-October 2016. The research instruments comprised factors of demographics and consumption behaviors and the questionnaire of Pittsburgh Sleep Quality Index. Multivariable logistic regression was used to calculate adjusted odds ratios (ORadj) and 95% Confidence Intervals (CI).Results: Prevalence of PSQ was 56.24%. The study subjects were mostly 16-17 years old (67.82%) and female (70.39%). Multivariable logistic regression, after controlling for possible confounders, there was an increased odds of PSQ in those who used a social media device (OR=1.34, 95%CI=0.97-1.87), and it showed a higher proportion of social media use among PSQ group.Conclusions: The surveillance system of media use and PSQ should be conducted accompanied by knowledge sharing on media use among parents, teachers and adolescents. To determine causal relationships, further longitudinal studies will be required to test for the association between media users and PSQ. This study may also provide some implications for health promotion on sleep quality of senior high school students.
Asthma-associated genetic variants induce IL33 differential expression through a novel regulatory region.
Authors: Aneas Ivy , Decker Donna , Howard Chanie , Sobreira Debora , Sakabe Noboru , Blaine Kelly , Stein Michelle , Hrusch Cara , Montefiori Lindsey , Tena Juan , Magnaye Kevin , Clay Selene , Gern James , Jackson Daniel , Altman Matthew , Naurekas Edward , Hogarth Douglas , White Steven , Gómez-Skarmeta José Luis , Schoettler Nathan , Ober Carole , Sperling Anne , Nobrega Marcelo 
Published: October 2020

Abstract
Genome-wide association studies (GWAS) have implicated the IL33 locus in asthma, but the underlying mechanisms remain unclear. Here, we identify a 5 kb region within the GWAS-defined segment that acts as a strong regulatory element in vivo and in vitro. Chromatin conformation capture showed that this 5 kb region loops to the IL33 promoter, potentially regulating its expression. We show that genotype at the asthma-associated SNP rs1888909, located within the 5 kb region, is associated with IL33 gene expression in human airway epithelial cells and IL-33 protein expression in human plasma, potentially through differential binding of OCT-1 (POU2F1) to the asthma-risk allele. Our data demonstrate that asthma-associated variants at the IL33 locus mediate allele-specific regulatory activity and IL33 expression, providing a novel mechanism through which a regulatory SNP contributes to genetic risk of asthma.
A Usability Study in Patients With Stroke Using MERLIN, a Robotic System Based on Serious Games for Upper Limb Rehabilitation in Home Setting
Authors: Guillén-Climent Silvia , Garzo Ainara , Muñoz-Alcaraz María Nieves , Casado-Adam Pablo , Ruiz-Ruano Javier Arcas , Mejías-Ruiz Manuela , Mayordomo-Riera Fernando Jesús 
Published: October 2020

Abstract
Background: Neuroscience and neurotechnology are changing stroke rehabilitation. Robotic devices as well as telerehabilitation have become of great interest and are increasingly being used to train the upper extremities after stroke. Its use in home settings allows to extend institutional rehabilitation by increasing and prolonging therapy. The aim of this study is to assess the usability of MERLIN robotic system based on serious games for the upper limb rehabilitation in stroke patients in a home environment.Methods: 12 participants with a stroke in three different stages of evolution (subacute, chronic of short evolution and long-term chronic) with impaired arm/hand function were recruited to use the MERLIN system for 3 weeks: one week of training at the Maimonides Biomedical Research Institute of Cordoba (IMIBIC), and 2 weeks at patients’ home. Evaluation of usability involved System Usability Scale (SUS), Adapted Intrinsic Motivation Inventory (IMI), Quebec User Evaluation of Satisfaction with assistive Technology (QUEST), and ArmAssist Usability Assessment Questionnaire which were evaluated post-intervention. Clinical outcomes on upper extremity motor function were assessed pre- and post-intervention.Results: Finally, 9 patients participated in the study, 3 drop-off due to the COVID-19. The usability assessment reported a high level of satisfaction: mean SUS score was 71.94 % (SD=16.38), mean QUEST scale was 3.81 (SD=0.38), and mean IMI score was 6.12 (SD=1.36). The results of the ArmAssist Questionnaire was an average of 6 out of 7, which indicates that MERLIN is easy to learn, easy to use and intuitive. Regarding clinical assessment, Fugl-Meyer scores showed moderated improvements from pre- to post-intervention in the total score of motor function (p = 0.002). There were no significative changes in Modified Ashworth scale outcomes (p = 0.169) Conclusions: This usability study indicates that home-based rehabilitation for upper limb with MERLIN system is safe, useful, feasible and motivating. The telerehabilitation suppose an important step towards an intensive rehabilitation to be bring to home.Trial registration: ClinicalTrials.gov, NCT04405609. Registered 06 January 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04405609