bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Study on the Short-Term Mortality and Related Risk Factors of Fragile Hip Fracture
Authors: Wang Pei-Wen , Zhuang Hua-Feng , Li Yi-Zhong , Xu Hao , Lin Jin-Kuang , Yao Xue-Dong 
Published: December 2020

Abstract
BackgroundThis study aimed to observe the mortality of patients with fragile hip fractures and assess the death-associated risk factors.MethodsSix hundred and ninety patients with osteoporotic hip fractures(aged 50-103-years-old) that were treated from January 2010 to December 2015 were enrolled in this study and followed-up and the clinical data were retrospectively examined. Three months, one year, and the total mortality during the follow-up time were measured. Mortality-related risk factors were assessed including age, gender, surgery, the duration from injury to operation, pulmonary infection, and the number and type of complications.ResultsThe 286 patients were followed up between 6 months and 42 months, with an average of 21.42±9.88 months. The three-month mortality was 7.69%, the number of patients who were followed up over one year was 231, the one-year mortality was 16.02%, and the total mortality of the follow-up time was 17.48%. The higher mortality was related to age over 75 years, associated cardio-respiratory diseases, male gender, non-operative treatment, surgery delayed over 5 days. Binary Logistic regression analysis showed that the independent risk factors affecting mortality included age (OR=5.385, P=0.003), surgery (OR=21.217, P=0.000), the number of complications (OR=9.038, P=0.000), and pre-injury cardiovascular disease (OR=3.201, P=0.041).ConclusionThe early mortality of fragile hip fractures was high and was also related to many risk factors. Age, surgery, the number of complications, and pre-injury cardiovascular disease were the independent risk factors affecting the mortality of patients with fragile hip fractures. Effective treatment without complications and early surgery can lower early mortality in patients with fragile hip fractures.
Minimally Invasive Transforaminal Lumbar Interbody Fusion Ameliorates Persistent Pain After Lumbar Fusion Surgery
Authors: Li Jun , Liu Kai , Yang Li , WANG DEGUO 
Published: December 2020

Abstract
Background: Approximately 4-20% patients with degenerative lumbar diseases showed persistent pain after lumbar fusion surgery that may develop into failed back surgery syndrome (FBSS), and this persistent pain may be related to the postoperative increased release of inflammatory mediators. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) can obviously reduce the intraoperative soft tissue trauma. The aim of this study is to investigate the persistent pain in the patients with degenerative lumbar diseases undergoing MIS-TLIF compared with conventional‑invasive TLIF. Material and methods: This study retrospectively included 146 patients (MIS-TLIF vs. conventional‑invasive TLIF: 56 vs. 90), and the incidence of persistent pain were evaluated. Furthermore, inflammation related markers in both blood and drainage fluid samples, including white blood cell (WBC) count, C-reactive protein (CRP), creatine kinase (CK), interleukin-6 (IL-6) and IL-1β, were tested before and after operation. Results: Significantly larger number of patients undergoing conventional‑invasive TLIF showed postoperative persistent pain compared to those undergoing MIS-TLIF (4/56, 7.1% vs. 20/90, 22.2%; P < 0.05). In both treatment groups, the patients with postoperative persistent pain showed increased IL-6 and IL-1β in drainage fluid, as well as increased IL-6 in blood samples (P < 0.05), and there is significant correlation between the inflammation markers in drainage fluid and the extent of postoperative persistent pain in patients with postoperative persistent pain (P < 0.05). Conclusions: Local inflammatory substance accumulation may be potential cause for postoperative persistent pain, and MIS-TLIF may reduce this inflammatory accumulation at the surgical site and subsequently reduce the risk of persistent pain.
Arthroscopic Treatment for Intraosseous Ganglion Cyst of Carpal Bone Combined With Occult Wrist Instability
Authors: Zhao Gang , Tao Shanchun , Mi Jingyi , Yao Qun 
Published: December 2020

Abstract
Background: Intraosseous ganglion cysts (IOGs) of the carpal bone are uncommon tumors that may represent rare causes of chronic wrist pain. Arthroscopic resection has been described in isolated symptomatic cases as a feasible technique; however, there is no published study investigating this technique in an unstable wrist. We aimed to study the outcome of arthroscopic lesion resection combined with intercarpal ligament thermal shrinkage for the IGOs in the wrists with occult instability.Methods: Fourteen patients from our hospital database between 2013 and 2015 who had IOGs combined with occult carpal instability were retrospectively reviewed. Diagnosis was exclusively established based on persistent wrist pain and functional limitation before surgery. The IOGs were removed under arthroscope, and bone grafting was performed accordingly dependent on the sizes and locations of the lesion. The lax intercarpal ligaments were tightened by radiofrequency shrinkage. Results were analyzed for demographic data and functional outcomes.Results: At a mean follow-up of 27 months, all patients were satisfied with pain relief and the patients’ grip power improved. The pre- and postoperative range of motion of the affected wrist had no significant difference. Radiologically, cyst recurrence and joint instability development were not observed. The postoperative function of the wrists significantly improved based on the Mayo Wrist Score and Patient-rated Wrist Evaluation score.Conclusions: For IOGs of carpal bones in the wrist with occult instability, arthroscopic treatment, including cyst resection and ligament thermal shrinkage, was an effective way to improve pain and function of the effected wrist.
Finite Element Analysis of the Indirect Reduction of Posterior Pedicle Screw Fixation for a Thoracolumbar Burst Fracture
Authors: Song Yuanzheng , Li Wei , Zhu Fahao 
Published: December 2020

Abstract
Background: Because burst fractures often involve damage to the column and posterior structures of the spine, the fracture block may invade the spinal canal and compress the spinal cord or the cauda equina, causing corresponding neurological dysfunction. When a thoracolumbar burst fracture is accompanied by the presence of bone in the spinal canal, whether posterior surgery requires spinal canal incision decompression remains controversial.Methods: Computed tomography (CT) images of the thoracolumbar spine of a 31-year-old male with an L1 burst fracture and Mimics 10.0 were used to establish a three-dimensional fracture model for simulating the indirect reduction process. The model was imported into Ansys 10.0, and a 1-10 mm displacement was loaded 10° behind the Z-axis on the upper endplate of the L1 vertebral body to simulate position reduction and open reduction. The displacement and stress changes in the intervertebral disc, fractured vertebral body and posterior longitudinal ligament were observed during reduction.Results: Under a displacement loaded 10° behind the Z-axis, the maximum stress in the vertebral body was concentrated on the upper disc of the injured vertebrae. The maximum displacement corresponded to the anterior edge of the vertebral body of the injured vertebrae, and the vertebral body height and the anterior lobes were essentially restored. When the displacement load was applied in the positive Z-axis direction, the maximum displacement corresponded to the posterior longitudinal ligament behind the injured vertebrae. Under a 6 mm load, the posterior longitudinal ligament displacement was 11.3 mm. Under an 8 mm load, this displacement significantly increased to 15.0 mm, and the vertebral stress was not concentrated on the intervertebral disc.Conclusions: The reduction of thoracolumbar burst fractures by positioning and distraction allowed the injured vertebrae to be restored to the normal height and kyphotic angle. The reduction of the posterior longitudinal ligament can move the bone block in the spinal canal into the reset space and yield good reset results.
The Analysis of Hepatitis B Virus Precore/core Mutations Arising in Different States of Infection
Authors: Hosseini Seyed Younes , Sanaei Neda , Hashemi Seyed Mohammad Ali , Dehno Seyedeh Zahra Salehi , Asl Mozhde Mahmoudi , Moini Maryam , Malek-Hosseini Seyed Ali , Sarvari Jamal 
Published: December 2020

Abstract
Background: In hepatitis B virus (HBV) infection, an association between Precore/Core variations and liver disease progression has been suggested. In this study, we aimed to determine the frequency of Precore/Core mutations in HBV-infected patients at various clinical stages. Methods: Totally, 73 HBV-infected patients including 26 inactive carriers, 20 chronic active and 27 patients with liver cirrhosis/hepatocellular carcinoma were randomly selected. The HBV DNA was extracted from the sera and subjected to nested PCR for amplification of pre-core/core region. The PCR product was then sequenced by Sanger method. Results: The stop codon of W/*28 was determined as the most prevalent mutation (55%) of pre-core region. The comparison of groups also demonstrated that core substitutions at residues of S21, E40 and I105 (<0.05) correlated with the development of inactive carrier state. Furthermore, the total substitutions in Th epitopes (117-131) were significantly higher in C/HCC group than IC and CA groups (P=0.001). Conclusion: Our results indicated a high frequency of W/*28 mutation in HBV studied patients. Moreover, variations including S21, E40 and I105 and R151 that were mapped onto cellular epitopes might be related to inactive state development.
The Perception of Ideal Facial Aesthetics Among Middle Eastern University Dental Students
Authors: Al-Harbi Asma , Al-Sanea Shoug , Al-Harbi Hajar , Kamal Mohammad 
Published: December 2020

Abstract
Background: The perception of facial aesthetics has been the subject of debate since ancient times and it is not considered to be absolute or fixed, rather relative. The dynamic relativity of facial aesthetics is thought to be affected by many factors, including but not limited to ethnicity, demographic variations, geographic locations, and other social backgrounds. The aim of this study was to assess the perception of ideal facial aesthetics among dental students in their preclinical and clinical years.Methods: A cross-sectional study of all dentistry students (n= 175 students) at Kuwait University Faculty of Dentistry. A morphometric questionnaire of six computer-generated 3D avatar female models with various facial features were constructed by altering the facial units: jaw shapes, chin shapes, nose shapes, mouth shapes, cheek shapes, profile shapes. Students were asked to choose the most and least preferred among the 6 avatar models.Results: A total of 149 questionnaire were completed by the students, with an overall response rate of 85.1%. The majority of students were female (92.6%). The preclinical and clinical students agreed on the most and least attractive facial model for all features except jaw shape. Students agreed that models with a broad jaw shape, moderately protruded chin with moderate height, short and less projected nose, prominent and full projected lips, prominent cheek bone with minimal buccal fat, and straight profile, were considered the most attractive faces.Conclusion: The study showed that dental students at Kuwait University have a perception of the facial esthetics that is largely in accordance with previously published studies. Dental students must recognize the variations of facial units and ideals of esthetics to better understand the demands and wishes of the patients, and thus, optimizing the treatment plan to achieve this goal.
Out-of-pocket Payments for Health Care Under the National Health Insurance Scheme in Ghana: What Do Clients Pay for?
Authors: Akweongo Patricia , Aikins Moses , Wyss Kaspar , Salari Paola , Tediosi Fabrizio 
Published: December 2020

Abstract
Background: The introduction of social health insurance in developing countries is an important policy to improve financial access to health care. In 2003, Ghana implemented a national health insurance scheme (NHIS) designed to promote universal health coverage and equitable access to health care. The scheme has largely been successful, yet it is confronted with many challenges threatening its sustainability. Out-of-pocket payments by insured clients is one such challenges of the scheme. This study seeks to examine the types of services that these unauthorized charges are made for, who pays these charges and how much clients pay out-of-pocket.Methods: This was a descriptive cross-sectional health facility survey. A total of 2066 respondents were interviewed using structured questionnaires at the point of health care exit in the Ashanti, Northern and Central regions of Ghana. Health facilities of different levels were selected from 3 districts in each of the three regions. Data were collected between April and June 2018. Using Epidata and STATA Version 13.1 data analyses were done using multiple logistic regression and simple descriptive statistics and results presented as proportions and means.Results: Of all respondents in the study 49.7% reported paying out-of-pocket for out-patient health care while 48.6% of insured clients paid out-of-pocket. 42% of the insured poorest quintile also paid out-of-pocket. Respondents suffered fever-malaria like symptoms (45.7%). Insured clients paid for consultation (75%) and drugs (68.5%) and 34.9% purchased drugs outside the health facility visited. The unavailability of the drugs (67.9%) and drugs not covered by the NHIS (20.8%) led to out-of-pocket payments. On average patients paid GHS33.00 (USD6.6) out-of-pocket. Compared to the Northern region, patients living in the Ashanti region were 4.4 times more at odds to pay out-of-pocket for health care. Conclusions: Insured clients of Ghana’s NHIS seeking health care in accredited health facilities make out-of-pocket payments for consultation and drugs that are covered by the scheme. The out-of-pocket payments are largely attributed to unavailability of drugs at the facilities. These out of-pocket payments occur in disadvantaged regions, among individuals and in all health facilities. Out-of-pocket payments under NHIS leads to inequity in access to health care.
Determinants of Severe Acute Malnutrition Among Children 6-36 Months in Kalafo District, Riverine Context, Ethiopia. Unmatched Case Control With Qualitative Study.
Authors: Ahmed Ahmed Tahir , Elmi Abdifatah , Abas Abdulahi , Omer Abdilahi 
Published: December 2020

Abstract
Background: Malnutrition remains prevalent and existing health problem globally. Particularly Undernutrition is a major public health issue in developing countries.Globally the causes of severe acute undernutrition varies across context. The aim of this study was to identify the determinants of severe acute malnutrition to uncover contextual factors based on UNICEF conceptual framework, as there was no study done in a similar context in Ethiopia.Methods: Health facility based (health post) un-matched case control study with Key informant interview was conducted to identify determinant factors of severe acute malnutrition(SAM) among children between 6 to 36 months. 246 children (82 cases and 164) with their mothers or care takers participated the study which was conducted between December 20, 2019 to January 20, 2020 in Kalafo district in Shebele River. Odds ratio with 95% confidence interval was calculated to identify the determinants of SAM among children aged 6-36 months using multivariate logistic regression.Results: The Odds of Severe Acute Malnutrition was 2.28(1.22,4.26); 4.68(2.29,9.58); 2.85(1.26,6.45); 2.39(1.16,4.96) and 3.262(1.46,7.31) and 3.237(1.45,7.23); respectively for mothers with three or more under five children, Children with inadequate dietary diversity, experienced diarrhea in past two weeks, their mothers had not nutrition counselling during pregnancy, Children’s age between 6-11 and 12-17 months as compared to controls.Conclusion: The finding of this study reveals that the main determinants of severe acute malnutrition in riverine context are multi-level. On top of poor childcare and polygamy in qualitative finding, Diarrhea and inadequate dietary intake under the category of immediate cause of malnutrition. Having more than (≥3) under-five children, young age (6-11 and 12-17months) and not having nutrition counseling during pregnancy were also among basic determinants of severe acute malnutrition in riverine context. Decisive and multi-sectoral approach is required to addressing SAM in the riverine area.
Occupational Noise-Induced Tinnitus：Knowledge, Attitude and Practice (KAP)
Authors: Bai Lu , Yu Jianping , Du Hong , Shen Zhuang , Yang Hongyan 
Published: December 2020

Abstract
Background: Occupational noise is the most common hazards in the workplaces. Noise exposure may induce tinnitus (ringing in the ears), which seriously affects workers’ normal life, even impair their work performance. To investigate associations between if respondents are awareness of tinnitus induced by occupational noise (Knowledge), what the viewpoint they have (Attitude) and how they cope with it (Practice). Methods: A questionnaire based cross-sectional study was conducted. 519 noise-exposed workers in railway transportation mechanical manufacturers were recruited as the exposed group. 515 non noise-exposed workers as the control group. To investigate the effects of noise exposure level, the exposed group was classified into 4 subgroups according to sound level measurements reported by industrial hygienists., while the exposed group was categorized into 3 subgroups according to usage of personal hearing protection device (PHPD). Questionnaire was focused on medical history, occupational history, life habits and tinnitus for all participants. Qualified audiologists assessed hearing threshold by using standardized audio-metric procedures assuring at least 48 h of noise avoidance.Results: The prevalence of tinnitus were 36.6% and 18.8% in the exposed group and in the control group, respectively. The difference was statistically significant (c2=40.725, P<0.05). The prevalence of tinnitus were 36.2%, 20.5% and 41.7% in 3 using PHPD subgroups of the exposed group. The difference was statistically significant (c2=6.072, P<0.05). The prevalence of tinnitus were 34.7%，8.3%，63.6% and 54.0% in 4 sound level subgroups. The difference was statistically significant (c2trend=30.491, P < 0.05). The percentage of clinic visit for tinnitus was 15.8% in the exposed group. 93.2% workers claimed tinnitus symptoms were unimproved since they still heard buzzing or ringing in ears. 81.05% of them gave up treatment. The percentage of clinic visit for tinnitus was 7.2% in the control group and 99.0% workers claimed tinnitus symptoms were unimproved. Conclusions: Only when workers have awareness of tinnitus and tinnitus treatment can they have positive attitude and better practice. Noise-exposed workers should periodically attend educational courses on “taking care of your ears” and should be under the supervision.
Ethambutol Induced Lichenoid Drug Eruption: A Case Report
Authors: Yuyaem Thitaree , Sudchada Patcharaporn , Srisuttiyakorn Chutika , Juntawong Jirapan , Khanngern Naruemon , Watcharapokin Natwara , Chansangiam Pitchayakorn 
Published: December 2020

Background:
A rare type of cutaneous adverse drug reaction (CADR), lichenoid drug
eruption (LDE), can be associated with ethambutol.

Case Report:
A 60-year-old woman with spinal tuberculosis received multiple anti-TB medications
and developed rashes after 3 months of the treatments. A skin biopsy from the posterior auricular
area confirmed lichenoid dermatitis, and the Naranjo causality assessment indicated ethambutol
as a probable cause of LDE in the patient. The rashes slowly improved after discontinuation of
ethambutol. Unfortunately, the residual of brown hyperpigmentation on the body still persisted for
over 16 months.

Conclusion:
The medications were reduced to isoniazid 300 mg/day and rifampicin 450 mg /day
as planned for another 3 months. This case report points out the essentials of early recognition of
ethambutol LDE by health care professionals.
A Comparative Study on Cultivars of Capsicum: Critical Assessment based on Colour Values, Pungency and total Capsaicinoids Content
Authors: Sarojam Smitha , Mohan Nikhil , Paul Sumi S. , Chacko Baby K. , Nema Neelesh K. , Jacob Viju 
Published: December 2020

Introduction:
Chillies or red peppers are consumed globally as a spice, condiment, culinary and as folk medicine because of their pungent taste, spicy flavour and therapeutic values. Colour, pungency and capsaicinoids are the potential characteristic attributes for assessing the quality of the dried chilli and are accountable for market price, trade and standardisation of the oleoresins.

Objective:
The present study was designed to prepare crude oleoresins from nineteen varieties of chilli and to enrich carotenoids contents in oleoresin paprika and capsaicinoids extractives in oleoresin capsicum separately for the evaluation and standardisation of colour, pungency and total capsaicinoids content.

Methods:
Crude oleoresins from dried fruits of chilli were prepared using conventional solvent extraction method, which were further enriched for the carotenoid and capsaicinoids extractives by fractionation techniques, and yielded oleoresin paprika and oleoresin capsicum separately. Oleoresins and their derivatives were subjected to analytical estimation of colour values, pungency and capsaicinoids content. The colour content was quantified using a UV Vis Spectrophotometer, whereas pungency was determined using HPLC and quantified as Million Scoville Heat Units. Total capsaicinoids contents were also quantified.

Results:
The highest extraction yield was found in the variety Teja (S-17) that is 8.82%, whereas enriched versions of oleoresin paprika and oleoresin capsicum were calculated higher in the varieties 273 and Teja (S-17) with the values 6.04 and 2.62%, respectively. The colour value of crude extract was the highest (3085.2 CU) in the variety 5531-IPM, whereas paprika was enriched high in the variety Lolly Chilli (3400.5 CU). The highest pungency (1.59 MSHU) was noted in the variety 5531-HPH. In the case of oleoresin capsicum, the pungency was highly enriched in the two varieties 4884 and Teja (S-17), with the MSHU values 6.11 and 5.5, respectively. Total capsaicinoids contents in the crude oleoresin were found maximum in the variety 5531-HPH (10.60%), whereas after purification (oleoresin capsicum), the maximum capsaicinoids contents were enriched in the varieties 4884 and Teja (S-17) with the values 40.73 and 36.67%, respectively.

Conclusion:
The outcome of our elaborated studies elucidates that Teja (S-17) 5531-HPH, 5531-IPM and 4884 varieties are better for extractive yield, pungency, and total capsaicinoids content, whereas 5531-IPM and Lolly Chilli varieties are better for colour extraction compared to all other varieties.