bluuebunny/crossref_metadata_2025_split huggingface dataset:
Walking Under the Influence
Authors: Knight Margot T. , Li Tong , Dhillon Navpreet K. , Srour Marissa , Huang Raymond , Margulies Daniel R. , Ley Eric J. , Barmparas Galinos 
Published: September 2020

Aim Pedestrian fatalities commonly involve alcohol. We sought to characterize alcohol intoxication among pedestrians struck by vehicles and examine correlations between admission time and injury severity. Methods The Los Angeles County Trauma and Emergency Medicine Information System database was reviewed for pedestrians struck by vehicles over a 16-year period starting January 2000. Subjects aged ≥18 years with available time and day of admission were selected. Patients with available blood alcohol content (BAC) were analyzed and those with positive (+) BAC (≥ 0.01%) were compared with those with negative (−) BAC. The primary outcome was mortality. Result 35 840 patients met criteria, with 12 122 (33.8%) tested for BAC. 71.2% were (+) BAC. The proportion of (+) BAC pedestrians peaked at 02:00 (48.9% of admitted pedestrians, 88.5% of BAC tested pedestrians). Patients with a (+) BAC were more likely hypotensive (3.5% vs 2.7%, P = .019) and admitted with a Glasgow Coma Scale ≤ 8 (9.4% vs 7.1%, P < .001). Overall mortality was 4.6%. Those admitted from 06:00 to 11:00 had the highest odds of mortality in (+) BAC patients (4.7%, adjusted odds ratio 3.16, adjusted P < .001). Conclusion Pedestrians struck by vehicles during late hours are commonly intoxicated. These findings could help legislators to implement changes and strategies to decrease the risk and burden of injury in intoxicated pedestrians.
Recess as a practical strategy to implement the Whole School, Whole Community, Whole Child model in schools
Authors: McLoughlin Gabriella M , Massey William V , Lane Hannah G , Calvert Hannah G , Turner Lindsey , Hager Erin R 
Published: September 2020

Objectives: Schools can provide an optimal environment for promoting children’s health behaviours. The Whole School, Whole Community, Whole Child (WSCC) model addresses 10 aspects of the school environment that can be used to promote student health behaviours and academic outcomes: namely, Health Education; Nutrition Environment and Services; Employee Wellness; Social and Emotional School Climate; Physical Environment; Health Services; Counselling, Psychological and Social Services; Community Involvement; Family Engagement; and Physical Education and Physical Activity. Design: Guidelines for practical use of the WSCC model for school professionals are limited, impeding potential impact on school health promotion. Accordingly, in this article, we seek to demonstrate an application of the WSCC model to a specific school-based practice: recess. Setting: School recess. Results: An overview of literature and evidence-informed practices details how recess can facilitate WSCC adoption and initial implementation. Areas requiring further empirical research prior to making additional recommendations are also discussed. Conclusion: Strategies to enhance learning and health are described, attempting to bridge the gap between research and practice in school settings using the WSCC model.
Predicting Procedure Step Performance From Operator and Text Features: A Critical First Step Toward Machine Learning-Driven Procedure Design
Authors: McDonald Anthony D. , Ade Nilesh , Peres S. Camille 
Published: September 2020

Objective The goal of this study is to assess machine learning for predicting procedure performance from operator and procedure characteristics. Background Procedures are vital for the performance and safety of high-risk industries. Current procedure design guidelines are insufficient because they rely on subjective assessments and qualitative analyses that struggle to integrate and quantify the diversity of factors that influence procedure performance. Method We used data from a 25-participant study with four procedures, conducted on a high-fidelity oil extraction simulation to develop logistic regression (LR), random forest (RF), and decision tree (DT) algorithms that predict procedure step performance from operator, step, readability, and natural language processing-based features. Features were filtered using the Boruta approach. The algorithms were trained and optimized with a repeated 10-fold cross-validation. After training, inference was performed using variable importance and partial dependence plots. Results The RF, DT, and LR algorithms with all features had an area under the receiver operating characteristic curve (AUC) of 0.78, 0.77, and 0.75, respectively, and significantly outperformed the LR with only operator features (LROP), with an AUC of 0.61. The most important features were experience, familiarity, total words, and character-based metrics. The partial dependence plots showed that steps with fewer words, abbreviations, and characters were correlated with correct step performance. Conclusion Machine learning algorithms are a promising approach for predicting step-level procedure performance, with acknowledged limitations on interpolating to nonobserved data, and may help guide procedure design after validation with additional data on further tasks. Application After validation, the inferences from these models can be used to generate procedure design alternatives.
The Journey Within
Authors: Dumitru Ana Maria 
Published: September 2020

A reflection on the challenges and joys of practicing medicine as a Catholic physician: God often leads us on paths we could not have imagined, and there is a beauty in the surrender to His will. The practice of medicine is increasingly challenging and yet we are called to shine brightly and to live out our vocations without fear, as stumbling blocks to our colleagues. Written from the perspective of a first-year resident in general surgery, this essay is a collection of experiences aimed at inspiring hope and providing encouragement to other Catholic physicians on our collective journey through the practice of medicine as a vocation. Summary: A collection of short stories from medical school, graduate school and the first year of residency, with reflections on the personal transformation that occurs along the journey of practicing as a Catholic physician scientist.
Comparison of small-diameter decellularized scaffolds from the aorta and carotid artery of pigs
Authors: He Zhijuan , Liu Guofeng , Ma Xu , Yang Daping , Li Qingchun , Li Ning 
Published: September 2020

Aim: Tissue-specific extracellular matrix promotes tissue regeneration and repair. We aimed to identify the optimal decellularized matrices for tissue-engineered vascular graft (TEVG). Methods: Decellularized aorta of fetal pigs (DAFP, n = 6, group A), decellularized aorta of adult pigs (DAAP, n = 6, group B), and decellularized carotid artery of adult pigs (DCAP, n = 6, group C) were prepared. Scaffolds were compared using histology and ultrastructure. Endothelial cell (EC) and myofibroblast (MFB) infiltration assessments were performed in vitro. Cell infiltration was measured in vivo. Biomechanical properties were also determined. Results: Almost original cells were removed by the acellularization procedure, while the construction of the matrix basically remained. In vitro, monolayer ECs and multi-layer MFBs were formed onto the internal surface of the specimens after 3 weeks. In vivo, cell infiltration in group A significantly increased at the 6th and 8th week when compared with groups B and C ( p < 0.01). The infiltrated cells were mainly MFBs and a few CD4+ T-lymphocytes/macrophages in the specimens. Groups A and B showed greater axial compliance than group C ( p < 0.01). Conclusion: DAFP was the most suitable for use as a small-caliber vascular graft.
Emergency Oral Contraceptive Consultations in Pharmacies in a Rural Setting: An Epidemiological Analysis
Authors: Pearce Emma , Jolly Kate 
Published: September 2020

Background: Emergency contraception has been available in pharmacies across England since 2001.There is a paucity of evidence describing those women accessing the service, particularly in rural locations, where pharmacies are integral to improving healthcare accessibility. Methods: Routinely collected data from all pharmacy consultations for emergency contraception in Shropshire, England, were obtained and anonymized for the study period April 1, 2016 to January 31, 2019. Consultations were described by time, age of consultee, rationale for consultation, method dispensed (levonorgestrel or ulipristal acetate), referral for copper intrauterine device fitting, chlamydia screening where appropriate and reason for choosing pharmacy setting. Repeat attenders were also described separately. Results: 3499 consultations occurred during the study period; 39% were aged between 16-20 years, and 52% attended following unprotected sexual intercourse. Levonorgestrel was initially most prescribed, however ulipristal acetate overtook it in 2018. Onward referral for copper intrauterine device and age-appropriate chlamydia screening took place in 3% and 4% of the eligible populations respectively. Women overwhelmingly chose the pharmacy setting owing to its convenience. Repeat attenders tended to be younger than single attenders, but otherwise similar. Conclusion: Pharmacy-based emergency contraception is an important and well-utilized service in this rural location and continued funding and possible service expansion should be considered.
The effect of imatinib administered in the prenatal period on testis development in rats
Authors: Suzan Z Topal , Tumkaya L , Mercantepe T , Atak M , Uydu HA 
Published: September 2020

Background: The purpose of this study was to examine the effects of exposure to imatinib in the prenatal period on testis development in rats. Methods: Although all the study groups received intraperitoneal imatinib on prenatal days 1–8, no pregnancy occurred in the Imatinib-80 group. Immunohistochemical analysis, TUNEL, c-kit and PDGF staining revealed no difference between the groups in terms of positivity scoring. Results: A significant decrease was detected in total sperm counts in the Imatinib-20 group compared to the control group, but the sperm count was higher in the Imatinib-60 group than in the Imatinib-20 group. At biochemical measurements, the drug increased oxidative stress in the testis and serum in the Imatinib-20 group, but caused a decrease in tissue in the Imatinib-60 group. Thiol measurements revealed a decrease in the testis and serum in the Imatinib-60 group, while an increase in serum measurements was observed in the Imatinib-40 group. Analysis revealed no difference between the groups in terms of protamine and histone gene expression levels in testis tissue exposed to imatinib. Conclusion: Our findings show that prenatal exposure to imatinib can lead to histopathological and biochemical changes in testis tissue, but that no adverse effect occurs in nuclear maturation of germ cells during spermiogenesis.
International Trade Cooperation and Exogenous Economic Shocks in Developing Countries
Authors: Gnangnon Sena Kimm 
Published: September 2020

This article explores whether the World Trade Organization (WTO), through its role of promoting multilateral trade liberalisation and mobilising greater financial resources (i.e., Aid for Trade [AfT] flows) in favour of the trade sector in developing countries, contributes to reducing the size of external economic shocks experienced by these countries. An empirical analysis is carried out using a sample of 111 countries over the period 1996–2016 and relying on the two-step system generalised method of moments (GMM) approach. The findings indicate that taken separately, multilateral trade liberalisation and AfT flows reduce the size of shocks. While the two factors are substitutable in negatively influencing countries’ size of shocks, it also appears that multilateral trade liberalisation always results in smaller shocks, irrespective of the amount of AfT that accrues to countries. JEL: F13, F14, F32, F35
A Qualitative Analysis of Factors Impacting Comprehensive Cleft Lip and Palate Care in Ghana
Authors: Sommer Chelsea L. , Wankier Ali P. , Obiri-Yeboah Solomon , Gyamfi Seth , Frimpong Barbara Amponsah , Dickerson Ty 
Published: September 2020

Objective: The objective of this study was to examine practices regarding cleft lip and palate (CLP) among medical professionals and caregivers of children with CLP and to identify barriers and facilitators to comprehensive CLP care at a hospital in West Africa. Design: Qualitative methods used consisted of individual semistructured interviews with caregivers of children with CLP and one focus group with CLP team members. Setting: A majority of the interviews took place in the hospital, with some occurring during home visits. The focus group was conducted in the same hospital. Participants: Forty-five caregivers of children with CLP and 1 adult with CLP completed an interview. Additionally, 2 of the caregivers had CLP and completed an interview from their perspective. The focus group consisted of 13 CLP team members from a comprehensive CLP team in Ghana. Interventions: Interviews consisted of semistructured, open-ended questions, and the focus group relied on a discussion guide. Line-by-line coding was used to identify common themes regarding barriers and facilitators to CLP care. Results: Barriers to CLP care that were consistent across caregiver interviews and the focus group were lack of knowledge regarding CLP, stigma and cultural beliefs surrounding CLP, transportation, financial, and feeding/nutrition issues. Barriers to care identified in the interviews and focus group were similar; however, facilitators to care varied greatly between the 2. Conclusions: Two different qualitative methods provided unique perspectives on barriers and facilitators to CLP care. However, patients and caregivers continue to face substantial barriers to obtaining care.
Use of the Modified Unilateral Cleft Lip Repair Technique to Establish a Cupid’s Bow With a Natural Structure
Authors: Ishigaki Tatsuya , Udagawa Akikazu 
Published: September 2020

Introduction: There are several surgical techniques for unilateral cleft lip repair. In most of these techniques, the points where the postoperative scars cross the vermilion border are on the peak of the Cupid’s bow. These scars make the shape of Cupid’s bow indistinct. To maintain the natural shape of the Cupid’s bow, we modified the surgical technique. Methods: We modified the modified Millard’s surgical technique (Onizuka’s surgical technique). The main point of this modification was as follows: we combined a small triangular flap and a vermilion triangular flap (described by Noordhoff). We maintained the projection point on the lateral side of cleft lip which was coordinated to the peak of the Cupid’s bow. Results: We could preserve the shape and symmetry of the peak of the Cupid’s bow. Conclusion: To keep the projection point on the affected side of cleft lip and the surrounding vermilion border as one curve structure is important in maintaining the natural shape of the Cupid’s bow.
Cisplatin-induced nephrotoxicity in children: what is the best protective strategy?
Authors: Ruggiero Antonio , Ariano Anna , Triarico Silvia , Capozza Michele Antonio , Romano Alberto , Maurizi Palma , Mastrangelo Stefano , Attinà Giorgio 
Published: September 2020

Introduction Platinum compounds, which are considerably effective for the treatment of childhood malignancies, have significantly contributed to the increase in long-term survival of children with cancer. Unfortunately, children receiving cisplatin-based chemotherapy have been known to be at risk for severe disabling adverse effects, such as nephrotoxicity. Methods A literature research of the MEDLINE PubMed database was conducted to identify articles published between 1980 and 2019 reviewing “Cisplatin AND mannitol.” Results The primary pharmacodynamics and clinical characteristics of cisplatin were described, focusing on its renal toxic effects and potential preventive strategies, in order to improve clinical outcomes among children with cancer aged 1 to 14 years. Currently, selecting either hydration alone or hydration plus mannitol for preventing nephrotoxicity has been controversial considering the lack of guidelines to provide treatment recommendations both among adults and children. Conclusions Appropriate knowledge regarding the pharmacokinetics and toxicological profile of cisplatin may help physicians prevent renal toxicity. Unfortunately, published data regarding the nephroprotective utility of adding mannitol appear to be inconclusive. As such, appropriate hydration remains the main fundamental strategy for reducing the risk of cisplatin-induced nephrotoxicity. Considering the increasing number of children safely cured of their tumours, it is imperative that those treated with cisplatin receive the most appropriate nephroprotective strategy for reducing the negative impact of platinum compounds on quality of life.
Heterotopic Nodules in the Placenta, an Immunohistochemical Re-evaluation of the Diagnosis of Adrenocortical Heterotopia
Authors: Heerema-McKenney Amy , Rabinowitz Laura , Bendon Robert , Bruehl Frido , Blank Alexander , Pinar Halit 
Published: September 2020

Background Rare nodules of heterotopic adrenocortical and hepatic tissue are reported in the placenta. A mechanism for adrenocortical tissue in the placenta has been perplexing, while hepatic tissue is generally considered related to yolk sac primordia. The clear cell morphology of these nodules is similar to the adrenal cortex of the adult; however, the fetal adrenal gland does not usually display clear cells. Methods We stained 9 placental nodules, histologically identical to “adrenocortical” heterotopia of the placenta, to determine whether adrenocortical differentiation could be confirmed. These cases include 3 archival cases initially diagnosed as “adrenocortical” heterotopia. Results Immunohistochemical staining with steroid factor-1 (SF-1), HepPar-1, and Arginase-1 showed that these nodules of clear cells are actually hepatic (SF-1 negative, HepPar-1, and Arginase-1 positive). PAS staining suggests that glycogen accumulation is responsible for the clear cytoplasm. In contrast, a nodule of adrenocortical heterotopia near the testis and the adrenal gland from a 38-week-old neonatal autopsy case confirm SF-1 reactivity as expected. Conclusion We propose that adrenocortical heterotopia in the placenta is a misnomer, and that these subchorionic nodules of clear cells demonstrate hepatic differentiation.
Diabetes consultation versus diabetes education in patients with poor glycaemic control: A telemedicine intervention study
Authors: Nyenwe Ebenezer A , Ashby Sydney , Tidwell Jamie 
Published: September 2020

Introduction The prevalence of diabetes is increasing around the world, especially in populations with limited health service resources. Diabetes is associated with increased mortality and cost. Therefore, we investigated the impact of increasing access to diabetes care through telemedicine. Methods Five rural communities were connected via videoconference. Patients received diabetes consultation (DC) or diabetes self-management education (DSME). DC was performed by an endocrinologist, while DSME was delivered by a certified diabetes educator. Haemoglobin A1c (HbA1c), blood pressure (BP) and lipid profile were evaluated as outcome measures. Results Sixty-nine subjects (70% females, 91% Caucasians) were studied, with 33 receiving DC and 36 receiving DSME. Patients were aged 56.7 ± 9.4 and 56.5 ± 6.7 years, respectively ( p > 0.5), and had had diabetes for 11.4 ± 10.1 and 11.7 ± 9.2 years, respectively ( p > 0.5). Both DC and DSME reduced HbA1c equally: DC at baseline 9.3 ± 1.3% compared to at 12 months 7.2 ± 0.9% ( p = 0.0002), and DSME at baseline 9.8 ± 1.6% compared to at 12 months 8.3 ± 1.9% ( p = 0.009). There was no difference in HbA1c between DC and DSME at baseline and at 12 months ( p > 0.1). On the average, BP and lipids were equally controlled in DC and DSME at six months: total cholesterol 178.3 ± 50.5 mg/dL versus 185.9 ± 57.3 mg/dL, low-density lipoprotein cholesterol 91.4 ± 36.1 mg/dL versus 91.5 ± 50.2 mg/dL, high-density lipoprotein cholesterol 46.2 ± 11.0 mg/dL versus 43.5 ± 10.8 mg/dL, systolic BP 136.8 ± 23.6 mmHg versus 131.9 ± 22.3 mmHg, diastolic BP 72.0 ± 13.2 mmHg versus 77.7 ± 11.3 mmHg ( p > 0.1). All subjects found DC and DSME cost effective, while 97% reported better diabetes control. Discussion In patients with long-standing uncontrolled diabetes who lived in rural communities with high diabetes-related mortality rates, DC or DSME delivered by videoconference improved glycemic control. No difference was found between the two interventions.
Management of diastasis of the rectus abdominis muscles: recommendations for swedish national guidelines
Authors: Carlstedt Anders , Bringman Sven , Egberth Mattias , Emanuelsson Peter , Olsson Anders , Petersson Ulf , Pålstedt Joakim , Sandblom Gabriel , Sjödahl Rune , Stark Birgit , Strigård Karin , Tall Jael , Theodorsson Elvar 
Published: September 2020

Background: Diastasis of the rectus abdominis muscle is a common condition. There are no generally accepted criteria for diagnosis or treatment of diastasis of the rectus abdominis muscle, which causes uncertainty for the patient and healthcare providers alike. Methods: The consensus document was created by a group of Swedish surgeons and based on a structured literature review and practical experience. Results: The proposed criteria for diagnosis and treatment of diastasis of the rectus abdominis muscle are as follows: (1) Diastasis diagnosed at clinical examination using a caliper or ruler for measurement. Diagnostic imaging by ultrasound or other imaging modality, should be performed when concurrent umbilical or epigastric hernia or other cause of the patient’s symptoms cannot be excluded. (2) Physiotherapy is the firsthand treatment for diastasis of the rectus abdominis muscle. Surgery should only be considered in diastasis of the rectus abdominis muscle patients with functional impairment, and not until the patient has undergone a standardized 6-month abdominal core training program. (3) The largest width of the diastasis should be at least 5 cm before surgical treatment is considered. In case of pronounced abdominal bulging or concomitant ventral hernia, surgery may be considered in patients with a smaller diastasis. (4) When surgery is undertaken, at least 2 years should have elapsed since last childbirth and future pregnancy should not be planned. (5) Plication of the linea alba is the firsthand surgical technique. Other techniques may be used but have not been found superior. Discussion: The level of evidence behind these statements varies, but they are intended to lay down a standard strategy for treatment of diastasis of the rectus abdominis muscle and to enable uniformity of management.