bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation and Optimization of Telehealth during the COVID-19 Public Health Crisis—Our Journey
Authors: Pirtle Claude J. , Tetleton-Burns Anna , Webb Ashley , Krodel Scott 
Published: July 2020

Telehealth offered a great opportunity for the clinicians at West Tennessee Healthcare to provide an essential service to the community at large during these unprecedented times. Our telehealth footprint continues to enlarge daily with more clinicians and specialties becoming comfortable with the workflows and technology. The program is described herein.
The COVID-19 pandemic tests the ability of many primary care, urgent care, and hospital systems to adapt quickly to new circumstances. In many of these offices, virtual telehealth visits have become a strategy to decrease the use of personal protective equipment, and mitigate the risk of exposure of providers, staff, or patients to the coronavirus, among many other opportunities.1 West Tennessee Healthcare noted these same strong headwinds, as the pandemic and emergency decelerations began to send individuals to continue to reschedule appointments for a multitude of reasons—including fear.
West Tennessee Healthcare is located in an underserved area with a lack of access to healthcare in all of our servicing districts. Each of these districts holds a classification of a partial or full healthcare professional shortage area. In our over 40 primary and specialty care clinics, face-to-face visits began to shudder near the end of March with the Tennessee governor’s first social distancing and business step-down regulations. With the foresight of other health systems being impacted by COVID-19, our medical practices were forced into a dilemma to creatively continue to offer quality care, but from a new environment. Prior to this federal and state emergency, our clinics were in the planning stages of creating a telehealth environment but had not completed any medical telehealth visits.
Standardization of Ayurvedic Drug- Nyctanthes arbor-tristis, Hippophae salicifolia, Ocimum tenuiflorum and Reinwardtia indica and Combined Herb-Herb
Authors: Kumari Rinki , Dubey G.P. 
Published: July 2020

The herbal medicines have reached extensive acceptability as therapeutic agents for various clinical diseases due to global demand. Therefore, standardization is the essential and initial step to drug development. It is for the establishment of consistent biological activity, a consistent chemical profile and biomarker identification. It improves the safety and efficacy of herbal medicine to provide the best herbal medicine to society and increase popularity rather than non-standardized extracts. In addition, it is essential to practice or maintain a quality assurance program for the production and manufacturing of herbal medicine that includes the basis of organoleptic characters and photomicrographs, physicochemical, proximate analysis phytochemical evaluation and quality control analysis and order to assess the quality of drugs, based on the concentration of their active principles. WHO has provided specific guidelines for the assessment of the safety, efficacy and quality of herbal drugs as a prerequisite for global harmonization and of utmost importance. In the present study, the herbal extracts were cleaned, dried in the shade and powdered by passing through the sieve as per the method described in the standard protocol. An overview covering various techniques employed in the extraction and characterization of Nyctanthes arbortristis, Hippophae salicifolia, Ocimum tenuiflorum and Reinwardtia indica, standardization is reported in this study. The obtained data would be very significant for future clinical aspects, as the bioactive molecules present in the extracts may exhibit synergistic effect with other bioactive compound and show a better therapeutic value. Thus, this study provides standardized and therapeutically potential data of active polyherbal formulations for the different ailments.
Política de gratuidad y desempeño académico en educación superior técnica profesional. Lecciones a partir del caso de Duoc UC.
Authors: Flores Roberto , Iglesias Catalina , Paredes Ricardo , Valdés Natalia 
Published: July 2020

This paper analyses the relationship between the gratuity policy implemented in Chile and measures of student academic performance from a higher vocational education and training institution. The research contributes evidence in a little explored field, especially regarding vocational education and training. Through the use of lineal and logistic regression models, it is possible to conclude that gratuity had an effect on reducing the number of dropouts and improving academic progress. The most significant effect is observed with students who in its absence, would have had to make a co-payment, since the financial aid they received would not have covered all expenses. Â However, if gratuity beneficiaries are compared to those that would not have had to pay, because their scholarships and loans covered all expenses, the results show that the gratuity policy is less effective in terms of the two academic indicators analyzed.Â Â Â
Residual numbness of the upper extremity after cervical surgery in patients with cervical spondylotic myelopathy
Authors: Iwamae Masayoshi , Suzuki Akinobu , Tamai Koji , Terai Hidetomi , Hoshino Masatoshi , Toyoda Hiromitsu , Takahashi Shinji , Ohyama Shoichiro , Hori Yusuke , Yabu Akito , Nakamura Hiroaki 
Published: July 2020

OBJECTIVEAlthough numbness is one of the chief complaints of patients with cervical spondylotic myelopathy (CSM), preoperative factors relating to residual numbness of the upper extremity (UE) and impact of the outcomes on cervical surgery are not well established. The authors hypothesized that severe preoperative UE numbness could be a risk factor for residual UE numbness after surgery and that the residual UE numbness could have a negative impact on postoperative outcomes. Therefore, this study aimed to identify the preoperative factors that are predictive of residual UE numbness after cervical surgery and demonstrate the effects of residual UE numbness on clinical scores and radiographic parameters.METHODSThe study design was a retrospective cohort study. The authors analyzed data of 103 patients who underwent cervical laminoplasty from January 2012 to December 2014 and were followed up for more than 2 years postoperatively. The patients were divided into two groups: the severe residual-numbness group (postoperative visual analog scale [VAS] score for UE numbness > 40 mm) and the no/mild residual-numbness group (VAS score ≤ 40 mm). The outcome measures were VAS score, Japanese Orthopaedic Association scores for cervical myelopathy, physical and mental component summaries of the 36-Item Short-Form Health Survey (SF-36), radiographic film parameters (C2–7 sagittal vertical axis, range of motion, C2–7 lordotic angle, and C7 slope), and MRI findings (severity of cervical canal stenosis, snake-eye appearance, severity of foraminal stenosis). Following univariate analysis, which compared the preoperative factors between groups, the variables with p values < 0.1 were included in the multivariate linear regression analysis. Additionally, the changes in clinical scores and radiographic parameters after 2 years of surgery were compared using a mixed-effects model.RESULTSAmong 103 patients, 42 (40.8%) had residual UE numbness. In the multivariate analysis, sex and preoperative UE pain were found to be independent variables correlating with residual UE numbness (p = 0.017 and 0.046, respectively). The severity of preoperative UE numbness did not relate to the residual UE numbness (p = 0.153). The improvement in neck pain VAS score and physical component summary of the SF-36 was significantly low in the severe residual-numbness group (p < 0.001 and 0.040, respectively).CONCLUSIONSForty-one percent of the CSM patients experienced residual UE numbness for at least 2 years after cervical posterior decompression surgery. Female sex and preoperative severe UE pain were the predictive factors for residual UE numbness. The patients with residual UE numbness showed less improvement of neck pain and lower physical status compared to the patients without numbness.
Safety of responsive neurostimulation in pediatric patients with medically refractory epilepsy
Authors: Panov Fedor , Ganaha Sara , Haskell Jennifer , Fields Madeline , La Vega-Talbott Maite , Wolf Steven , McGoldrick Patricia , Marcuse Lara , Ghatan Saadi 
Published: July 2020

OBJECTIVEApproximately 75% of pediatric patients who suffer from epilepsy are successfully treated with antiepileptic drugs, while the disease is drug resistant in the remaining patients, who continue to have seizures. Patients with drug-resistant epilepsy (DRE) may have options to undergo invasive treatment such as resection, laser ablation of the epileptogenic focus, or vagus nerve stimulation. To date, treatment with responsive neurostimulation (RNS) has not been sufficiently studied in the pediatric population because the FDA has not approved the RNS device for patients younger than 18 years of age. Here, the authors sought to investigate the safety of RNS in pediatric patients.METHODSThe authors performed a retrospective single-center study of consecutive patients with DRE who had undergone RNS system implantation from September 2015 to December 2019. Patients were followed up postoperatively to evaluate seizure freedom and complications.RESULTSOf the 27 patients studied, 3 developed infections and were treated with antibiotics. Of these 3 patients, one required partial removal and salvaging of a functioning system, and one required complete removal of the RNS device. No other complications, such as intracranial hemorrhage, stroke, or device malfunction, were seen. The average follow-up period was 22 months. All patients showed improvement in seizure frequency.CONCLUSIONSThe authors demonstrated the safety and efficacy of RNS in pediatric patients, with infections being the main complication.
Drivers for nonhome discharge in a consecutive series of 1502 patients undergoing 1- or 2-level lumbar fusion
Authors: Ogura Yoji , Gum Jeffrey L. , Steele Portia , Crawford Charles H. , Djurasovic Mladen , Owens R. Kirk , Laratta Joseph L. , Brown Morgan , Daniels Christy , Dimar John R. , Glassman Steven D. , Carreon Leah Y. 
Published: July 2020

OBJECTIVEUnexpected nonhome discharge causes additional costs in the current reimbursement models, especially to the payor. Nonhome discharge is also related to longer length of hospital stay and therefore higher healthcare costs to society. With increasing demand for spine surgery, it is important to minimize costs by streamlining discharges and reducing length of hospital stay. Identifying factors associated with nonhome discharge can be useful for early intervention for discharge planning. The authors aimed to identify the drivers of nonhome discharge in patients undergoing 1- or 2-level instrumented lumbar fusion.METHODSThe electronic medical records from a single-center hospital administrative database were analyzed for consecutive patients who underwent 1- to 2-level instrumented lumbar fusion for degenerative lumbar conditions during the period from 2016 to 2018. Discharge disposition was determined as home or nonhome. A logistic regression analysis was used to determine associations between nonhome discharge and age, sex, body mass index (BMI), race, American Society of Anesthesiologists grade, smoking status, marital status, insurance type, residence in an underserved zip code, and operative factors.RESULTSA total of 1502 patients were included. The majority (81%) were discharged home. Factors associated with a nonhome discharge were older age, higher BMI, living in an underserved zip code, not being married, being on government insurance, and having more levels fused. Patients discharged to a nonhome facility had longer lengths of hospital stay (5.6 vs 3.0 days, p < 0.001) and significantly increased hospital costs ($21,204 vs $17,518, p < 0.001).CONCLUSIONSIncreased age, greater BMI, residence in an underserved zip code, not being married, and government insurance are drivers for discharge to a nonhome facility after a 1- to 2-level instrumented lumbar fusion. Early identification and intervention for these patients, even before admission, may decrease the length of hospital stay and medical costs.
Guidelines for Establishing and Maintaining Farm-Based Weather Stations in Haiti
Authors: Staub Caroline G. , Eisenstadt William R. , Blanc William , Monval Nicole , Fraisse Clyde W. , Lusher William , Braun George , Staudt Lee 
Published: July 2020

Weather can significantly influence the success or failure of agricultural enterprises. Monitoring weather conditions can provide critical decision-making information. This new 4-page publication provides Haitian farmers with basic guidelines for installing and maintaining an on-farm weather station. Written by Caroline G. Staub, William Eisenstadt, William Blanc, Nicole Monval, Clyde W. Fraisse, William Lusher, George Braun, and Lee Staudt, and published by the UF/IFAS Department of Agricultural and Biological Engineering, May 2019. http://edis.ifas.ufl.edu/ae532
Adapted for Haitian audiences from Your Farm Weather Station: Installaton and Maintenance Guidelines (https://edis.ifas.ufl.edu/ae502)
Design and Construction of a Constant Head Infiltrometer
Authors: Bashyal Mahesh , Mulvaney Michael J. , Bean Eban Z. 
Published: July 2020

This new 8-page document details the construction procedure for a Mariotte siphon constant head infiltrometer using readily available materials. Written by Mahesh Bashyal, Michael J. Mulvaney, and Eban Z. Bean, and published by the UF/IFAS Agronomy Department, June 2019. http://edis.ifas.ufl.edu/ag433
COVID-19: Recommendations for Optimum Patient Management and Surgeons’ Safety
Authors: Bar Debashish , Alam ABM Khurshid , Rahman Fatema , Rahman AZM Mahfuzur , Suzana Nawreen 
Published: July 2020

The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2), has evolved rapidly as a global pandemic stretching the healthcare systems worldwide to their limits. This pandemic has resulted in significant changes to surgical practice across the world. Surgeons need to react immediately to this unexpected clinical challenge in a customized and dynamic approach to the selection, screening, planning, and conduct of surgery for their patients. This current literature will review various international society guidelines to provide a set of recommendations to safely accommodate the exponentially rising cases of SARSCoV- 2 infected patients without compromising the care of emergency surgery and oncological patients or jeopardizing the well-being of hospital staff. The recommendations include guidance for selection and screening of patients during different phases of COVID-19 spread throughout the country. Personal protective equipment requirements for safety measures are also reviewed for each phase as minimum requirements. We also provide recommendations on the patient prioritization for surgery, selection of surgical techniques to reduce transmission and exposure risk, operating room set up and conduct of general surgery. During the COVID-19 pandemic, every surgical unit needs to follow clear guidelines to ensure both patient and staff safety. These current guidelines may assist to provide guidance to units in developing their own protocols.
J Bangladesh Coll Phys Surg 2020; 38(0): 116-121
Psychological Assessment of Doctors Working in a Pandemic Condition in Dhaka Medical College Hospital
Authors: Mahmud Imran , Azad Khan Abul Kalam , Mamun Abdullah Al , Hoque Mohammad Mahfuzul , Mallik Md Uzzwal , Md Moniruzzaman - , Saha Shukdeb , Mark Sayeef Hossain Khan , Rahman Md Mujibur 
Published: July 2020

Introduction: The outbreak of COVID-19 is taking an unprecedented mental toll on health workers worldwide. So it comes as no surprise that the mental well-being of health care workers of Bangladesh too is in serious jeopardy. This survey was aimed to assess the immediate psychological impact on doctors working in largest Covid-19 dedicated facility in Bangladesh, Dhaka Medical College Hospital.
Methods: This cross sectional study was conducted in a single-centre with response received from participating doctors between 31st May to 3rd June, 2020. Mental health variables were assessed via the Athens Insomnia Scale (AIS) and Hospital Anxiety Depression Score (HADS).
Results: We received 192 completed questionnaires (response rate, 64.43%) among whom around 50% of the participating doctors reportedly have depression and anxiety symptoms respectively. Among them 104 doctors (54.17%) responded to have insomnia. Around 56% of the responding subjects perceived the highly contagious nature of the SARS-CoV-2 as the most striking threat of COVID-19.
Conclusion: Agonizing disease process, high death toll, highly contagious nature of the responsible virus is taking a serious mental toll on physicians in the background of their heightened concern about personal health and family health, scarcity in PPE and adequate hospital facility. Psychological protective measures implemented by the hospital could be helpful.
J Bangladesh Coll Phys Surg 2020; 38(0): 50-55
A Case Series of 100 COVID-19 Positive Patients Treated with Combination of Ivermectin and Doxycycline
Authors: Alam Mohammed Tarek , Murshed Rubaiul , Bhiuyan Elias , Saber Sadia , Alam Rafa Faaria , Robin Rishad Choudhury 
Published: July 2020

Background: A definitive treatment of SARS CoV-2 is yet to arrive and the human death toll rises exponentially globally. In this health emergency, it might be useful to look into the old therapies which could be effective against the virus. In vitro research showed Ivermectin could decrease the concentration of coronavirus 4000 to 5000 folds in living lung tissue.
Aim: In this prospective study a combination of Ivermectin and Doxycycline will be evaluated therapeutically to treat COVID-19 patients. Methods: 100 COVID-19 patients were enrolled in this study with a predefined inclusion and exclusion criteria. RT- PCR of the SERS-CoV-2 will be done at designated government hospitals. The clinical features and response to treatment were noted according to a dedicated protocol.
Results: In this study male and female were 64 and 36 respectively, the age ranged between 8 to 84 years. Retesting was done between 4 and 18 days of starting medication. All patients tested negative and their symptoms improved within 72 hours. There were no noticeable side effects.
Conclusion: Combination of Ivermectin and doxycycline was found to be very effective in viral clearance in mild and moderately sick COVID-19 patients. Medical societies and institutions should undertake larger multi center studies to validate and recommend this combination therapy to include in national guidelines.
J Bangladesh Coll Phys Surg 2020; 38(0): 10-15
Comparison of Viral Clearance between Ivermectin with Doxycycline and Hydroxychloroquine with Azithromycin in COVID-19 Patients
Authors: Rahman Md Azizur , Iqbal Syed Asif , Islam Md Azizul , Niaz Md Kaisar , Hussain Tahmeed , Siddiquee Taufiqul Hasan 
Published: July 2020

Introduction: The whole world is on the brink of collapse due to the outbreak of COVID-19 with no solution to treat these cases with any specific drug. Extensive search for the Vaccine or effective treatment is going on while alarming infection and death toll is rising every day.
Aim: The study will compare the effect of Ivermectin with Doxycycline and Hydoxychloroquine with Azythromicin on a selective group of COVID -19 positive patients.
Method: This is a comparative study that included 400 patients of COVID 19 positive patient who were divided in to two groups. Group- A Received Ivermectin with Doxycycline and the other group- B received hydroxichloroquine(HCQ) with azithromycin.
Result: Viral clearance is 132 ( 66%) on day 5 and 167( 83.5% ) on day 6. Among them 33(16.5%) remain PCR positive after 6th day of Ivermectin ingestion in Group A. Whereas there is154 ( 77.0%) viral clearance at 11th day and 163(81.5%) viral clearance at 12th day of Hydroxychloroquine ingestion in Group B. Among them 37 (18.5%) remain PCR positive after 12 day in group B. The P value is 0.000427 which is significant considering 5th day viral clearance of Ivermectin ingestion and 11th day of Hydroxychloroquine ingestion. But considering 6th day and 12th day the P-value is 0.59 which is not significant.
Conclusion: It appears Ivermectin and Doxycycline is safeand effective combination drug therapy in COVID- 19infected patients but need further extensive study to find out the scope of application on other groups of patients.
J Bangladesh Coll Phys Surg 2020; 38(0): 5-9
O consumo subcultural à luz da Teoria Cultural e da Filosofia da Diferença: a identidade e a identificação na esfera micro do gótico
Authors: Caetano Stella Mendonça 
Published: July 2020

Dentro de uma sociedade de consumo acelerado muitos produtos são direcionados aos sujeitos sociais, no entanto, nem todos são adquiridos por eles. As relações de consumo não são isentas de atravessamentos que as modificam, direcionam ou redirecionam. Um desses atravessamentos é a identidade. O presente ensaio propõe uma reflexão em torno das dinâmicas culturais entre identidade e consumo a partir das perspectivas da Teoria Cultural, cujo principal nome é Stuart Hall, e da Filosofia da Diferença proposta pelos filósofos Deleuze e Guattari; entender como se se dão as interferências entre esses à nível subjetivo e, assim, contribuir para o debate acerca das possibilidades e formas de consumo no momento contemporâneo. A partir das interseções entre as teorias e sob a ótica da identificação e singularização, concluímos que ambas apontam para o consumo subcultural enquanto uma atividade híbrida que, mesmo sendo reintegrada ao rizoma sistematicamente, também configura um rompimento com o mesmo. Por fim, o consumo subcultural é um elemento essencial na dinâmica de subsistência de grupos culturais, como o caso da subcultura gótica, analisada neste ensaio.
Hormone-Like Effects of 4-Vinylcyclohexene Diepoxide on Follicular Development
Authors: Cao Lian Bao , Liu Hong Bin , Lu Gang , Lv Yue , Leung Chi Kwan , Du Yan Zhi , Wang Wu Ming , Xiong Zhi Qiang , Su Xian Wei , Li Hong Jian , Chen Zi-Jiang , Ma Jin Long , Chan Wai Yee 
Published: July 2020

Background4-vinylcyclohexene diepoxide (VCD) has long been considered a hazardous occupational chemical that promotes ovarian failure. However, VCD is also used as a research compound to chemically induce animal models of premature ovarian insufficiency (POI), and in related work we unexpectedly found that VCD apparently exhibits both dose- and duration-dependent opposing, hormone-like effects on the maintenance of the primordial follicle pool, follicle development, and ovulation induction.ResultsWe conducted experiments with cultured murine ovaries and performed transplantation experiments using postnatal day (PD) 2 and PD12 mice and found that low-dose, short-term exposure to VCD (VCDlow) actually protects the primordial/primary follicle pool and improves the functional ovarian reserve (FOR) by disrupting follicular atresia. VCDlow inhibits follicular apoptosis and regulates the Pten-PI3K-Foxo3a pathway. Short-term VCD exposure in vivo (80 mg/kg, 5 days) significantly increases the number of superovulated metaphase II oocytes, preovulatory follicles, and corpus luteum in middle-aged mice with diminished ovarian reserve (DOR). We demonstrate that low-dose but not high-dose VCD promotes aromatase levels in granulosa cells (GCs), thereby enhancing the levels of estradiol secretion.ConclusionOur study illustrates a previously unappreciated, hormone-like action for the occupational “ovotoxin” molecule VCD and strongly suggests that VCDlow should be explored for its potential utility for treating human ovarian follicular development disorders, including subfertility in perimenopausal women.