bluuebunny/crossref_metadata_2025_split huggingface dataset:
Waddell (Nonorganic) Signs and Their Association With Interventional Treatment Outcomes for Low Back Pain
Authors: Cohen Steven P. , Doshi Tina L. , Kurihara Connie , Dolomisiewicz Edward , Liu Richard C. , Dawson Timothy C. , Hager Nelson , Durbhakula Shravani , Verdun Aubrey V. , Hodgson John A. , Pasquina Paul F. 
Published: July 2020

BACKGROUND:
The rising use of injections to treat low back pain (LBP) has led to efforts to improve selection. Nonorganic (Waddell) signs have been shown to portend treatment failure for surgery and other therapies but have not been studied for minimally invasive interventions.

METHODS:
We prospectively evaluated the association between Waddell signs and treatment outcome in 3 cohorts: epidural steroid injections (ESI) for leg pain and sacroiliac joint (SIJ) injections and facet interventions for LBP. Categories of Waddell signs included nonanatomic tenderness, pain during sham stimulation, discrepancy in physical examination, overreaction, and regional disturbances divulging from neuroanatomy. The primary outcome was change in patient-reported “average” numerical rating scale for pain intensity (average NRS-PI), modeled as a function of the number of Waddell signs using simple linear regression. Secondary outcomes included a binary indicator of treatment response. We conducted secondary and sensitivity analyses to account for potential confounders.

RESULTS:
We enrolled 318 patients: 152 in the ESI cohort, 102 in the facet cohort, and 64 in the SIJ cohort, having sufficient data for primary analysis on 308 patients. Among these, 62% (n = 192) had no Waddell signs, 18% (n = 54) had 1 sign, 11% (n = 33) had 2, 5% (n = 16) had 3, 2% (n = 7) had 4, and about 2% (n = 6) had all 5 signs. The mean change in average NRS-PI in each of these 6 groups was −1.6 ± 2.6, −1.1 ± 2.7, −1.5 ± 2.5, −1.6 ± 2.6, −1 ± 1.5, and 0.7 ± 2.1, respectively, and their corresponding treatment failure rates were 54% (102 of 192), 67% (36 of 54), 70% (23 of 33), 75% (12 of 16), 71% (5 of 7), and 83% (5 of 6). In the primary analysis, an increasing number of Waddell signs were not associated with a significant decrease in average NRS-PI (coefficient [Coef] = 0.19; 95% confidence interval [CI], –0.43 to 0.05; P = .12). A higher number of Waddell signs were associated with treatment failure, with a 1.35 increased odds of treatment failure per cumulative number of signs (P = .008).

CONCLUSIONS:
Whereas this study found no consistent relationship between Waddell signs and decreased mean pain scores, a significant relationship between the number of Waddell signs and treatment failure was observed.
Interview Data Highlight Importance of “Same-State” on Anesthesiology Residency Match
Authors: Love Ephy R. , Dexter Franklin , Reminick Jason I. , Sanford Joseph A. , Karan Suzanne 
Published: July 2020

Background:
The US residency application, interview, and match processes are costly and time-intensive. We sought to quantify the importance of an applicant being from the same-state as a residency program in terms of how this impacted the number of interviews needed to match.

METHODS:
We examined data from interview scheduling software used by 32 programs located in 31 US states and 1300 applicants for the US anesthesiology recruitment cycles from 2015 to 2018. Interviewee data (distance from program, region, numbers of interviews, and program at which interview occurred) were analyzed to quantify the effect of the interviewee being from the same state as the residency program on the odds of matching to that program. Other variables of interest (medical school, current address, US Medical Licensing Exam [USMLE] Step 1 and 2 clinical knowledge [CK] scores, Alpha Omega Alpha [AOA] status, medical school ranking) were also examined as controls. Confidence intervals (CI) were calculated for the ratios of odds ratios.

RESULTS:
An interviewee living in the same state as the interviewing program could have 5.42 fewer total interviews (97.5% CI, 3.02–7.81) while having the same odds of matching. The same state effect had an equivalent value as an approximately 4.14 USMLE points-difference from the program’s mean (97.5% CI was 2.34–5.94 USMLE points). Addition of whether the interviewee belonged to an affiliated medical school did not significantly improve the model; same-state remained significant (P < .0001) while affiliated medical school was not (P = .40).

CONCLUSIONS:
Our analysis of anesthesiology residency recruitment using previously unstudied interview data shows that same-state locality is a viable predictor of residency matching and should be strongly considered when evaluating whether to interview an applicant.
Determination of high sensitive cardiac troponin I 99th percentile upper reference limits in a healthy Pakistani population
Authors: Bahadur Kulsoom , Ijaz Aamir , Salahuddin Momin , Alam Aftab 
Published: July 2020

Objective: This study aims to establish the 99th percentile upper reference limits of high sensitive cardiac troponin I in a healthy Pakistani population.
Methods: It was an Observational cohort study carried out in Department of Chemical Pathology and Endocrinology Rehman Medical Institute Peshawar, over the period of one year (January 2019- December 2019). Total 299 cardio-healthy males and females were interviewed and taken past medical history. Based on history, clinical examination, echocardiogram and laboratory data including results of estimated glomerular filtration rate (eGFR) and N-terminal pro-B-type natriureteric peptide (NT-proBNP), subjects with possible subclinical diseases were excluded. High Sensitive Cardiac Troponin I (hs-cTtrop I) was analysed on Abbot ARCHITECT STAT ci8200 using chemiluminescent immunoassay technique. The 99th percentile upper reference limit (URL) of hs-cTtrop I was determined using a non-parametric statistic, while gender specific results were compared.
Results: In this study, 178 males (59.5%) and 121 females (40.5%) were included. The median Interquartile ranges (IQR) of age was 57 (11.6) for males and 56 (13) for females. The 99th percentile URL hs-cTtrop I was found to be 33.9 ng/L, while gender specific values were 38.41ng/L and 15.73ng/L for males and females, respectively (p= 0.0045).
Conclusion: High sensitivity cardiac troponin I 99th percentile URL in our study population was found to be 33.9 ng/L with gender specific values being 38.41 ng/L and 15.73ng/L for males and females respectively. Troponin I in males was substantially high in comparison with females.
doi: https://doi.org/10.12669/pjms.36.6.2328
How to cite this:Bahadur K, Ijaz A, Salahuddin M, Alam A. Determination of high sensitive cardiac troponin I 99th percentile upper reference limits in a healthy Pakistani population. Pak J Med Sci. 2020;36(6):1303-1307. doi: https://doi.org/10.12669/pjms.36.6.2328
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Characteristics, morbidity and mortality factors associated with Intra-Aortic Balloon Pump in Coronary Artery Bypass Graft Surgery patients
Authors: Shah Sayed Mumtaz Anwar , Jan Azam , Awan Nabil I , Rehman Mujeeb Ur 
Published: July 2020

Objective: The aim of our study is to analyze the characteristics, morbidity and mortality of patients requiring an Intra-Aortic Balloon Pump (IABP) in Coronary Artery Bypass Grafting (CABG).
Methods: An analysis was done on the prospectively collected data of 1216 patients who had CABG in our center between July, 2017 and May, 2019 at our hospital. We categorized patients in to an IABP and non-IABP group on the basis of IABP use. We then compared the pre-operative, per-operative and post-operative characteristics of the two groups. We further stratified the patients according to pre-op ejection fraction (EF).
Results: Out of 1216 patients, 135(11.10%) patients required an IABP. 70(51.9%) patients of IABP group and 699(64.7%) patients of non-IABP group had hypertension (p-value 0.0036). 23.0% had previous myocardial infarction (MI) in the IABP group and 13.8% had prior myocardial infarction (MI) in non-IABP group (p-value 0.0463). Among the patients requiring an IABP, 21(15.5%) of patients had normal EF (>50%) (P-value<0.0001), 72 (53.3%) had EF 35-50%, and 41(30.3%) patients had EF<35% (p-value <0.0001). Mortality of IABP group (19.3%) was greater than non-IABP group (2.4%) (P-value 0.00001).
Conclusions: Use of IABP increased as the EF decreased. Rate of post-operative stroke, prolonged ICU stay, prolonged ventilation, re-opening due to bleeding and mortality was seen to be significantly higher in the IABP group.
doi: https://doi.org/10.12669/pjms.36.6.2649
How to cite this:Shah SMA, Awan NI, Jan A, Rehman MU. Characteristics, morbidity and mortality factors associated with Intra-Aortic Balloon Pump in Coronary Artery Bypass Graft Surgery patients. Pak J Med Sci. 2020;36(6):1318-1324. doi: https://doi.org/10.12669/pjms.36.6.2649
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Fractional Equity, Blockchain, and the Future of Creative Work
Authors: Whitaker Amy , Kräussl Roman 
Published: July 2020

A core challenge in studying the real return on artist' work is the extreme difficulty accessing private records from when an artwork was first sold and thus relying on public auction data. In addition, artists do not typically receive proceeds after the initial sale. This paper, for the first time, uses archivally sourced primary market records to model returns on art and introduces a novel fractional equity structure for artists. We first model what would happen if the American artists Jasper Johns and Robert Rauschenberg had retained 10% equity in their work when it was first sold. Second, we model a portfolio return using data from the Betty Parsons Gallery and the Green Gallery. To add a portfolio analysis to the performance of “star” artists, we model the galleries as a fund invested in all of artworks sold, using auction sales as the realization event. We find that the individual Johns and Rauschenberg works would have vastly outperformed equities markets. The gallery portfolio still substantially outperforms the S&P, even including 20% transaction costs. Beyond the art market, our larger conceptual framework for retained fractional equity has broad implications for compensation of early-stage creative work in any field and for potential applications of blockchain technology. This paper was accepted by Karl Diether, finance.
Inflammatory response in postmenopausal osteoporotic fracture healing
Authors: Chow Simon K-H. , Chim Yu-Ning , Wang Jin-Yu , Wong Ronald M-Y. , Choy Victoria M-H. , Cheung Wing-Hoi 
Published: July 2020

A balanced inflammatory response is important for successful fracture healing. The response of osteoporotic fracture healing is deranged and an altered inflammatory response can be one underlying cause. The objectives of this review were to compare the inflammatory responses between normal and osteoporotic fractures and to examine the potential effects on different healing outcomes. A systematic literature search was conducted with relevant keywords in PubMed, Embase, and Web of Science independently. Original preclinical studies and clinical studies involving the investigation of inflammatory response in fracture healing in ovariectomized (OVX) animals or osteoporotic/elderly patients with available full text and written in English were included. In total, 14 articles were selected. Various inflammatory factors were reported; of those tumour necrosis factor-α (TNF-α) and interleukin (IL)-6 are two commonly studied markers. Preclinical studies showed that OVX animals generally demonstrated higher systemic inflammatory response and poorer healing outcomes compared to normal controls (SHAM). However, it is inconclusive if the local inflammatory response is higher or lower in OVX animals. As for clinical studies, they mainly examine the temporal changes of the inflammatory stage or perform comparison between osteoporotic/fragility fracture patients and normal subjects without fracture. Our review of these studies emphasizes the lack of understanding that inflammation plays in the altered fracture healing response of osteoporotic/elderly patients. Taken together, it is clear that additional studies, preclinical and clinical, are required to dissect the regulatory role of inflammatory response in osteoporotic fracture healing. Cite this article: Bone Joint Res 2020;9(7):368–385.
Atraumatic Intercostal and Intrathoracic Liver Herniation Related to Influenza A
Authors: Harne Prateek S. , Mukherjee Samiran , Shepherd Zachary 
Published: July 2020

ABSTRACT
Nontraumatic and spontaneous intercostal and intrathoracic herniations are defined as protrusions of intra-abdominal contents through acquired or congenital defects of the abdominal and thoracic walls without any proceeding trauma and are sparsely reported in the literature with less than 35 detailed case reports reported in the literature worldwide. Most of these cases result from abdominal trauma and are considered surgical emergencies. The content of these herniations, as reported in the literature, have classically been lungs and intra-abdominal organs. We report a case of nontraumatic intercostal and intrathoracic liver herniation, which was managed conservatively given minimal liver injury and rapidly improving symptoms.
A promoção internacional do português brasileiro a partir das práticas do Programa de Leitorado
Authors: Oliveira Leilane Morais 
Published: July 2020

O presente artigo apresenta uma discussão relativa às ações desenvolvidas, no âmbito do Programa de Leitorado - uma das políticas linguísticas externas do Brasil, pelos sujeitos que lecionam a língua portuguesa e a cultura nacional neste contexto. Isso se dá a partir de dados recolhidos via questionário, aplicado por Google Forms a sujeitos que atuaram ou atuam nessa política, e também por meio de pesquisa documental, que foi realizada no Palácio do Itamaraty e que deu origem a aproximadamente 750 páginas de arquivos aqui discutidos em caráter de ineditismo. O objetivo é apresentar e discutir as ações que, nessa política linguística, caracterizam o trabalho dos profissionais atuantes, tanto em termos de ensino quanto de atividades extraletivas. De modo geral, os dados mostram que a política em questão cumpre, sob muitos aspectos, a sua função de internacionalizar a língua e a cultura do país. No entanto, também esclarecem que algumas fragilidades caracterizam o dia a dia laboral dos sujeitos que participaram da pesquisa, o que também clarificou a existência de demandas ligadas à gestão da política linguística em questão. Por isso, o fim do artigo apresenta algumas proposições ligadas a reformulações na gerência do Programa de Leitorado.
Voice outcome after type-1 thyroplasty for unilateral vocal cord paralysis: our experience at tertiary care hospital
Authors: Ali Ihsan , Shafi Omar Mohammad , Khalid Faheem , Makhdoomi Owais 
Published: July 2020

<p class="abstract"><strong>Background:</strong> Vocal cord paralysis is a clinical sign caused by paralysis of intrinsic muscles of larynx due to dysfunction of recurrent laryngeal nerve or injury to the vagus nerve. One of the common and effective methods of medialization is by using silicone implants. This study was aimed at prospectively assessing and analysing the vocal outcomes and quality of life of patients in type 1 medialization thyroplasty using silicone implants.</p><p class="abstract"><strong>Methods:</strong> Prospective study of 18 months was done on 17 patients with unilateral vocal cord paralysis. Surgical procedure for the patients was standardized by using silicon implant to medialize the cord. The parameters used for the pre and post treatment objective analysis were stroboscopic analysis, psychoacoustic evaluation, maximum phonation time (MPT) and patient’s self-assessment. </p><p class="abstract"><strong>Results:</strong> In our study all 17 patients with unilateral vocal cord paralysis who were subjected to vocal cord medialization using silicone implant showed a statistically highly significant improvement in all the parameters of assessment. The mean preoperative MPT was 7.260 and post-operative MPT showed significant improvement and was 17.428 seconds. mean preoperative GRBAS score was 11.695 and post-operative was 3.826. Similarly, pre op vocal handicap index was 31.173 which decreased significantly after the procedure was 7.695.</p><p class="abstract"><strong>Conclusions:</strong> In the present study, we obtained favourable results of medialization thyroplasty as expressed by objective analysis of voice including GRABS score and acoustic analysis as well as maximum phonation time apart from traditional voice recording.</p><p> </p>
Comparative evaluation of mastoid pneumatization pattern using X-ray mastoid and high-resolution computed tomography temporal bone in unilateral squamosal chronic otitis media
Authors: Dhiman Akanksha , Gupta Ankur , Sharma Nishi , Prasad Akhilandeswari 
Published: July 2020

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) affects 0.5-30% of individuals in any community and over 20 million people are estimated to suffer from this condition worldwide. COM often evolves in a continuum. Squamosal disease is more commonly found in poorly pneumatized bones, but whether the sclerosis is relevant to the etiology of the disease or is caused by it, has not been fully resolved. Our study aimed at comparing the mastoid pneumatization patterns obtained using X-ray mastoid and high-resolution computed tomography (HRCT) temporal bone. It was an interventional study.</p><p class="abstract"><strong>Methods:</strong> Sixty patients of unilateral squamosal COM, aged more than 8 years, underwent X-ray mastoid Schuller’s view and HRCT temporal bone, using Philips extended brilliance 48 slice CT. </p><p class="abstract"><strong>Results:</strong> Upon analysis, in diseased and healthy ears, the coincidence of X-ray and HRCT findings was 63.33% and 80% respectively.</p><p class="abstract"><strong>Conclusions:</strong> HRCT temporal bone should be done in all cases of squamosal COM to know the extent of the disease, pneumatization patterns and the presence of anatomical variations. </p>
Comodulation masking release effect in children with and without dyslexia
Authors: Dhara Sovon , Chatterjee Indranil , Kumar Himansu , Pani Susmi 
Published: July 2020

<p class="abstract"><strong>Background:</strong> Speech recognition in a modulating noise background can be facilitated by a process attributable to comodulation masking release (CMR). CMR is usually assumed to depend on comparisons of the outputs of different auditory filters. There was an immense importance to study to find the CMR effect in children with and without dyslexia.</p><p class="abstract"><strong>Methods:</strong> The study was to find the CMR effect in children with and without dyslexia. The current research was carried out through five steps i.e. auditory attention task stimuli preparation, auditory performance test, CMR stimuli preparation, CMR task and statistical analysis. Through these processes for measuring the CMR was done for the children with and without dyslexia. All the data were tabulated and statistically computed for the analysis of the data. SPSS software version 16 was used for the statistical analysis of the data. </p><p class="abstract"><strong>Results:</strong> Independent t-test was used for the statistical analysis while the comparison between groups. Paired t- test was used for the statistical analysis while the comparison within the group at 95% confidence interval. These results indicated that the amount effect of CMR is greater in children with dyslexia. There was not a significant difference of CMR between the children with and without dyslexia to the effect of CMR was not significantly different between the ears in children without dyslexia and with dyslexia.</p><p class="abstract"><strong>Conclusions:</strong> The present study indicates that children with dyslexia have selective inability to use the temporal and spectral cues necessary for signal extraction in CMR.</p>
Role of navigation system in functional endoscopic sinus surgery
Authors: Agrawal Manish , Arya Pooja , Meghwal Deepchand , Samor Vivek , Gupta Gaurav , Kumar Vijay 
Published: July 2020

<p class="abstract"><strong>Background:</strong> Functional endoscopic sinus surgery (FESS) is a challenging procedure for otorhinolaryngologists. Navigation can reassure the surgeon’s judgement and enhance surgical performance and prevent complication. The study done with aim of comparison between FESS with navigation and conventional FESS and explore other indication of navigation in endoscopic sinus surgery in difficult clinical scenario.</p><p class="abstract"><strong>Methods:</strong> This is a cross-sectional study on patients with sino-nasal disease. 100 patients in whom the ability to identify surgical site is assumed to be compromised by various conditions like previous surgery, massive/ recurrent polyposis, front oethmoidal mucocele, frontal, sphenoid sinus disease were included in the study. Patients were randomly allocated into two groups, group A (50 patients) FESS with navigation and group B (50 patients) conventional FESS. Pre-operative preparation time, intraoperative time, blood loss (Fromme–Boezzaart scoring), surgeon satisfaction, patient satisfaction (SNOT-20), complications were documented on a preformed, pretested proforma. Equipments used were –StealthStation S7 system, CD for recording intraoperative findings. </p><p class="abstract"><strong>Results:</strong> Preoperative preparation time duration was applicable for group A only. Intraoperative time was slightly and insignificantly higher in group A. Blood loss according to Fromme-Boezzaart scoring had lesser scoring values in group A and difference among gradings was statistically insignificant. Surgeons satisfaction and confidence was statistically significant higher in group A. The SNOT-20 score values were lower and insignificant in group A.</p><p class="abstract"><strong>Conclusions:</strong> FESS with navigation is more convenient to surgeon, appears to be safer tool.</p>