bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Fracture Liaison Service Program in Reducing Refracture Rate in the Elderly Osteoporotic Trauma Patients Presenting With Vertebral Compression Fracture: A Six-Year Study
Authors: Kelm Noah , Wasfie Tarik , Volk Max , Walker Zach , Galovska Stephanija , Brock Cara , Jackson Avery 
Published: September 2021

Introduction As the elderly population of the United States and the world increases, so does the incidence of osteoporotic fragility fractures from a fall or minor injury. This results in a large cost to the health care system. This cost is further increased as more than 50% of individuals will have refractures within the first year. In order to reduce the refracture rate in such patients, we enrolled our elderly trauma patients with vertebral compression fractures and vertebral augmentation in a Fracture Liaison Service (FLS) clinic for two years and reevaluated their refracture rate. Method This is a retrospective analysis of 720 patients. 142 patients (Group A) were seen between 2012 and 2014 before establishing the FLS program and 578 patients (Group B) were seen between 2015 and 2020 after implementation of the FLS program. The patients enrolled in the FLS program were followed for two years after sustaining a vertebral compression fracture. The data collected included age, sex, serum calcium and vitamin D levels, dual energy X-ray absorptiometry (DXA) scan, 10-year fracture risk (FRAX) score, pressure measurements in PSI taken during vertebral augmentation, as well as the refracture rate. The data collected were analyzed and compared between the two groups using the Student’s t-test and chi-square test. Results There was significant reduction in the refracture rate of pre-FLS vs post-FLS vertebral, as well as other fractures in the FLS group (pre-FLS: 48.9% vs post-FLS: 37.0%; P = .01). There was no significant difference between groups A and B in regard to the mean serum level of calcium (9.44 mg/dL vs 9.53 mg/dL), vitamin D level (35.04 ng/mL vs 41.39 ng/mL), DXA scan for spine (−.52 vs −.76) and for femur (−1.77 vs −1.52), and 10-year refracture risk for osteoporotic major fracture (FRAX score-mean: 22.6% vs 19.2%) and for hip fracture (9.18% vs 7.53%). There was a significant difference in the mean age between the groups (79.5 vs 73.5 years; P = .01). Of those who underwent vertebral augmentation, 235 had Pressure Scale Index (PSI) measurements taken. There was a trend in increasing refracture rate when PSI ≤199 compared with those who had PSI ≥200, although statistical significance was not met (33.9% vs 27.0%, P = .21). Conclusion A Fracture Liaison Service program will improve the bone health of geriatric osteoporotic patients presenting to the trauma service with vertebral compression fractures and thus reduces the subsequent refracture rate. Further study is needed to evaluate the best PSI used to impact reduction in refracture rate.
Orocutaneous Fistula After Oral Cavity Resection and Reconstruction: Systematic Review and Meta-Analysis
Authors: Tassone Patrick , Galloway Tabitha , Dooley Laura , Zitsch Robert 
Published: September 2021

Objective: Orocutaneous fistula (OCF) after reconstruction for oral cavity resection can lead to prolonged hospitalization and adjuvant treatment delay. Few studies have examined factors leading to OCF after oral cavity resection. Primary objective: evaluate overall incidence and factors associated with OCF after oral cavity reconstruction. Data Sources: Scopus 1960—database was searched for terms: “orocutaneous fistula,” “oro cutaneous fistula,” “oral cutaneous fistula,” “orocervical fistula,” “oral cavity salivary fistula.” Review Methods: English language studies with >5 patients undergoing reconstruction after oral cavity cancer resection were included. About 1057 records initially screened; 214 full texts assessed; 78 full-texts included. PRISMA guidelines were followed, and MINORS criteria used to assess risk of bias. Data were pooled using random-effects model. Primary outcome was OCF incidence. Meta-analysis to determine the effect of preoperative radiation on OCF conducted on 12 eligible studies. Pre-collection hypothesis was that prior radiation therapy is associated with increased OCF incidence. Post-collection analyses: free versus pedicled flaps; mandible-sparing versus segmental mandibulectomy. Results: Seventy-eight studies were included in meta-analysis of overall OCF incidence. Pooled effect size showed overall incidence of OCF to be 7.71% (95% CI, 6.28%-9.13%) among 5400 patients. Meta-analysis of preoperative radiation therapy on OCF showed a pooled odds ratio of 1.68 (95% CI, 0.93-3.06). OCF incidence was similar between patients undergoing free versus pedicled reconstruction, or segmental mandibulectomy versus mandible-sparing resection. Conclusion: Orocutaneous fistula after oral cavity resection has significant incidence and clinical impact. Risk of OCF persists despite advances in reconstructive options; there is a trend toward higher risk after prior radiation.
Videofluoroscopic Swallow Studies and Diagnostic Outcomes in Otherwise Healthy Infants With Dysphagia
Authors: Shih Michael C. , Rappazzo Christina , Hudson Caroline , Ongkasuwan Julina 
Published: September 2021

Objectives: To evaluate videofluoroscopic swallow study (VFSS) findings in infants with dysphagia and without prior diagnoses, and to characterize the outcomes and any diagnoses that follow. Methods: A chart review of all pediatric patients who received a VFSS at a tertiary children’s hospital from November 2008 to March 2017 was performed. Results: There were 106 infants (57 males and 49 females) with 108 VFSS. VFSS was normal in 18 (16.98%) infants. Regarding airway protection, 50 (47.17%) infants had laryngeal penetration, and 8 (7.55%) had tracheal aspiration; 3 (2.83%, 37.5% of all aspirators) exhibited silent aspiration. Of the 75 infants with minimum 2-year follow-up, 35 (46.67%) had no sequelae of disease and received no diagnoses. The most common diagnoses and pathologic sequelae were gastroesophageal reflux (n = 18, 24.00%), asthma (n = 8, 10.67%), laryngomalacia (n = 6, 8.00%), and tracheomalacia (n = 4, 5.33%), all consistent with United States pediatric data on prevalence. All infants (n = 51) with follow-up for dysphagia had resolution of symptoms within 9 months from VFSS order date. Conclusions: Otherwise healthy infants may show signs of dysphagia and not develop later illness. Parents can thus be counseled on the implications of dysphagia in a previously healthy infant. Our findings provide comparative statistics for future research in pediatric dysphagia.
Mental health and wellbeing among Iranian medical students: a descriptive study
Authors: Ashrafi Agaah , Kadhum Murtaza , Molodynski Andrew , Bhugra Dinesh 
Published: September 2021

Background: The psychological wellbeing and stresses on medical students are currently under a global spotlight. Under a wider initiative supported by the British Medical Association (BMA), international surveys have been conducted to understand and begin to tackle these issues. Method: This study aimed at describing the mental wellbeing and levels of burnout of Iranian medical students. A total of 179 medical students from 19 different cities participated voluntarily in the survey by answering an online questionnaire between April and August 2020. We detected a trend toward higher prevalence of psychiatric disorders (namely depressive disorders) and substance misuse when compared to previous national studies. Results: About 6% of students screened positive for alcohol problems with the CAGE questionnaire. About 77% of medical students screened positive for mental health problems with the GHQ12 questionnaire. Very high rates of burnout were also reported. These findings emphasize the urgent need to define methods to screen at risk medical students and implement local and national initiatives to curtain their potential detrimental effects.
Why Does the Common Law Conform to the Constitution?
Authors: Sheppard Joshua 
Published: September 2021

AbstractThe High Court has often said that the common law must conform to the Constitution. The High Court has not completely explained why this is so. This requirement is not explicitly mentioned anywhere in the Constitution itself. A number of scholars have suggested possible answers. One is that the Constitution is the supreme law and binding on everyone. Another suggestion has been that the common law must conform because the Constitution constrains ‘state action’: something more than just an exercise of constitutionally conferred power. This latter explanation appears to deviate from the High Court's exposition of the common law's relationship with the Constitution in Lange v Australian Broadcasting Commission. This article suggests that the Constitution has a broader application to the common law, in that it constrains all uses of judicial power, not just those that are considered to be ‘state action’. It contends that it is implicit in s 71 of the Constitution that the power to develop the common law yields to constitutional imperatives. This theory is more descriptively consistent with the High Court's practice and observations about the relationship between the common law and the Constitution.
Applicability of a sheep model for training in plastic surgery of eyelids and orbit
Authors: Isaacson Glenn , Wulc Allan E. 
Published: September 2021

Objective To test the applicability of a fresh tissue model for teaching facial plastic techniques and approaches to the eyelids and orbit. Design Observational animal experiments. Subjects Ten prepubescent sheep heads harvested following humane euthanasia at the completion of unrelated live animal research. Methods Young sheep were saline perfused at the end of an in vivo protocol. Head and neck tissues were harvested and refrigerated for 3–7 days. An experienced oculoplastic surgeon and an otolaryngologist explored the feasibility of common oculoplastic procedures in the ovine model. Results The model has potential for teaching basic principles in eyelid surgery including upper lid blepharoplasty, aponeurotic ptosis repair, upper lid gold weight lid loading for facial paralysis, lateral canthotomy and inferior limb cantholysis, lower lid tightening, and transconjunctival approach to the orbital floor. Eye muscle advancement, optic nerve sheath fenestration, and enucleation also accurately simulated human surgery. Anatomic variations limit the sheep model for orbital floor reconstruction and lacrimal drainage procedures. Conclusions The sheep head and neck provide an inexpensive, safe model for developing skills in several oculoplastic procedures. Formal simulation testing is needed to confirm these expert opinions.
The NLRP3 inflammasome mediates liver failure by activating procaspase-1 and pro-IL-1 β and regulating downstream CD40-CD40L signaling
Authors: Li Zenghui , Jiang Jianning 
Published: September 2021

Objectives In this prospective case–control study, we explored the regulatory roles of the NLRP3 inflammasome in hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). Methods Thirty patients with HBV-ACLF, 30 patients with chronic hepatitis B, and 30 healthy individuals were enrolled. Real-time reverse transcription polymerase chain reaction was used to assess mRNA levels in peripheral blood mononuclear cells and serum protein levels were assessed by enzyme-linked immunosorbent assay. Results Serum levels of alanine aminotransferase, asparagine aminotransferase, total bilirubin, and direct bilirubin in patients with HBV-ACLF were increased. Transcript levels of NLRP3 and ASC and protein levels of interleukin (IL)-1β, IL-18, and sCD40L were elevated in patients with HBV-ACLF. Expression of the NLRP3 inflammasome signaling pathway components procaspase-1 and pro-IL-1β was elevated in patients with HBV-ACLF. Conclusions This prospective case-control study demonstrated that significant activation of the NLRP3 inflammasome occurs in patients with HBV-ACLF. The activated NLRP3 inflammasome mediated liver failure by stimulating procaspase-1 and pro-IL-1 β and regulating downstream CD40-CD40L signaling.
Use of a new set of key performance indicators for evaluating the performance of an in vitro fertilization laboratory in which blastocyst culture and the freeze-all strategy are the primary treatment in patients with in vitro fertilization
Authors: Wang Hui-tian , Hong Ping-ping , Li Hai-yang , Zhou Wen , Li Tao 
Published: September 2021

Objective To evaluate the performance of an in vitro fertilization (IVF) laboratory using a new set of key performance indicators (KPIs) when the main treatment of IVF patients had been changed. Methods Patients who underwent fresh embryo transfer and the freeze-all strategy in August, September, and October 2017 were retrospectively studied to evaluate the performance of an IVF laboratory in September when implantation rate of fresh embryo transfer decreased. KPIs associated with blastocyst culture and the first frozen embryo transfer (FET) cycle in patients with the freeze-all strategy were compared over 3 months. Results Day 5 usable blastocyst and good quality blastocyst rates, and day 3 usable/good quality embryo rates were not different among the three periods. The implantation rate and KPIs associated with morphological changes in warmed blastocysts in the first FET cycle in patients with the freeze-all strategy were also not different among the periods. Conclusions KPIs associated with embryo quality, blastocyst culture, and the pregnancy outcome of the first FET cycle in patients with the freeze-all strategy suggested that performance was unaffected in our IVF laboratory in September. These KPIs might be useful for internal quality control analysis of IVF laboratories.
Tuberculosis screening coverage and isoniazid preventive therapy among people living with HIV at Gambella Hospital, southwest Ethiopia: a retrospective study design
Authors: Aboma Mecha , Dida Nagasa 
Published: September 2021

Objective We aimed to assess the coverage of tuberculosis screening and isoniazid preventive therapy (IPT) among people living with human immunodeficiency virus (PLHIV) at Gambella Hospital, southwest Ethiopia. Methods We conducted a 5-year retrospective study of PLHIV receiving care in an antiretroviral therapy clinic from 1 January 2011 to 30 December 2015. We reviewed a total of 900 medical records of patients with complete information. Result Of the total, 897 (99.7%) PLHIV were screened for tuberculosis, among which 77 (8.6%) were found to be positive for active tuberculosis. Among 820 (91.4%) individuals eligible for IPT, only 545 (66.5%) were provided IPT; 275 (33.5%) eligible PLHIV were not provided IPT. Male sex (adjusted odds ratio [AOR] 1.63) and ages 18–29 years (AOR 0.33) and 30–44 years (AOR 0.31) were significantly associated with the likelihood of tuberculosis infection. Conclusion The present study findings demonstrated that tuberculosis screening for PLHIV at Gambella Hospital was improved in comparison with reports from many African countries and other parts of Ethiopia. Despite this improvement, the implementation rate of IPT was below national and World Health Organization recommendations. Overall, tuberculosis diagnostic approaches and available preventive measures should be strengthened in the study area.
Doron medicum—the gift of medicine: How a rare 17th century medical translation positively impacted the community and predicted current analgesic techniques
Authors: Apelbaum Natalie 
Published: September 2021

In 1683, a self-proclaimed apothecary physician and London professor of physick by the name of Guilelmus (William) Salmon authored a pharmacopoeia titled Doron medicum, the ‘gift of medicine’ (Greek/Latin translation). This text formulates an English supplement to the Latin Materia medica (16th century), discussing internal and external compound medicines of the late 17th century. This pharmacopoeia enabled those incapable of reading Latin to provide medical care to a challenging post-plague community. Opiology, mercury, dragon’s blood, willow bark, animal preparations and therapies now considered obscure, provide insight into therapies at the time. Early critical care treatments in haemorrhage control and pain management are described. Doron medicum preceded the controversial opening by the College of Physicians of the first London Dispensary in 1698, and was published in a maturing period of medical governance and healthcare establishment in London. During the 17th century, great competition and debate existed between the Royal College of Physicians and the apothecaries. Throughout such debates, William Salmon advocated for access to medical care for the poor and recognition of an allied approach to healthcare. This paper discusses Salmon’s contribution to medicine, which has been poorly transcribed in medical history. A selection of opiate-based analgesic therapies, early critical care strategies and animal preparations are revisited. A small chronicle of William Salmon’s life and professional achievements will be reviewed. Debate surrounding the opening of the first London Dispensary will be discussed in relation to William Salmon’s contribution, echoing ongoing contemporary challenges in healthcare over 300 years later.
Shoulder External Rotational Properties During Physical Examination Are Associated With Injury That Requires Surgery and Shoulder Joint Loading During Baseball Pitching
Authors: Stokes Hannah , Eaton Koco , Zheng Naiquan (Nigel) 
Published: September 2021

Background: Throwing arm injuries are common because of the demand on the shoulder. The shoulder is qualitatively checked regularly by team physicians. Excessive instability and joint loading in baseball pitching are risk factors for throwing arm injuries. Knowledge of shoulder flexibility, range of motion, and joint loading may provide new insights for treatments to reduce the likelihood of injury incidence. Purpose: To investigate the relationship among injuries, shoulder external rotational properties, and shoulder joint loading in baseball pitchers. Study Design: Descriptive laboratory study. Methods: Pitching kinetics, shoulder rotational tests, and self-reported injury questionnaires were used to study 177 collegiate baseball pitchers. Pitching motion data were collected at 240 Hz using a motion capture system. A custom program calculated the shoulder joint loading. The shoulder rotational test quantitatively records shoulder range of motion and flexibility using a custom-made wireless device. Self-reported injury questionnaires were filled out during tests and yearly follow-ups. The total length of the study was 5 years. Analysis of variance, chi-square, and regression tests were performed to compare differences among groups and detect correlations with surgery and shoulder joint loadings. Results: There were significant differences in shoulder flexibility among surgery groups. Shoulder external rotational properties during physical examination were significantly associated with shoulder joint loading in baseball pitching. High shoulder external rotation was associated with 14% to 36% lower shoulder posterior force and adduction, internal rotation, and horizontal adduction torque ( P < .05). High shoulder flexibility was associated with 13% higher anterior force ( P < .05). High shoulder external rotation before external rotation torque was applied was associated with 13% to 33% lower shoulder inferior force and adduction, internal rotation, and horizontal adduction torque ( P < .05). There were no significant differences in shoulder joint loading among the surgery groups. Conclusion: Shoulder injuries that require surgery were associated with shoulder external rotation flexibility. High shoulder external rotation may be advantageous because it lowers the force and torque on the shoulder joint. Clinical Relevance: The ability to understand shoulder external rotational properties, joint loading, and injury during baseball pitching helps further our understanding of injury mechanisms. The shoulder rotational test should be used as a screening tool to identify players at risk.
Neo-Dualism: Accumulation, Distress, and Proliferation of a Fissured Informality
Authors: Sadhu Kasturi , Chakrabarti Saumya 
Published: September 2021

A dominant strand of orthodoxy argues that the problem of the informal sector could be mitigated through the capitalistic growth process. But our observations on India are different—with an expansion of the capitalistic formal sector, as the economy grows, there is a proliferation of fissured informality. Using a structuralist macro-model, we provide certain explanations for this phenomenon, which are also tested empirically using Indian subnational-state and firm-level data. Thus, we explore both the short- and long-run effects of the expansion of the formal sector on the heterogeneous informal economy. While a section of the population is pulled into the advanced informal activities, a vast segment is pushed to petty production. Accordingly, the orthodox transition narrative is questioned and alternative policy and political possibilities are introduced. JEL Classification: O11, O13, O17, P48
Electroacupuncture attenuates vascular hyporeactivity in a rat model of portal hypertension induced by bile duct ligation
Authors: Chen Yu-Sheng , Wen Chorng-Kai , Liu Geng-Hao , Lee Tzung-Yan 
Published: September 2021

Background: A hyperdynamic circulation and impaired vascular responsiveness to vasoconstrictors are observed in portal hypertension (PHT) rats. Inflammation is a major contributor to the hyperdynamic circulation state in murine models of PHT. Electroacupuncture (EA) may ameliorate the inflammatory response and limit arterial vasodilatation and portal pressure. This study investigated the possible mechanisms underlying putative hemodynamics effects of EA in normal and PHT rats. Methods: PHT was induced by bile duct ligation (BDL) surgery over 4 weeks in rats. Sham-operated and BDL rats were treated with low-frequency EA (2 Hz) at ST36 10 min three times weekly for one or two consecutive weeks (for a total of 3 or 7 treatments, respectively). Serum tumor necrosis factor-α (TNF-α), nitrite/nitrate (NOx) and 6-keto-prostaglandin F1α (6-keto-PGF1α) were analyzed, and hemodynamic variation and contractile responses to phorbol-12,13-dibutyrate and phenylephrine in aortic and superior mesenteric arterial rings were recorded. Inducible (i) and endothelial (3) nitric oxide synthase (NOS), cyclooxygenase-1 (COX-1), and protein kinase C-α (PKC-α) levels were determined by Western blotting. Results: EA significantly reduced portal pressure and serum TNF-α, NOx and 6-keto-PGF1α levels compared to the untreated BDL group, enhanced maximum contractile responses in the aorta, up-regulated PKC-α, and down-regulated iNOS and COX-1 levels. In addition, EA decreased the aortic angiogenesis signaling cascade, reflected by down-regulation of vascular endothelial growth factor (VEGF) abundance and transforming growth factor β receptor (TGFβR)I/II expression, as assessed by immunostaining. Conclusion: EA attenuates TNF-α, NO and 6-keto-PGF1α overproduction, modulates the vascular levels of constitutive NOS and PKC-α, blunts the development of the angiogenesis cascade, and enhances vascular contractile force in PHT rats.