bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining mechanical instability in tuberculosis of the spine: a systematic review
Authors: Ahuja Kaustubh , Ifthekar Syed , Mittal Samarth , Yadav Gagandeep , Sarkar Bhaskar , Kandwal Pankaj 
Published: March 2021

Over the years, a number of authors have used different working definitions of instability in tuberculosis of the spine (TB spine). However, no clear consensus exists to define instability in TB spine. The current systematic review addresses the question ‘What defines instability in TB spine’? A comprehensive medical literature search was carried out to identify all the studies which defined instability in the setting of spinal TB. The extracted data included the clinical, X-ray and CT or MRI-based definitions. The current review identified lesser age, junctional region of the spine, mechanical pain and ‘instability catch’, kyphotic deformity above 40 degrees, pan-vertebral or bilateral facetal involvement and multifocal contiguous disease involving more than three vertebrae as predictors for spinal instability in the dorso-lumbar spine. Cervical kyphosis more than 30 degrees and facetal or pan-vertebral involvement were found to be the factors used to define instability in subaxial cervical spine. With respect to C1–C2 TB spine, migration of the tip of the odontoid above the McRae or McGregor line or anterior translation of C1 over C2 were considered as determinants for instability. Although definitive conclusions could not be drawn due to lack of adequate evidence, the authors identified factors which may contribute towards instability in TB spine. Cite this article: EFORT Open Rev 2021;6:202-210. DOI: 10.1302/2058-5241.6.200113
Anal cancer survival: a socioeconomic analysis
Authors: Ali F , Ghareeb AE , Jha A , Van der Voet H , Garg D , Jha M 
Published: March 2021

Introduction Squamous cell carcinoma is the most common variant of anal malignancy. Certain disease-related factors have been established in determining survival. These include tumour size, differentiation and nodal involvement. Other factors such as HIV status, human papillomavirus infection, smoking and socioeconomic disparity may have important roles, however few data are available on the UK population. We aim to correlate social deprivation and survival of anal cancer patients at a tertiary centre. Materials and methods All consecutive cases diagnosed with anal squamous cell carcinoma and treated as per local protocol between July 2010 and April 2017 were included. The pathological and demographical details were collected from a prospectively maintained database. Socioeconomic deprivation was defined for each postcode using the Index of Multiple Deprivation decile compiled by local governments in England. Survival was estimated using Kaplan–Meier analysis and Cox regression was used to investigate the effect of different factors on overall survival. Results A total of 129 patients with anal squamous cell carcinoma over a median follow-up of 43 months were included. Overall survival for the entire patient cohort was 87.7% (95% confidence interval, CI, 82.0–93.7%), 75.5% (95% CI 67.5–84.5%) and 68.9% (95% CI 59.7–79.6%) at one year, three years and five years, respectively. On multivariate analysis, Index of Multiple Deprivation and income do not significantly influence overall survival (p = 0.79, hazard ratio, HR, 1.07; 95% CI 0.61–1.63), (p = 0.99, HR=1.00; 95% CI 0.61–1.63), respectively. Increased risk of death was observed for male sex (p = 0.02, HR=2.80; 95% CI 1.02–5.50) and larger tumour size (p = 0.01, HR=1.64; 95% CI 1.12–2.41). Conclusion In contrast to US studies, there is little difference in survival between the least deprived and most deprived groups. We attribute this to equal access to intensity-modulated radiation therapy-based chemoradiotherapy. Thus, a highly effective treatment made available to all mitigates any survival difference between socioeconomic groups.
Orthopaedic assessment unit: a service model for the delivery of orthopaedic trauma care in a major trauma centre during the global pandemic (COVID-19)
Authors: Lim JW , Rehman H , Gaba S , Sargeant H , Stevenson IM , Boddie DE 
Published: March 2021

Introduction We describe a new service model, the Orthopaedic Assessment Unit (OAU), designed to provide care for trauma patients during the COVID-19 pandemic. Patients without COVID-19 symptoms and isolated musculoskeletal injuries were redirected to the OAU. Methods We prospectively reviewed patients throughput during the peak of the global pandemic (7 May 2020 to 7 June 2020) and compared with our historic service provision (7 May 2019 to 7 June 2019). The Mann–Whitney and Fisher Exact tests were used to test the statistical significance of data. Results A total of 1,147 patients were seen, with peak attendances between 11am and 2pm; 96% of all referrals were seen within 4h. The majority of patients were seen by orthopaedic registrars (52%) and nurse practitioners (44%). The majority of patients suffered from sprains and strains (39%), followed by fractures (22%) and wounds (20%); 73% of patients were discharged on the same day, 15% given follow up, 8% underwent surgery and 3% were admitted but did not undergo surgery. Our volume of trauma admissions and theatre cases decreased by 22% and 17%, respectively (p=0.058; 0.139). There was a significant reduction of virtual fracture clinic referrals after reconfiguration of services (p<0.001). Conclusions Rapid implementation of a specialist OAU during a pandemic can provide early definitive trauma care while exceeding national waiting time standards. The fall in trauma attendances was lower than anticipated. The retention of orthopaedic staff in the department to staff the unit and maintain a high standard of care is imperative.
High-Q quadrupolar plasmonic lattice resonances in horizontal metal–insulator–metal gratings
Authors: Fang Xinyu , Xiong Lei , Shi Jianping , Li Guangyuan 
Published: March 2021

We propose a plasmonic platform for achieving out-of-plane quadrupolar plasmonic surface lattice resonances (SLRs) with large quality factors. The proposed platform is composed of a horizontal metal–insulator–metal (MIM) grating embedded in a homogeneous dielectric environment. Numerical results based on rigorous coupled-wave analysis show that under oblique incidences, high-Q out-of-plane quadrupolar SLRs can be excited at wavelengths of 1242 nm over a wide range of insulator widths, and the quality factor can reach 1036. As a comparison, under the same conditions, only dipolar SLRs with much lower quality factors of

∼

300

can be excited in a vertical MIM grating, which has the same period and a quarter-turned unit cell. We expect that the proposed high-Q quadrupolar SLR platform will find applications in light–matter interactions on the nanoscale.
Infection Manager System (IMS) as a new hemocytometry-based bacteremia detection tool: A diagnostic accuracy study in a malaria-endemic area of Burkina Faso
Authors: Post Annelies , Kaboré Berenger , Bognini Joel , Diallo Salou , Lompo Palpouguini , Kam Basile , Herssens Natacha , van Opzeeland Fred , van der Gaast-de Jongh Christa E. , Langereis Jeroen D. , de Jonge Marien I. , Rahamat-Langendoen Janette , Bousema Teun , Wertheim Heiman , Sauerwein Robert W. , Tinto Halidou , Jacobs Jan , de Mast Quirijn , van der Ven Andre J. 
Published: March 2021

Background
New hemocytometric parameters can be used to differentiate causes of acute febrile illness (AFI). We evaluated a software algorithm–Infection Manager System (IMS)—which uses hemocytometric data generated by Sysmex hematology analyzers, for its accuracy to detect bacteremia in AFI patients with and without malaria in Burkina Faso. Secondary aims included comparing the accuracy of IMS with C-reactive protein (CRP) and procalcitonin (PCT).

Methods
In a prospective observational study, patients of ≥ three-month-old (range 3 months– 90 years) presenting with AFI were enrolled. IMS, blood culture and malaria diagnostics were done upon inclusion and additional diagnostics on clinical indication. CRP, PCT, viral multiplex PCR on nasopharyngeal swabs and bacterial- and malaria PCR were batch-tested retrospectively. Diagnostic classification was done retrospectively using all available data except IMS, CRP and PCT results.

Findings
A diagnosis was affirmed in 549/914 (60.1%) patients and included malaria (n = 191) bacteremia (n = 69), viral infections (n = 145), and malaria-bacteremia co-infections (n = 47). The overall sensitivity, specificity, and negative predictive value (NPV) of IMS for detection of bacteremia in patients of ≥ 5 years were 97.0% (95% CI: 89.8–99.6), 68.2% (95% CI: 55.6–79.1) and 95.7% (95% CI: 85.5–99.5) respectively, compared to 93.9% (95% CI: 85.2–98.3), 39.4% (95% CI: 27.6–52.2), and 86.7% (95% CI: 69.3–96.2) for CRP at ≥20mg/L. The sensitivity, specificity and NPV of PCT at 0.5 ng/ml were lower at respectively 72.7% (95% CI: 60.4–83.0), 50.0% (95% CI: 37.4–62.6) and 64.7% (95% CI: 50.1–77.6) The diagnostic accuracy of IMS was lower among malaria cases and patients <5 years but remained equal to- or higher than the accuracy of CRP.

Interpretation
IMS is a new diagnostic tool to differentiate causes of AFI. Its high NPV for bacteremia has the potential to improve antibiotic dispensing practices in healthcare facilities with hematology analyzers. Future studies are needed to evaluate whether IMS, combined with malaria diagnostics, may be used to rationalize antimicrobial prescription in malaria endemic areas.

Trial registration
ClinicalTrials.gov (NCT02669823) https://clinicaltrials.gov/ct2/show/NCT02669823
Knowledge and practice of clients on preventive measures of COVID-19 pandemic among governmental health facilities in South Wollo, Ethiopia: A facility-based cross-sectional study
Authors: Dewau Reta , Mekonnen Tefera Chane , Tadesse Sisay Eshete , Muche Amare , Bogale Getahun Gebre , Tadesse Amsalu Erkihun 
Published: March 2021

IntroductionCoronavirus-19 is a global health challenge and need an immediate action. Thus, understanding client’s knowledge about SARS-COV2 causes, roots of transmissions, and prevention strategies are urgently warranted. Although there were global studies reported knowledge and preventive practices of COVID-19, but the information is not representative and inclusive for Ethiopia. Thus, the current study is done to identify the knowledge and the prevention strategies for COVID-19 among clients in South Wollo, Ethiopia.MethodsAn institutional based cross-sectional study was conducted from May 21 to 30, 2020 among clients seeking service in Dessie town health facilities. A total of 81 clients were included from the selected health facilities with simple random sampling technique. We developed measuring tools by adopting from World Health Organization and center for disease prevention recommendation manual for assessing service providers’ knowledge and preventive practices. For data entry Epi-data 3.1 version was employed and further data management and analysis was performed using STATA Version 14. Student T-test and one way ANOVA were computed to see the mean difference in knowledge and practice between and among the group. Chi-square test was also done to portray the presence of association between different co-variants with client’s knowledge and preventive practices.ResultsFindings of the study showed that more than half (56.8%) of the participants had good knowledge about its symptoms, way of spread and prevention of the virus. Furthermore, 65.4% of clients demonstrated five or more preventive practice measures of COVID-19. The mean preventive practice score with standard deviation was (4.75±1.28 from 6 components). In the current study, knowledge had no significant difference among sex, education status, and monthly income. However, COVID-19 transmission knowledge was significantly higher among urban residents. Thus, clients who were knowledgeable about way of transmission and symptoms of COVID-19 had significantly higher COVID-19 preventive practice.ConclusionOur findings revealed that clients’ knowledge and preventive practice of COVID-19 were not optimal. Clients with good knowledge and urban residents had practiced better prevention measures of the pandemic, signifying that packages and programs directed in enhancing knowledge about the virus is useful in combating the pandemic and continuing safe practices.
Association of electronic cigarette exposure with serum uric acid level and hyperuricemia: 2016-2017 Korea National Health and Nutritional Examination Survey
Authors: Kim Taeyun , Kim Yunkyung , Kang Jihun 
Published: March 2021

Objectives
The present study evaluated the association of electronic cigarette (EC) exposure with serum uric acid (UA) level and hyperuricemia (HUA) using a nationally representative sample of South Korea.

Methods
This study included 10,692 participants (9,905, 609, and 178, never, ever, and current EC users, respectively). Urinary cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels were used to determine conventional smoking exposure among EC users. The association between EC use and UA level was evaluated by linear regression analysis. Multivariable logistic regression analysis was used to assess the association between EC and HUA. Subgroup analysis confined to cotinine-verified active smokers was performed to address the association between the dual use of EC and combustible cigarettes and serum UA levels.

Results
The serum UA level was highest among current EC users, followed by ever and never EC users. The prevalence of HUA was 26.2%, 19.3%, and 10.8% in current, ever, and never EC users, respectively. Although EC exposure was positively associated with HUA in a dose-dependent manner only in men (Ptrend = 0.04), a similar tendency was also observed in women with marginal significance (Ptrend = 0.102). The positive association of HUA with EC exposure was more apparent among dual users (odds ratio [OR] = 1.96, 95% confidence interval [CI]: 1.29–2.99) than among those who only smoked combustible cigarettes.

Conclusions
EC exposure was associated with higher serum UA level and higher OR of HUA. The positive association between EC exposure and HUA was more prominent in dual users who concurrently consumed EC and combustible cigarettes.
Eficácia da Técnica de Colpossuspensão a Burch Laparoscópica para o Tratamento da Incontinência Urinária de Esforço: Uma Revisão Sistemática / Efficacy of the Colpossuspension Technique to Laparoscopic Burch for the Treatment of Stress Urinary Incontinence: A Systematic Review
Authors: Pacheco Alison De Santana , Vasconcelos Neto José Ananias 
Published: March 2021

Resumo: A incontinência urinária ocorre em 30% das mulheres no mundo é uma condição prevalente com carga médica, social e psicológica significativae com o aumento da expectativa de vida da população é esperado que esse valor se eleve. Assim, fez-se necessários estudos que avaliem a eficácia dos tratamentos disponíveis na atualidade. Objetivos: Objetivou-se discutir a eficácia do tratamento da incontinência urinária com o uso do método de colpossuspensão a Burch laparoscópica descritos na literatura científica nos últimos dez anos. Metodologia: Foi realizada uma revisão sistemática, a qual utiliza de fonte de dados a literatura sobre determinado tema. Resultados: O processo de seleção dos artigos nas bases de dados SciELO (11,1%), LILACS (11,1%) e MEDLINE (88,8%). A taxa de cura objetiva variou de 70,7% a 90,6% e a subjetiva de 31% a 77,8%. A taxa de recidiva esteve presente em três (33,3%) variando de 2,2% a 9,3%. A colpossuspensão foi realizada com outras cirurgias ginecológicas em 33,3% dos estudos. O mesmo valor foi encontrado na realização de comparações com a colpossuspensão laparotômica, sling retropúbico e um com sling two-team; com a quantidade de pontos utilizados na colpossuspensão e o custo financeiro entre as abordagens cirúrgicas. A taxa de complicação intra operatório variou de 0% a 14,9% e pós-operatório de 0% a 20%. O grau de satisfação dos pacientes foi abordado em 33,3% do estudo com variação de 51% a 90%. O tempo de seguimento das pacientes variou de seis a 60 meses. Conclusão: Com base nas características das pesquisas analisadas, verifica-se a necessidade de estudos mais amplos que realizem a comparação da colpossuspensão laparoscópica de Burch com outras abordagens terapêuticas cirúrgicas para a incontinência urinária.
Circulating Macrophage Activation Markers Predict Transplant-Free Survival in Patients With Primary Sclerosing Cholangitis
Authors: Bossen Lars , Vesterhus Mette , Hov Johannes R. , Färkkilä Martti , Rosenberg William M. , Møller Holger J. , Boberg Kirsten M. , Karlsen Tom H. , Grønbæk Henning 
Published: March 2021

INTRODUCTION:
Primary sclerosing cholangitis (PSC) is a progressive liver disease characterized by bile duct inflammation and fibrosis. The role of macrophages in PSC development and progression is less studied. Macrophage activation markers soluble (s)CD163 and mannose receptor (sMR) are associated with disease severity and outcome in other liver diseases, but not previously investigated in PSC. We evaluated sCD163 and sMR regarding disease severity and prognosis in patients with PSC.

METHODS:
We investigated 2 independent PSC cohorts from Oslo (n = 138) and Helsinki (n = 159) and analyzed blood sCD163 and sMR levels. The Mayo score, Enhanced Liver Fibrosis Test, and Amsterdam-Oxford model were assessed for comparison.

RESULTS:
Median (interquartile range) sCD163 was 3.32 (2.27–5.60) and 1.96 (1.47–2.70) mg/L in the Oslo and Helsinki cohorts, respectively, reflecting differences in disease severity between cohorts. Median sMR was similar in both cohorts, 0.28 (0.22–0.44) and 0.28 mg/L (0.20–0.36), respectively. In both cohorts, sCD163 and sMR levels raised with increasing disease severity (liver enzymes, Mayo score, and enhanced liver fibrosis test). Patients with high baseline levels of sCD163 had shorter transplant-free survival than patients with low baseline levels. Furthermore, sCD163 was associated with transplant-free survival in univariate cox-regression analyses. Both sCD163 and sMR performed better in the Oslo cohort of more severely diseased patients than those in the Helsinki cohort of more mildly diseased patients.

DISCUSSION:
Macrophage activation markers are elevated according to disease severity suggesting an important role of macrophages in PSC. Furthermore, sCD163 was identified as a prognostic marker and predictor of transplant-free survival in PSC (see Visual Abstract, Supplementary Digital Content 4, http://links.lww.com/CTG/A516).
Support for osteopathic manipulative treatment inclusion in chronic pain management guidelines: a narrative review
Authors: Franzetti Megan , Dries Emily , Stevens Brady , Berkowitz Lisa , Yao Sheldon C. 
Published: March 2021

Abstract

Context
Osteopathic manipulative treatment (OMT) is used to treat chronic pain conditions. However, few guidelines focusing on chronic pain management include recommendations for OMT.

Objectives
To evaluate previous literature on the use of OMT for improving chronic pain.

Methods
A literature search was conducted on MEDLINE/PubMed and ScienceDirect on August 26–27, 2019, using the terms “osteopathic,” “chronic,” and “pain,” yielding a total of 312 MEDLINE/PubMed articles and 515 ScienceDirect articles. Eligibility criteria required that studies investigate pain, functional status, or medication usage through an experimental design, focusing on human subjects with chronic pain who had various forms of OMT administered by osteopathically trained individuals in which the comparator group received no intervention, a sham or placebo, or conventional care. Three authors independently performed literature searches and methodically settled disagreements over article selection.

Results
In the 22 articles included in our study that examined OMT use in chronic pain conditions, we evaluated primary outcomes of pain (22; 100%) and functional status (20; 90.9%), and the secondary outcome of medication usage (3; 13.6%). The majority of articles showed that OMT resulted in a significant decrease in pain levels as compared to baseline pain levels or the control group (20; 90.9%) and that OMT resulted in an improvement in functional status (17; 77.3%). In articles that did not find a significant difference in pain (2; 9.1%) or functional status (3; 13.6%), there were overall outcomes improvements noted. All articles that investigated medication usage (3; 13.6%) showed that OMT was effective in decreasing patients’ medication usage. Our study was limited by its small sample size and multimodal comparator group exclusion.

Conclusions
OMT provides an evidence-based management option to reduce pain levels, improve functional status, and decrease medication usage in chronic pain conditions, especially low back pain (LBP). Pain management guidelines should include OMT as a resource to alleviate chronic pain.
On the modeling of pulp properties in CTMP processes
Authors: Bengtsson Fredrik , Karlström Anders , Wik Torsten 
Published: March 2021

Abstract
The goal of this paper is to model the pulp properties fiber length, shives width and freeness. This will be done utilizing specific energy, flat zone inlet consistency and the internal variables, consistencies and fiber residence times estimated from refining zone soft sensors. The models are designed using more than 3600 hours of data from a RGP82CD refiner. The pulp properties are sampled using a measurement device positioned after the latency chest. Such measurements are noisy and irregularly sampled which opens for a number of challenges to overcome in modeling procedures. In this paper it is shown that the models for shives width and fiber length are capable of predicting most of the major dynamics. However, for freeness no reliable linear models can be derived. When estimating fiber length, the specific energy together with flat zone inlet consistency, fiber residence times and the consistency in the conical zone were the dominant inputs. For shives width it was found that a similar set of inputs resulted in the best models, except that the consistencies during normal process conditions did not significantly influence shives width. Furthermore, fiber residence times were shown to have considerably more pronounced impact on fiber length compared with shives width estimates.
Stingray envenomation and injury in a dog
Authors: Adegboye Olutoye , Adegboye Olusegun 
Published: March 2021

Abstract
The stingray, a seemingly harmless cartilaginous fish, is capable of causing painful injuries and envenomation in humans. There is no known peer reviewed case report involving dogs in a veterinary journal at the time of writing this case report. Poor management of the condition or overzealous attempts to remove embedded barbs has resulted in complications in humans. This case report presents an effective approach to the treatment of stingray envenomation in dogs which is likely to be reproducible in other domestic animals. Clearly elucidated are the principles behind antibiotic therapy in the treatment of stingray injuries and the benefit of lignocaine injection in cases of embedded stingers. There is a need for case reports to enhance clinical knowledge of stingray management in domestic animals. This case report, thus, serves as an impetus for future research in this area of veterinary medicine.