bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital bed capacity and usage across secondary healthcare providers in England during the first wave of the COVID-19 pandemic: a descriptive analysis
Authors: Mateen Bilal Akhter , Wilde Harrison , Dennis John M , Duncan Andrew , Thomas Nick , McGovern Andrew , Denaxas Spiros , Keeling Matt , Vollmer Sebastian 
Published: January 2021

ObjectiveIn this study, we describe the pattern of bed occupancy across England during the peak of the first wave of the COVID-19 pandemic.DesignDescriptive survey.SettingAll non-specialist secondary care providers in England from 27 March27to 5 June 2020.ParticipantsAcute (non-specialist) trusts with a type 1 (ie, 24 hours/day, consultant-led) accident and emergency department (n=125), Nightingale (field) hospitals (n=7) and independent sector secondary care providers (n=195).Main outcome measuresTwo thresholds for ‘safe occupancy’ were used: 85% as per the Royal College of Emergency Medicine and 92% as per NHS Improvement.ResultsAt peak availability, there were 2711 additional beds compatible with mechanical ventilation across England, reflecting a 53% increase in capacity, and occupancy never exceeded 62%. A consequence of the repurposing of beds meant that at the trough there were 8.7% (8508) fewer general and acute beds across England, but occupancy never exceeded 72%. The closest to full occupancy of general and acute bed (surge) capacity that any trust in England reached was 99.8% . For beds compatible with mechanical ventilation there were 326 trust-days (3.7%) spent above 85% of surge capacity and 154 trust-days (1.8%) spent above 92%. 23 trusts spent a cumulative 81 days at 100% saturation of their surge ventilator bed capacity (median number of days per trust=1, range: 1–17). However, only three sustainability and transformation partnerships (aggregates of geographically co-located trusts) reached 100% saturation of their mechanical ventilation beds.ConclusionsThroughout the first wave of the pandemic, an adequate supply of all bed types existed at a national level. However, due to an unequal distribution of bed utilisation, many trusts spent a significant period operating above ‘safe-occupancy’ thresholds despite substantial capacity in geographically co-located trusts, a key operational issue to address in preparing for future waves.
Electron spectrometry with Silicon drift detectors: a GEANT4 based method for detector response reconstruction
Authors: Biassoni Matteo , Gugiatti Matteo , Capelli Silvia , Carminati Marco , Cremonesi Oliviero , Fiorini Carlo , King Pietro , Lechner Peter , Mertens Susanne , Pagnanini Lorenzo , Pavan Maura , Pozzi Stefano 
Published: January 2021

AbstractPrecision electron spectrometry in the keV range has always been considered a challenging task. The reconstruction of the original electron energy from the detected signal is not trivial because multiple effects modify the kinetic energy of the electron along its path. If not correctly accounted for, these effects can spoil and bias the reconstructed energy with a dramatic reduction of accuracy and precision. In this paper we address one of the most critical aspects of electron spectrometry: the generally unknown effect of the detector entrance window. We show that, with a MonteCarlo-based approach, we are able to build a model of the entrance window accurate enough to reduce the negative effects due to its existence. We adopt for this purpose Silicon Drift Detectors that, thought primarily used for X-ray spectrometry, appear a promising device for electron spectrometry. The technique we discuss exploits characterization and validation measurements performed with electron beams from a Scanning Electron Microscope, later reconstructed with a GEANT4 MonteCarlo simulation.
Selective Atrophy of the Vastus Medialis: Does It Exist in Women With Nontraumatic Patellofemoral Pain?
Authors: Ho Kai-Yu , Chen Yu-Jen , Farrokhi Shawn , Tsai Liang-Ching , Liao Tzu-Chieh , Haas Nicole , Powers Christopher M. 
Published: January 2021

Background: A commonly cited theory related to the pathomechanics of patellofemoral pain (PFP) states that atrophy of the vastus medialis (VM) muscle leads to lateral tracking of the patella. However, isolated atrophy of the VM or atrophy of the quadriceps muscle group as a whole, has not been consistently reported in this population. Purpose: To compare individual and total quadriceps muscle volumes between women with nontraumatic PFP and women without PFP as measured on magnetic resonance imaging scans. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 52 women with nontraumatic PFP and 64 women without PFP between the ages of 18 and 45 years participated. Magnetic resonance imaging scans of the thigh were obtained from the anterior inferior iliac spine to the tibial plateau. Individual quadriceps muscle cross-sectional area measurements were obtained from each image, and muscle volumes for the VM, vastus lateralis, vastus intermedius, and rectus femoris were calculated. Muscle volume measurements were expressed in absolute values and normalized to body mass. Separate 2-way mixed-factorial analysis of variance (group × muscle) were used to compare absolute and normalized individual muscle volumes between groups. Independent t tests were used to compare absolute and normalized total quadriceps volumes between groups. Results: There was no difference in absolute and normalized individual muscle volumes between individuals with and those without PFP. Additionally, absolute and normalized total muscle volumes did not differ between groups. Conclusion: Our findings do not support the concept of preferential atrophy of the VM or generalized quadriceps atrophy in women with nontraumatic PFP.
Efficacy of minocycline in the treatment of early syphilis
Authors: Wu Haoqing , Qi Manli , Wang Huiping , Liu Quanzhong , Liu Yuanjun 
Published: January 2021

Syphilis is the third prevalent infectious disease in China, caused by the spirochete bacterium Treponema pallidum. Minocycline is a derivative of tetracycline used as an alternative treatment for syphilis, but there are few studies in this field. In this research, we compared the efficacy of benzathine penicillin and minocycline in the treatment of early syphilis patients and analyzed some of the factors affecting the efficacy of minocycline. A total of 276 eligible patients treated between January 2011 and December 2017 were retrospectively analyzed, and 158 patients received 100 mg of minocycline orally, twice daily for 28 days, while 118 patients received benzathine penicillin, 2.4 million units intramuscular injections, once a week, 1–2 times in all. All patients accepted rapid plasma regain (RPR) serological tests and followed up for 24 months to evaluate serological treatment responses. After comparison, the serological cure rate of the minocycline treatment group (85.44%) was similar to the benzathine penicillin treatment group (88.14%). Besides, patients in the minocycline treatment group with higher initial RPR titer (≥1:32) exhibited better treatment effect. In addition, during the 24-month follow-up, the serological cure rate of primary syphilis patients after minocycline treatment was significantly higher than that of secondary and early latent syphilis patients. Therefore, minocycline may be an effective alternative treatment to early syphilis when benzathine penicillin is not available.
Increased cancer risk in patients with cutaneous lupus erythematosus and systemic lupus erythematosus compared with the general population: A Danish nationwide cohort study
Authors: Westermann Rasmus , Zobbe Kristian , Cordtz René , Haugaard Jeanette H , Dreyer Lene 
Published: January 2021

Objectives To investigate if patients with cutaneous lupus erythematosus (CLE) or systemic lupus erythematosus (SLE) have an increased risk of cancer compared with the general population, and furthermore to identify specific cancer types associated with increased risk. Methods This is an observational cohort study of 5310 patients with CLE or SLE identified in the Danish National Patient Register from 1 January 1995 to 31 December 2014. The cohort was followed up for cancer by linkage to the Danish Cancer Registry. Based on the age, sex, and calendar specific cancer rates of the general population of Denmark, standardised incidence ratios (SIRs) were calculated. Results The patients with CLE or SLE were followed for 40.724 person-years, each group’s average duration of follow-up being 6.9 and 8.1 years. The SIR for overall cancer (except non-melanoma skin cancer (NMSC)) was increased in patients with CLE 1.35 (95%CI 1.15 to 1.58) and patients with SLE 1.45 (95%CI 1.30 to 1.62). Both groups had high risks of hematological – including a 3–4-fold increased risk of non-Hodgkin lymphoma –, pancreatic, and lung cancers. Several cancers associated with oncogenic viruses as liver and tongue/mouth/pharynx were increased in the SLE group, while the risk of ovarian cancer was increased 2–4-fold only in the CLE group. Conclusion The overall risk of cancer was significantly increased in both patients with CLE and SLE. SIRs for hematological, pancreatic and lung cancers were elevated in both groups. Extra awareness of cancer in patients with SLE and patients with CLE should be considered.
How Inclusive Are Indian States: Evidence from Inclusive Development Index
Authors: Aggarwal Suresh Chand 
Published: January 2021

The current study aims to find an ‘Inclusive Development Index’ (IDI) for the selected Indian states for the year 2017–2018 and has tried to incorporate indicators encompassing different aspects of the economy and life of the people. The index has tried to be more comprehensive and contemporary and attempts to keep the interest alive in the all-important policy objective of an inclusive growth in India as well as in many other countries around the world. The study has followed the guidelines given by Organisation for Economic Co-operation and Development ( OECD, 2008 , Handbook on constructing composite indicators: Methodology and user guide) to construct a composite index and has included two pillars of growth with a total of 14 dimensions (sub-pillars) represented by 62 indicators. Principal component analysis (PCA) has been applied at the indicators level and simple averaging at the dimension and pillar levels to obtain the composite IDI for 20 Indian states. The states are ranked based on their inclusiveness score on IDI and divided into the ‘front-runners’, the ‘achievers’ and the ‘aspirants’. IDI may help the states to identify their spheres of ‘low’ performance and learn from their ‘front-runner’ peers. JEL: D63, F43, O40
Does Infant Orthopedics and Neonate Lip Surgery Influence the Occlusal Relationship in Patients With Unilateral Cleft Lip and Palate (UCLP)?
Authors: Galassi Thalita V. , Souza-Brosco Telma V. , Lopes Lucy D. , de Almeida Araci Malagodi , da Silva Dalben Gisele , de Paiva Joao B. , Neto José Rino , Ozawa Terumi O. 
Published: January 2021

Objective: To compare occlusal relationship in patients undergoing neonate versus conventional lip surgery (LS) with and without infant orthopedics (IO) by assessment of dental arch relationship in individuals with complete unilateral cleft lip and palate. Material and Methods: Three groups treated by different protocols; Group I: neonate LS (1-15 days) + IO and palatoplasty (13-31 months); Group II: LS (3-12 months) + IO and palatoplasty (15-35 months); and Group III: LS (3-6 months) without IO and palatoplasty (12-18 months). The 112 intraoral photographs of individuals of all groups, obtained between 6 and 12 years of age, were assessed by the occlusal index for intraoral photograph rating. The groups were compared by the χ2 test. The correlation between surgical timing and the scores was tested by the Spearman test ( P < .05). Results: Group I presented the highest percentage of score 5, group II exhibited highest percentage of score 1, and group III presented the lowest percentage of score 5 according to the χ2 test ( P = .029). The Spearman correlation test revealed statistically significant difference between timing of LS and the occlusal index. The earlier the surgical timing, the higher the occlusal index ( P = .019). Conclusions: Infant orthopedics has demonstrated the possibility of postponing primary plastic surgeries. Patients submitted to late lip and palate repair had the best prognosis, while patients undergoing lip repair from 1 to 15 days of life, even operating the palate later, had the worst prognosis. Neonate LS negatively influenced the occlusal relationships.
Traditional Modified Broström vs Suture Tape Ligament Augmentation
Authors: Kulwin Robert , Watson Troy S. , Rigby Ryan , Coetzee J. Chris , Vora Anand 
Published: January 2021

Background: The modified Broström (MB) procedure has long been the mainstay for the treatment of chronic lateral ankle instability (CLAI). Recently, suture tape (ST) has emerged as augmentation for this repair. The clinical benefit of such augmentation has yet to be fully established. The purpose of this study was to determine if ST augmentation provides an advantage over the traditional MB. Methods: Adult patients were identified for inclusion in the study based on indications for primary lateral ligament reconstruction for CLAI. The primary outcome measure was time to return to preinjury level of activity (RTPAL). Secondary outcome measures included complications, ability to participate in an accelerated rehabilitation protocol (ARP), patient-reported outcomes (PROs), and visual analog pain scale (VAS). A total of 119 patients with CLAI were enrolled and randomized to the MB (59 patients) or ST (60 patients) treatment arm. Results: Average RTPAL was 17.5 weeks after MB and 13.3 weeks after ST ( P < .001). At 26 weeks, 12.5% of patients in the MB group and 3.6% of patients in the ST group had not managed RTPAL ( P = .14). The complication rate was 8.5% in the MB group vs 1.7% in the ST group ( P = .12). Four patients in the MB group failed to complete the ARP vs 1 in the ST group ( P = .144). Conclusion: Results from this multicenter, prospective, randomized trial suggest that ST augmentation allows for earlier RTPAL than MB alone. ST augmentation may support successful accelerated rehabilitation and did not result in increased complications or morbidity. Level of Evidence: Level II, prospective comparative study.
Beyond visual acuity: Patient-relevant assessment measures of visual function in retinal diseases
Authors: Puell María Cinta , Contreras Inés , Pinilla Isabel , Escobar José Juan , Soler-García Antonio , Blasco Antonio Javier , Lázaro Páblo 
Published: January 2021

Purpose: To identify patient-reported outcomes (PROs) and other clinical outcome measures (contrast sensitivity (CS), low-luminance visual acuity (LLVA) and reading acuity or reading speed (RA-RS)), relevant to patients with age-related macular degeneration (AMD) or diabetic retinopathy (DR), which would be recommended for use in clinical practice. Methods: The RAND/UCLA Appropriateness Method, based on the synthesis of the scientific evidence and the collective judgment of an expert panel using the two-round Delphi method, was applied. The evidence synthesis was performed by searching for articles on outcome measures for AMD and/or DR published between 2005 and 2018 in English or Spanish. The expert panel consisted of 14 Spanish ophthalmologists, who rated the recommendation degree for each outcome measure on a scale of 1 (extremely irrelevant) to 9 (maximum relevance). The recommended outcome measures were established according to the panel median score and the level of the panelists’ agreement. Results: Through the evidence search, 33 PRO-specific questionnaires (21 for visual function, six for AMD, three for DR, one for AMD and DR) and two treatment satisfaction questionnaires (one on AMD and one on DR) were identified. In addition, 21 methods were found for measuring CS, five for LLVA, and nine for RA-RS. According to the panel ratings, 11 of the 64 outcome measures evaluated for AMD, and seven of the 61 evaluated for DR were recommended. Conclusion: The AMD and DR outcome measures recommended will help ophthalmologists choose the outcome measure most appropriate for their patients. Furthermore, the use of PROs will contribute to shifting clinical practice towards patient-centered medicine.
Cataract and associated factors among adults visiting ophthalmic clinic at Debre Markos comprehensive specialized hospital, northwest Ethiopia, 2020
Authors: Wale Mengistu Zelalem , Derbew Mengist , Tilahun Melkamu , Terefe Mesenbet 
Published: January 2021

Introduction: Globally, it is estimated that 2.2 billion people have a visual impairment, of which around 65.2 million is due to cataract. Cataract is the leading cause of preventable blindness worldwide, with the greatest burden found in low-income countries. That is providing recent epidemiological data is very crucial to design intervention measures. The aim of this study was to assess the magnitude and associated factors of cataract among adults visiting ophthalmic clinic, Debre Markos comprehensive specialized hospital, Northwest Ethiopia, 2020. Methods: The sample size was calculated using single population formula and determined to be 174. All adult participants aged ⩾40 were the source population and those fulfilling the inclusion criteria were the study population. An institutional-based cross-sectional study design using a systematic random sampling technique was conducted from July to August, 2020. Semi-structured questionnaires and patients’ card were used to collect data. Data were entered into epi-data version 4.6 and the analysis was conducted using SPSS-25 software. Data were presented using graphs, tables and texts. Bivariable and multivariable binary logistic regression models were used to identify factors associated with cataract. Adjusted odds ratio with corresponding 95% confidence interval was computed to show the strength of association. A p-value < 0.05 was considered statistically significant. Result: From a total of 174 samples, 158 participated, giving a response rate of 90.8%. The prevalence of cataract was found to be 90 (57%). The variables—age 60–69 years (adjusted odds ratio = 6.667, 95% confidence interval: (1.662, 13.101)); age 70–79 years (adjusted odds ratio = 9.583, 95% confidence interval: (2.840, 32.342)), and single marital status (adjusted odds ratio = 2.945, 95% confidence interval: (1.241, 6.989))—had a significant association with cataract. Conclusion: The prevalence of cataract was found to be very high, which needs immediate intervention. Older age and single marital status were found to be significantly associated with cataract prevalence.
The Effect of Peri-Bracket Excess Adhesive on Shear Bond Strength and Enamel–Adhesive Interface Morphology With Confocal Laser Scanning Microscopy: An In Vitro Comparative Study
Authors: Almashali Banan , Alqahtani Nasser , Almahdy Ahmed 
Published: January 2021

Aim: To evaluate the effect of leaving excess adhesive around orthodontic brackets on the shear bond strength and on the enamel–adhesive interface characteristics. Materials and Methods: One hundred forty four human premolars were randomly divided into two groups according to the test performed. For the shear bond strength, 120 teeth were bonded with stainless steel orthodontic brackets using Transbond XT light cure adhesive composites. After positioning the bracket and before light curing, excess adhesive was removed according to the test group: group 1, all excess adhesive was removed (0 mm excess); group 2, 1 mm excess adhesive was left; group 3, 2 mm excess adhesive was left; shear bond strength was measured immediately and after three months of natural aging using a universal testing machine; and adhesive remnant index scores were also evaluated. For the enamel–adhesive interface characteristics, 24 teeth were bonded with stainless steel orthodontic brackets using Transbond XT light cure adhesive composites mixed with Rhodamine B fluorescent dye, excess adhesive was removed in the same manner according to the test groups, and teeth were evaluated using confocal laser scanning microscopy. Results: Time did not significantly affect the bond strength results ( P = .888) but the amount of excess adhesive significantly affected the results ( P < .05). Interaction terms were not significant ( P = .337). In both immediate and aged conditions, group 1 (0 mm excess) presented the highest bond strength results (MPa; P < .05). No significant difference was found in adhesive remnant index scores or enamel–adhesive interface characteristics. Conclusion: Excess adhesive around orthodontic bracket does not increase shear bond strength.
Cheilectomy With or Without Cryopreserved Amniotic Membrane–Umbilical Cord Allograft for Hallux Rigidus
Authors: Galli Sara Heintzman , Ferguson Chad M. , Davis W. Hodges , Anderson Robert , Cohen Bruce E. , Jones Carroll P. , Odum Susan , Ellington J. Kent 
Published: January 2021

Background: For hallux rigidus, dorsal cheilectomy remains a treatment option even with advances in interposition techniques and devices. Cheilectomy aims to alleviate dorsal impingement and improve pain and function as well as range of motion. Cryopreserved umbilical cord allograft, with properties to mitigate inflammation and scar formation, has theoretical benefit for improving outcomes following cheilectomy. In this first prospective randomized and blinded cheilectomy study reported, we aimed to compare outcomes between cheilectomy alone and cheilectomy with umbilical cord allograft. Methods: Patients were randomized to cheilectomy alone (CA) or cheilectomy with cryopreserved umbilical cord (ie, amniotic membrane–umbilical cord [AM-UC]). Patients were evaluated with American Orthopaedic Foot & Ankle Society (AOFAS), Foot Function Index (FFI), and visual analog scale (VAS) pain outcomes collected preoperatively and at 6 months and 1 year postoperatively. In addition, radiographic range of motion data were collected using stress radiographs. Fifty-one patients (26 AM-UC, 25 CA) completed the study, with 5 bilateral surgeries in the AM-UC group and 2 in the CA group, totaling 31 and 27 feet, respectively. Results: The AM-UC group had statistically significant improved AOFAS and FFI scores at 1 year compared with the CA group, but there was no difference at 6 months. There was no significant difference between groups for VAS-pain scores at any time point, but overall VAS-pain improved in both groups from preoperative values. There was no significant difference in range of motion (total arc) between groups and changes in range of motion (total arc) in both groups from preoperative to 1 year postoperative were small. Conclusion: We present the results of the first randomized and blinded prospective study of cheilectomy surgery patients. When appropriately selected, cheilectomy remains a good option for patients with symptomatic hallux rigidus. Cryopreserved umbilical cord is a potential adjuvant to cheilectomy, with 1-year results showing improvements in functional outcome scores. Level of Evidence: Level II, prospective comparative study.