bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safe corridors for external skeletal fixator pin placement in feline long bones
Authors: Prackova Ivana , Paral Vaclav , Kyllar Michal 
Published: December 2021

Objectives External skeletal fixation is an established technique in cats for biological fixation of long bone fractures, stabilisation of the joints, and treatment of shearing injuries and angular deformities. As appropriate and accurate pin insertion is imperative for a successful outcome, knowledge of topographic anatomy and areas that are safe (safe corridors) for pin placement is integral to successful surgery. At present, however, safe corridors have not been determined fully in feline orthopaedics, with surgeons having to rely on knowledge based on canine orthopaedics. This study was performed to determine safe corridors for pin placement in feline long bones. Methods The limbs of six feline cadavers were frozen. Only limbs with no history of orthopaedic conditions were used. Transverse sections through the limbs were examined, and anatomical structures were determined in relation to the bone. These structures were compared with those of the contralateral limbs, which were dissected for topographic assessment. Safe corridors were defined as topographic areas where no vital structures, muscles or joints were present. Results Examination of the humerus revealed safe corridors at its proximal craniolateral aspect and on the medial and lateral humeral condyles. Safe corridors of the antebrachium were identified on the lateral aspect of the olecranon, the distal two-thirds of the medial antebrachium and the distal third of the lateral antebrachium. Safe corridors in the femur consisted of a small area lateral to and just below the major trochanter, and on the medial and lateral femoral condyles. Evaluation of the tibia revealed safe corridors on the medial aspect of the entire tibia, the cranial aspect of the proximal tibia on the tibial crest and the area just proximal to the lateral malleolus. Conclusions and relevance Safe corridors for pin placement during external skeletal fixation in feline limbs differed from those in canine limbs. Knowledge of canine anatomy may be inapplicable to pin placement in feline limbs undergoing external skeletal fixation.
Monitoring therapy in anterior necrotizing scleritis with inflammation with anterior segment optical coherence tomography
Authors: Vidal Oliver Lourdes , López Montero Ana , Gil Hernández Irene , García Ibor Francisca , Vela Bernal Sara , Duch Samper Antonio Miguel 
Published: December 2021

Introduction Early diagnosis and initiation of immunosuppression can prevent the necessity of surgical intervention in necrotizing scleritis with inflammation and lowers the risk of perforation and loss of vision. However, clinical signs for early diagnosis and methods for monitoring response to immunosuppressive therapy are missing. Methods Here, we present a case of necrotizing scleritis with inflammation where avascular plaques precede scleral defects. We use slit lamp imaging and anterior segment optical coherence tomography to evaluate evolution lesions depth and impact on scleral structure. Results The patient presented 5 months after detection of avascular plaques with a new scleral ulcer of the left eye. After 3-day-administration of i.v. corticosteroids anterior segment optical coherence tomography showed progressive scleral thickening. The patient was therefore spared surgical intervention and discharged resulting in complete remission under decreasing doses of oral corticosteroids. Conclusions Avascular plaques can precede necrotizing scleritis with inflammation by several months and may therefore qualify as early clinical signs. Anterior segment optical coherence tomography enables objective evaluation of scleral structure for making rational decisions about surgical intervention.
Evaluation of the Utility of Amino Acid Citrulline as a Surrogate Metabolomic Biomarker for the Diagnosis of Celiac Disease
Authors: Lomash Avinash , Prasad Anupa , Singh Raghvendra , Kumar Somesh , Gupta Rishi , Dholakia Dhwani , Kumar Praveen , Batra Vineeta V , Puri Amarender S , Kapoor Seema 
Published: December 2021

Introduction: Citrulline is regarded as a biomarker for celiac disease (CD). Its utility for assessment and evaluation of additive predictive value for latent, potential CD and first degree relatives (FDRs) needs exploration. Method: Consecutive 558 index cases diagnosed as per European Society for Pediatric Gastroenterology and Nutrition (ESPGHAN) 2012 guidelines and their 1565 FDRs were evaluated over five and half year period. Serology negative FDRs at initial visit and follow ups were served as controls. HLA typing for DQ2 and DQ8 genotypes, along with plasma and dried blood spot (DBS) filter paper citrulline were evaluated. Results: Median plasma citrulline values were 20.1 and 37.33 µMol/l in cases and controls ( P < .001). Cut off values for Marsh grade 3a, 3b, and 3c were 35.0, 32.8, 25.26 µMol/l in CD patients and 36.51, 30.10, 25.26 µMol/l in biopsy proven FDR. Increasing trends of plasma citrulline levels with decreasing tTG-IgA levels were observed on follow up. Low plasma citrulline levels were observed with HLA DQ 2.5 genotype ( P < .05). Agreement between DBS and plasma citrulline was 94.8%. Conclusion: Citrulline is a good surrogate biomarker for identification of histopathological grade of damage, extent of mucosal recovery and has negative correlation with tTG-IgA. It identifies the silent and latent phase of CD. DBS citrulline provides adequate information and can be used for monitoring CD patients at remote locations.
The interaction of age, second language, types of code-alternation and multilingualism in the Zauzou community
Authors: Li Yu 
Published: December 2021

Aims and objectives: This paper describes the multilingualism patterns practiced in the Zauzou community, a small ethnic group in Southwestern China. Zauzou is in contact with Lisu, Bai, Lama, and Mandarin Chinese. The present study aims to characterize the relationship between the social/linguistic factors including age, second language (L2), types of code-alternation, and the multilingualism patterns in this community. Design/methodology/approach: Self-reports and participant observation were used to discover any recurrent multilingualism patterns regulated by social/linguistic factors. Data and analysis: Self-reported data on Zauzou speakers’ language repertoire and language use were collected by means of demographic survey. Code-alternation between Zauzou and different L2s were collected from systematic linguistic fieldwork. Findings/conclusions: Zauzou is the dominant language in intragroup multilingualism, while intergroup multilingualism is dominated by Zauzou speakers’ L2s. Zauzou speakers exhibit a shift from the local multilingualism toward Mandarin-Zauzou bilingualism. The two patterns can be characterized by speakers’ age, L2, and the type of code-alternation. Zauzou-Mandarin bilingualism is realized as both code-mixing and code-switching, and is pervasive among the younger generation, while multilingualism is realized as code-switching and is dominant among older speakers. This shift is due to the new market economy and the language policy that promotes Mandarin in the whole area. Originality: This study presents naturalistic data on multilingualism practices in a small minority group in China, which is overlooked by most linguistic descriptions and sociolinguistic studies of lesser-studied languages in China. Significance/implications: This paper discovers three parameters to define two cross-linguistic multilingualism patterns in small indigenous societies: the local multilingualism and the national bilingualism, and the shift toward bilingualism that directly results from language policy and economy.
Languages and ideologies at the Lower Yenisei (Siberia): Reconstructing past multilingualism
Authors: Khanina Olesya 
Published: December 2021

Aims and objectives: This paper reconstructs past multilingualism (1900–1930s) among the nomadic people of the Lower Yenisei in northern Siberia, with particular attention to the language ideologies behind it; it is validated by parallels from small-scale communities worldwide. Approach: An ethnographic approach is taken, which interprets sociolinguistic data in view of emic categorizations. Data and analysis: The reconstruction is based on: (a) 1926 census data; (b) ethnographic reports from the 1920s to 1960s; (c) narratives from the 1940s; (d) retrospective sociolinguistic interviews; and (e) ethnonyms of local languages. (a), (b) provide a background for the interpretation of the linguistic data from (c)–(e). Findings: The connection of local social categories/groups to languages was unstable both synchronically and diachronically. Linguistic repertoires described the authenticity of the speech communities better than the command of individual languages. The linguistic indexing of identity was relational and depended on social networks more than on ancestry/kinship. These ideologies together with constant migrations shaped the sociolinguistic profile of the area and facilitated language shifts. Originality: Besides providing a detailed sociolinguistic description for an underresearched part of the world, this paper uses a novel methodology for reconstructing multilingualism of the past. Implications: The described mechanisms of language shift within communities that are multilingual in related languages contribute to theories of language diversification and spread at least in the north, but possibly also in a broader perspective. The methodology can be applied to other cases of past multilingualism.
An In Silico Head-to-Head Comparison of the Do-It-Yourself Artificial Pancreas Loop and Bio-Inspired Artificial Pancreas Control Algorithms
Authors: Armiger Ryan , Reddy Monika , Oliver Nick S. , Georgiou Pantelis , Herrero Pau 
Published: December 2021

Background: User-developed automated insulin delivery systems, also referred to as do-it-yourself artificial pancreas systems (DIY APS), are in use by people living with type 1 diabetes. In this work, we evaluate, in silico, the DIY APS Loop control algorithm and compare it head-to-head with the bio-inspired artificial pancreas (BiAP) controller for which clinical data are available. Methods: The Python version of the Loop control algorithm called PyLoopKit was employed for evaluation purposes. A Python-MATLAB interface was created to integrate PyLoopKit with the UVa-Padova simulator. Two configurations of BiAP (non-adaptive and adaptive) were evaluated. In addition, the Tandem Basal-IQ predictive low-glucose suspend was used as a baseline algorithm. Two scenarios with different levels of variability were used to challenge the algorithms on the adult (n = 10) and adolescent (n = 10) virtual cohorts of the simulator. Results: Both BiAP and Loop improve, or maintain, glycemic control when compared with Basal-IQ. Under the scenario with lower variability, BiAP and Loop perform relatively similarly. However, BiAP, and in particular its adaptive configuration, outperformed Loop in the scenario with higher variability by increasing the percentage time in glucose target range 70-180 mg/dL (BiAP-Adaptive vs Loop vs Basal-IQ) (adults: 89.9% ± 3.2%* vs 79.5% ± 5.3%* vs 67.9% ± 8.3%; adolescents: 74.6 ± 9.5%* vs 53.0% ± 7.7% vs 55.4% ± 12.0%, where * indicates the significance of P < .05 calculated in sequential order) while maintaining the percentage time below range (adults: 0.89% ± 0.37% vs 1.72% ± 1.26% vs 3.41 ± 1.92%; adolescents: 2.87% ± 2.77% vs 4.90% ± 1.92% vs 4.17% ± 2.74%). Conclusions: Both Loop and BiAP algorithms are safe and improve glycemic control when compared, in silico, with Basal-IQ. However, BiAP appears significantly more robust to real-world challenges by outperforming Loop and Basal-IQ in the more challenging scenario.
Leveraging Interdisciplinary Teams for Pre-Visit Planning to Improve Pneumococcal Immunization Rates Among Internal Medicine Subspecialty Practices
Authors: Shafer Rebecca , Kearns Christina , Carney Maria , Sagar Ankita 
Published: December 2021

Background: Despite the ready availability of pneumococcal vaccines and recommendation of vaccination by Center for Disease Control and Prevention (CDC), the immunization rates among adults less than 65 years of age with chronic and immunocompromised conditions remain low. Methods: This interventional (cohort) study aimed to improve the pneumococcal vaccination rate for patients with an increased risk of pneumococcal disease by utilizing a three-pronged approach. This included: (1) clinician education webinar, (2) pre-visit counseling performed by registered nurses, targeted toward patients with upcoming appointments, to address vaccination status, and (3) modified pre-visit interdisciplinary team huddle with clinicians and registered nurses to review which patients are amenable to vaccination at the time of visit and those who may benefit from re-engagement and further motivational interviewing. After the completion of the 10-week intervention, study organizers reviewed the percent of patients with completed pneumococcal vaccinations. Results: In this 10-week rapid cycle initiative, a total of 482 patients were eligible for vaccination. During the intervention phase, 370 patients were contacted and of these 38% of patients were amenable to receiving a vaccine during the pre-visit counseling, 5% were previously vaccinated, 18% were not amenable, and 38% were unreachable prior to visit. This initiative resulted in a 43% increase in the vaccination rate in this cohort. Conclusions: The significant increase in vaccination rate supports the utilization of a framework in the multidisciplinary approach to pre-visit planning in non-primary care specialties and other vaccination efforts, especially emerging diseases such as COVID-19. Future directions of study include the efficacy of telemedicine counseling with a same-day appointment for vaccination, co-location of registered nurses within the practice sites, as well as the use of other ancillary staff (such as medical office assistants) to engage patients in pre-visit planning.
Research Practices and Needs Among Spine Surgeons Worldwide
Authors: Germscheid Niccole , Cheung Jason P. Y. , Neva Marko H. , Öner F. Cumhur , Kwon Brian K. , Valacco Marcelo , Awwad Waleed , Sciubba Daniel M. , Lewis Stephen J. , Rhines Laurence D. , Yoon S. Tim , Alini Mauro , Grad Sibylle , Fisher Charles G. , Samartzis Dino 
Published: December 2021

Objective Resource allocation to research activities is challenging and there is limited evidence to justify decisions. Members of AO Spine were surveyed to understand the research practices and needs of spine surgeons worldwide. Methods An 84-item survey was distributed to the AO Spine community in September of 2020. Respondent demographics and insights regarding research registries, training and education, mentorship, grants and financial support, and future directions were collected. Responses were anonymous and compared among regions. Results A total of 333 spine surgeons representing all geographic regions responded; 52.3% were affiliated with an academic/university hospital, 91.0% conducted clinical research, and 60.9% had 5+ years of research experience. There was heterogeneity among research practices and needs across regions. North American respondents had more research experience ( P = .023), began conducting research early on ( P < .001), had an undergraduate science degree ( P < .001), and were more likely to have access to a research coordinator or support staff ( P = .042) compared to other regions. While all regions expressed having the same challenges in conducting research, Latin America, and Middle East/Northern Africa respondents were less encouraged to do research ( P < .001). Despite regional differences, there was global support for research registries and research training and education. Conclusion To advance spine care worldwide, spine societies should establish guidelines, conduct studies on pain management, and support predictive analytic modeling. Tailoring local/regional programs according to regional needs is advised. These results can assist spine societies in developing long-term research strategies and provide justified rationale to governments and funding agencies.
Assessment of proton-pump inhibitor use at a tertiary teaching hospital in Nigeria
Authors: Okoro Roland Nnaemeka , Abdullahi Kasim , Dayar Dauda Ayuba 
Published: December 2021

Background: Proton-pump inhibitor (PPI) is a widely used medication class globally. Because of its good safety profile, there is a huge likelihood of inappropriate use. Objectives: To determine the prevalence of PPI use and indications, describe its pattern of usage, and identify factors associated with inappropriate prescriptions at a federal tertiary teaching hospital in Maiduguri, Nigeria. Methods: PPI prescriptions were retrospectively assessed in the General Outpatients’ Department (GOPD) and Gastroenterology Unit (GITU) of a teaching hospital. Relevant data for the study were extracted from the patients’ medical records. Chi-square or Fisher’s exact tests where appropriate were used to identify factors associated with inappropriate PPI prescriptions. A p < 0.05 was considered to be significant. Results: PPIs were prescribed to 73.3% (220/300) of patients, while inappropriate prescriptions were noted in 91.4% (201/220) of these patients. Epigastric pain (49.5%) was the most common PPI indication, while omeprazole was the highest prescribed (53.4%). Nearly all inpatients (98.2%), those with epigastric pain (95.7%), and patients who were prescribed intravenous PPIs had more inappropriate PPI prescriptions compared to others. Conclusion: This study revealed a high prevalence of PPI use and inappropriate prescriptions at the study hospital. As a result, these findings highlight the importance PPI-based stewardship program at the study hospital.
Coats’ disease: trends and long-term treatment outcomes in a tertiary referral centre
Authors: Oli Avadhesh , Balakrishnan Divya , Jalali Subhadra 
Published: December 2021

Background: The long-term treatment outcomes in Coat’s disease – particularly in the era of newer pharmacotherapies such as anti-vascular endothelial growth factor (VEGF) agents and depot steroids – are poorly understood. Aim: To describe the clinical features and treatment outcomes of 148 eyes with Coats’ disease assessed in a referral centre over 30 years. Materials and methods: We conducted a retrospective chart review of patients diagnosed with Coats’ disease between 1 June 1987 and 31 July 2017. The demographic, clinical and treatment data were collected and long-term functional and anatomical outcomes were analysed based on the treatment either with conventional therapy (cryo/laser) or along with adjuvants like intravitreal steroids or anti-VEGFs. Results: The mean age at presentation was 15.22 years (median 11). Familial exudative vitreoretinopathy was the most common referral diagnosis, 76/148 (51.5%), followed by Coats’ disease, 37/148 (25%), and retinoblastoma, 35/148 (23.6%). Stage 3B was most common at presentation (31.8%), followed by 2B (22.3%) and 2A (16.9%). A total of 107 patients were treated either with conventional therapy or in combination with adjuvants. The mean follow-up period was 24.95 months. The visual acuity improved from baseline logMAR 2.17 (Snellen-20/2958) to logMAR 1.88 (Snellen-20/1517) at final follow-up ( p = 0.004). The improvement in visual acuity was better when the presenting BCVA was <1 logMAR (Snellen 20/200), p = 0.004. No statistically significant change in BCVA was noted between conventional and adjuvant groups, p = 0.5. However, the final anatomical outcome was good in 78/99 (78.8%) in the conventional group and 45/49 (91.8%) in the adjuvant group, respectively ( p = 0.046). Conclusion: In this series of patients with Coats’ disease over three decades, the use of intravitreal steroids or anti-VEGFs as adjuvants resulted in better anatomical outcomes. A better baseline visual acuity, lower stage of the disease, and older age at presentation were found to be the factors leading to favourable visual outcomes. Summary In the current series of 148 eyes with Coats’ disease, adjuvant treatment with intravitreal steroids or anti-VEGFs resulted in better outcomes as compared with conventional cryotherapy or laser photocoagulation alone. Patients with Coats’ disease who had presented with better visual acuity at baseline, lower stage of the disease and older age had better final visual outcomes.
Serum magnesium in diabetic retinopathy: the association needs investigation
Authors: Shivakumar Koushik , Rajalakshmi A.R. , Jha Kirti Nath , Nagarajan Swathi , Srinivasan A.R. , Lokesh Maran A. 
Published: December 2021

Background: Magnesium has an essential role in glucose metabolism, and hypomagnesaemia is common in diabetes mellitus. However, the relationship between serum magnesium and diabetic retinopathy is poorly understood. Aim: To determine the association between serum magnesium levels and retinopathy in type 2 diabetic patients with normal renal function and to correlate it with severity of retinopathy. Methods: This cross-sectional observational study was conducted in a semi-urban tertiary-care teaching hospital. Clinicodemographic profile and serum magnesium levels were determined in patients with type 2 diabetes mellitus (DM) with (group 1) and without (group 2) retinopathy. Serum magnesium levels were correlated with the presence and severity of retinopathy. Results: Of 104 type 2 DM patients, 50 had retinopathy. Younger age, longer duration of disease and poorer glycaemic control ( p < 0.05) were found to be associated with retinopathy. The mean serum magnesium levels in patients with retinopathy and those without retinopathy were 1.63 ± 0.30 mg/dL and 1.76 ± 0.22 mg/dL, respectively ( p = 0.029). Reduced serum magnesium was associated with elevated fasting sugars ( p = 0.019) and female gender ( p = 0.037). On comparative analysis of patients with sight-threatening diabetic retinopathy (STDR), non-STDR and no retinopathy by ANOVA test, patients with STDR had significantly lower serum magnesium (1.55 ± 0.33 mg/dL) ( p = 0.031). Conclusion: Serum magnesium levels were lower in patients with diabetic retinopathy. Patients with STDR had lower serum magnesium compared with those without STDR. Summary Serum magnesium, studied extensively for its role in glucose metabolism, was found to be lower in patients with diabetic retinopathy compared with those without retinopathy. Sight-threatening diabetic retinopathy had significantly lower levels of serum magnesium.