bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective Analysis of Vascularised Free Fibula Grafts in Oromandibular Reconstruction and Dental Rehabilitation following Resection of Ameloblastoma
Authors: Lim William Tian Wei , Teh Luan Yook , Yong Loong Tee , Tan Hiang Khoon , Peck Raymond Hong Lian 
Published: July 2015

Objective: The objective of the study was to review 1) patient demographics, 2) hard tissue defect, 3) surgical information and outcomes, 4) early and late complications and 5) dental rehabilitation. Study Design: A retrospective review was carried out on 44 cases of mandibular ameloblastoma that were treated by resection and mandibular reconstruction using fibula grafts from October 1994 to October 2011 in local institutions. Results: The patients were predominantly Chinese (67.4%) with ages ranging from 11 to 57 years. Defect and surgical data were reviewed and there was only one failure of graft (2.3%). Early complications were observed in 10 patients (23.3%) while late complications were observed in six patients (14%). Dental rehabilitations were in the form of removable dentures (41.9%) and implant supported prostheses (4.7%). Conclusion: The fibula flap has been shown to be a reliable flap with low morbidity and also suitable for future dental rehabilitation.
The Minimally Invasive Treatments for Benign Prostrate Hyperplasia
Authors: Lim Yong Wei , Tay Kae Jack , Ho Henry Sun Sien 
Published: July 2015

The prevalence of benign prostatic hyperplasia (BPH) increases with age, affecting more than 50% of men above the age of 50 to varying degrees. As it enlarges, it compresses onto the urethra causing bladder outlet obstruction. This can cause a spectrum of problems ranging from irritative and obstructive lower urinary tract symptoms (LUTS) to retention of urine with obstructive uropathy. Transurethral resection of prostate (TURP) is the standard for surgical intervention, however with the advent of an ageing population, there is an increasing number of patients who have ischaemic heart disease who require long-term anticoagulation and have multiple co-morbidities that put them at an increased risk of general anaesthesia. This review aims to critically appraise the effectiveness and evidence for use of these minimally invasive techniques. Both PubMed and Ovid were used to search for randomised control trials (RCT) comparing the various minimally invasive techniques against TURP. In cases where there were no RCTs, the results of the respective trial were compiled. This was later compiled in a summary table. An effective minimally invasive treatment modality will play a complimentary role to TURP which remains the standard of surgical treatment for BPH. Technologies progressing towards rapid re-creation of prostatic channel, minimal blood loss and non-urethral instrumentation will bridge the divide between pharmacotherapy and surgery.
Prevalence of Burnout among Nurses in a Community Hospital in Singapore: A Cross-Sectional Study
Authors: Tay Wei Yi , Earnest Arul , Tan Shu Yun , Ng Matthew Joo Ming 
Published: July 2015

Introduction: Burnout among nurses is a significant problem in healthcare establishments and has negative implications on clinical outcomes. International studies have shown the prevalence of burnout ranged from 30% to 80%. However, this is unknown amongst nurses in a community hospital in Singapore. Our objectives are to determine the prevalence of burnout among nurses at a community hospital in Singapore as well as explore the factors associated with burnout. Methods: The nurses, from a community hospital with palliative, rehabilitation, chronic sick and nursing home services, self-administered the Professional Quality of Life Scale to determine the level of burnout. An anonymous survey was included to collect demographics and variables that were postulated to be associated with burnout. Results: With a response rate of 51.4%, the prevalence of burnout was found to be 33.3%. Nurses working in the rehabilitation wards had higher odds of burnout (p=0.026). Multivariate analysis indicated increased number of years working as a nurse (p = 0.006) and whether work interferes “sometimes” & “often” with family commitments (p = 0.006 & 0.028 respectively) to be significantly associated with burnout. Conclusion: The prevalence of burnout was found to be comparable to that of a tertiary hospital and this deserves further attention. In conclusion, this research reveals the extent of nursing burnout in intermediate and long term care sector as well as identifies factors associated with burnout.
The Effect of a Brief Low-Intensity Therapeutic Lifestyle Counselling Intervention on Weight Loss among Overweight Patients in Primary Care: A Pilot Randomised Controlled Trial
Authors: Ng Lee Beng , Yang Yong , Koh Gerald Choon-Huat 
Published: July 2015

Introduction: To preliminarily assess the effectiveness of a simple low intensity therapeutic lifestyle counselling intervention on weight reduction in overweight patients in primary care. Methods: We piloted a six-month randomised controlled trial on 200 primary care clinic patients aged between 21 to 75 years with body mass index (BMI) >23 kg/m2 who were randomised into two groups. The intervention group received a structured intervention consisting of a 15-minute education session on calorie content of common local food items, healthy food choices, exercise frequency, intensity, type, and time duration, and weight reduction goal setting; the control group received usual care. The primary outcome measure was change in body mass index (BMI) from recruitment to 6 months. Results: Five hundred and seventeen out of the 1,304 patients assessed were eligible for the study. Of these, 317 declined to participate (61.3%). Among the 200 who participated, 88 were assigned to usual care and 112 were assigned to intervention. Only 62 participants completed the six-month follow-up (24 in control and 38 in intervention group). The mean BMI decline was greater in the intervention than control group [0.71 (SD=1.17) and 0.08 (SD=0.90) kg/m2 respectively, p=0.021], and remained statistically significant after adjusting for age, gender and baseline BMI (p=0.041). Conclusion: Our pilot study found that a simple six-month low-intensity therapeutic lifestyle counselling intervention resulted in statistically significant but small reductions in BMI in overweight patients in primary care. These results should be interpreted with caution due to high participation refusal and lost-to-follow-up rates, and lack of objective process measures.
Barriers and Motivators of Influenza Vaccination Uptake among Primary Healthcare Workers in Singapore
Authors: Hwang Siew Wai , Lim Hwee Boon 
Published: July 2015

Introduction: Healthcare workers, especially primary healthcare workers, are at risk of contracting influenza from patients at their workplace. The uptake of influenza immunisation among healthcare workers has been inadequate in spite of this risk and the recommendation to receive annual influenza vaccination. This study aims to assess the barriers as well as the motivators of influenza immunisation among staff from an organisation of primary healthcare polyclinics in Singapore. Methods: Focus group interviews were conducted on healthcare workers from different occupation categories within the organisation and results were analysed. Results: Factors identified as barriers to influenza immunisation were: misconceptions regarding influenza immunisation, fear of experiencing pain or reaction from the vaccination, influence from other staff, uncertainty over the efficacy of influenza vaccination and perceived immunity against influenza virus. Motivators to immunisation were: the influence of other staff, direction from senior management, incentives for vaccination, accessibility and convenience in receiving the immunisation, reduction in risk of transmitting influenza to others and awareness and knowledge of influenza vaccination. Conclusion: Interventions to promote influenza immunisation based on these identified factors may help increase the immunisation uptake among healthcare workers.
Neck Pain in Changi General Hospital: An Observational Study
Authors: Praveen Jayamoorthy Jacob , Lim Ting Jun , O'Brien Aileen 
Published: July 2015

Introduction: The aim of this study is to describe the profile of neck pain patients in the local population and to investigate the efficacy of physiotherapy management of neck pain. Methods: A retrospective study was done with neck pain patients who have attended the Musculoskeletal Physiotherapy Clinic at Changi General Hospital from August 2010 to September 2011. The following data was collected from each patient: age, gender, occupation, mechanism of injury, chronicity, posture type, symptom location, physiotherapy management, number of treatment sessions, pain and functional scores pre- and post-therapy. The patients were also categorised according to International Classification of Functioning, Disability and Health (ICF) categories and observed for clinical profiles. Results: Ninety-one records were screened. The majority of patients (79%) were aged between 35–65 years. The condition was slightly more prevalent in males (55%) than females (45%). Seventy per cent of the patients had non-traumatic and 30% traumatic onset. The majority (69%) had chronic neck pain; 25% had sub-acute and 6% acute neck pain. The majority of patients had slouched sitting posture (84%). Almost half of the neck patients (48.9%) had unilateral neck pain; 20.2% had central neck pain, 16% had neck pain with shoulder pain, 12.8% had neck pain with radiating pain and 2.1% had neck pain with headache. The categorisation showed 51.1% reported neck pain with movement co-ordination, 30.9% with mobility deficit, 12.8% with radiating pain and 5.2% with headache. The multi-modal method showed significant improvement on the pain scale (p >0.001) within an average of 4.3 physiotherapy sessions. Conclusion: Neck pain is common in Singapore, affecting the middle-aged population. Many of these cases presented chronic neck pain, with no trauma involved at symptom onset. A slouched sitting posture was observed most commonly amongst patients with neck pain. Our study indicates that the classification system is valid for clinical use. Patients with headache registered a higher pain intensity than those in other categories. The multi-modal approach is effective in the treatment of neck pain.
Prospective Review of Safety Incidents Reported in the iMRI OT (Intraoperative Magnetic Resonance Imaging Operating Theatre)
Authors: Tan Jerry Keng Tiong , Tan Tong Khee , Goh June Pheck Suan , Ghadiali Natascha Fherzinah 
Published: July 2015

Introduction: The purpose of this study was to determine the types of incidents that occurred in the iMRI OT over a nineteen-month period in our institution. We aim to prevent any future avoidable incidents from happening in this potentially hazardous environment. Methods: This is a single centre prospective non-anonymous observational study conducted from February 2009 to September 2010 on surgeries performed in the iMRI OT. Safety incidents specific to the iMRI OT such as violation of safety protocols and equipment failures were reported as well as any other safety incidents resulting in potential or actual adverse safety outcomes. The outcomes of the incidents were included and the data analysed at the end of the study period. Results: Of 271 cases that were operated in the iMRI OT, 43 incidents were reported by the staff involved in the care of the patient. Of the 43 incidents, 14 incidents (32.6%) were classified as staff/personnel error and were preventable. Incidents resulted in either delayed surgery or cancellation of the surgery. There were no major adverse incidents that led to patient harm. Conclusion: Many of the incidents were preventable and measures have been instituted to prevent the recurrence of such incidents. Staff training, safety protocols and stringent maintenance of equipment are paramount to safe and efficient use of the iMRI operating theatre.
A Pilot Study of 2-Octyl Cyanoacrylate (Dermabond™) versus Conventional Suture Skin Closures for Caesarean Sections
Authors: Tan Shu Qi , Malhotra Rahul , Allen John Carson , Tan Thiam Chye 
Published: July 2015

Introduction: 2-octyl cyanoacrylate (Dermabond™, Ethicon, USA) has been available as an alternative skin closure since 1997. There are no reports on keloid formation with 2-octyl cyanoacrylate (2OC) closure for Caesarean section. Our study aims to assess keloid formation after Caesarean sections, as well as the safety and efficacy of 2OC for skin closure in Caesarean sections. Methods: A pilot study of 97 cases of Caesarean section performed by a single surgeon was done — 50 2OC closure versus 47 suture closure. Keloid formation, average operating time, wound infection, wound dehiscence and adverse peri-wound conditions were compared. Proportions across the two series were compared using chi-square/fisher exact test. Average operating time was compared using unpaired t-test. Results: Keloid formation was not statistically significant (2OC 24.0% versus S 14.9%, p=0.382). Mean operating time was similar (2OC 34.1±7.2 minutes versus S 32.7±7.2 minutes, p=0.33). Wound infection rate was similar (2OC 2.0% versus S 2.1%, p=0.939). More women experienced adverse peri-wound conditions with suture closure (2OC 2.0% versus S 6.4%, p=0.303). No woman experienced wound dehiscence. Conclusion: 2-octyl cyanoacrylate has similar efficacy to suture skin closure in terms of keloid formation, operating time, wound infection and adverse peri-wound conditions. It can be a safe alternative for Caesarean section skin closure.
Incidence and Prevalence of Musculoskeletal Injury in Ballet
Authors: Smith Preston J. , Gerrie Brayden J. , Varner Kevin E. , McCulloch Patrick C. , Lintner David M. , Harris Joshua D. 
Published: July 2015

Background Most published studies on injuries in the ballet dancer focus on the lower extremity. The rigors of this activity require special training and care. By understanding prevalence and injury pattern to the musculoskeletal system, targeted prevention and treatment for this population can be developed. Purpose To determine the incidence and prevalence of musculoskeletal injuries in ballet. Study Design Systematic review; Level of evidence, 4. Methods A systematic review registered with PROSPERO was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Level 1 through 4 evidence studies reporting incidence of musculoskeletal injuries in male and female ballet dancers were included, with the numbers and types of injuries extracted from each. Injury rates were recorded and calculated based on professional status, sex, and nature of injury. Incidence was defined as number of injuries sustained over a specific time. Prevalence was defined as proportion of subjects with an injury at a given point in time. Results The studies analyzed reported injury incidence or prevalence in more than 1365 amateur and 900 professional dancers. The mean age was 16.2 years among amateur and 27.0 years among professional dancers. The incidence of injury among amateur dancers was 0.99 and 1.09 injuries per 1000 dance hours in males and females, respectively; 75% of injuries were overuse, with similar rates among males and females. In professional dancers, the incidence of injury was 1.06 and 1.46 injuries per 1000 dance hours in males and females, respectively, and 64% of female injuries were overuse, compared with 50% in males ( P < .001). Only 3 studies provided prevalence data, including 62% prevalence of lumbosacral pain, 58% painful snapping hip, and 29% patellofemoral pain. Lower extremity injuries comprised 66% to 91% of all injuries, with the foot and ankle accounting for 14% to 57%. Conclusion The overall incidence of injury among amateur and professional ballet dancers is 0.97 and 1.24 injuries per 1000 dance hours, respectively. The majority are overuse in both amateur and professional dancers, with amateur ballet dancers showing a higher proportion of overuse injuries than professionals ( P < .001). Male professional dancers show a higher proportion of traumatic injuries, accounting for half of their injuries ( P < .001).
The polyphosphate–factor XII pathway drives coagulation in prostate cancer-associated thrombosis
Authors: Nickel Katrin F. , Ronquist Göran , Langer Florian , Labberton Linda , Fuchs Tobias A. , Bokemeyer Carsten , Sauter Guido , Graefen Markus , Mackman Nigel , Stavrou Evi X. , Ronquist Gunnar , Renné Thomas 
Published: July 2015

Key Points
Polyphosphate-activated coagulation factor XII drives prostate cancer-associated venous thrombosis. Targeting the polyphosphate/factor XII pathway reduces procoagulant activity in prostate cancer patient plasma and may permit safe anticoagulation.
Pegylated, full-length, recombinant factor VIII for prophylactic and on-demand treatment of severe hemophilia A
Authors: Konkle Barbara A. , Stasyshyn Oleksandra , Chowdary Pratima , Bevan David H. , Mant Tim , Shima Midori , Engl Werner , Dyck-Jones Jacqueline , Fuerlinger Monika , Patrone Lisa , Ewenstein Bruce , Abbuehl Brigitt 
Published: July 2015

Key Points
BAX 855, a pegylated full-length rFVIII with extended half-life, was highly effective in the prevention and treatment of bleeding events. No subjects receiving BAX 855 developed FVIII inhibitory antibodies nor experienced unexpected adverse events.
Differences in glutamate receptors and inflammatory cell numbers are associated with the resolution of pain in human rotator cuff tendinopathy
Authors: Dean Benjamin John Floyd , Snelling Sarah J. B. , Dakin Stephanie G. , Murphy Richard J. , Javaid Muhammad Kassim , Carr Andrew Jonathan 
Published: July 2015

Abstract
Introduction
The relationship between peripheral tissue characteristics and pain symptoms in soft tissue inflammation is poorly understood. The primary aim of this study was to determine immunohistochemical differences in tissue obtained from patients with persistent pain and patients who had become pain-free after surgical treatment for rotator cuff tendinopathy. The secondary aim was to investigate whether there would be differences in glutaminergic and inflammatory gene expression between disease-derived and healthy control cells in vitro.

Methods
Supraspinatus tendon biopsies were obtained from nine patients with tendon pain before shoulder surgery and from nine further patients whose pain had resolved completely following shoulder surgery. Histological markers relating to the basic tendon characteristics, inflammation and glutaminergic signalling were quantified by immunohistochemical analysis. Gene expression of glutaminergic and inflammatory markers was determined in tenocyte explants derived from painful rotator cuff tendon tears in a separate cohort of patients and compared to that of explants from healthy control tendons. Dual labelling was performed to identify cell types expressing nociceptive neuromodulators.

Results
Tendon samples from patients with persistent pain demonstrated increased levels of metabotropic glutamate receptor 2 (mGluR2), kainate receptor 1 (KA1), protein gene product 9.5 (PGP9.5), CD206 (macrophage marker) and CD45 (pan-leucocyte marker) versus pain-free controls (p <0.05). NMDAR1 co-localised with CD206-positive cells, whereas PGP9.5 and glutamate were predominantly expressed by resident tendon cells. These results were validated by in vitro increases in the expression of mGluR2, N-methyl-D-aspartate receptor (NMDAR1), KA1, CD45, CD206 and tumour necrosis factor alpha (TNF-α) genes (p <0.05) in disease-derived versus control cells.

Conclusions
We conclude that differences in glutamate receptors and inflammatory cell numbers are associated with the resolution of shoulder pain in rotator cuff tendinopathy, and that disease-derived cells exhibit a distinctly different neuro-inflammatory gene expression profile to healthy control cells.
Occupational gender segregation in an equilibrium search model
Authors: Usui Emiko 
Published: July 2015

Abstract
This paper develops an equilibrium search model to explain gender asymmetry in occupational distribution. Workers’ utility depends on salary and working hours, and women have a greater aversion to longer working hours than men. Simulations indicate that women crowd into shorter-hour, lower-paying jobs than men. If employers discriminate against women, offers are tailored more toward the working-hour preferences of men by requiring longer working hours. Similarly, if women have a disutility factor in their utility toward positions with a higher proportion of men, fewer women work at these jobs. In both cases, gender segregation is reinforced.

JEL classification: E24, J16, J64, J71
International knowledge flows and technological advance: the role of migration
Authors: Douglas Kacey N 
Published: July 2015

Abstract
This paper investigates whether knowledge flows from host to source country as a result of migration, alleviating the negative effects associated with outward migration. Using a fixed effects Poisson regression, patent citations are used as a proxy for knowledge flows and regressed on immigration and other control variables; the effect of immigration on patent citations is found to be positive and statistically significant. Additionally, the coefficient on immigration is found to be robust to different parameter changes in the model. These results suggest that reverse knowledge flows from outward migration help mitigate negative effects of outward migration on source countries.
Extending the persistent primary variable algorithm to simulate non-isothermal two-phase two-component flow with phase change phenomena
Authors: Huang Yonghui , Kolditz Olaf , Shao Haibing 
Published: July 2015

Abstract
In high-enthalpy geothermal reservoirs and many other geo-technical applications, coupled non-isothermal multiphase flow is considered to be the underlying governing process that controls the system behavior. Under the high temperature and high pressure environment, the phase change phenomena such as evaporation and condensation have a great impact on the heat distribution, as well as the pattern of fluid flow. In this work, we have extended the persistent primary variable algorithm proposed by (Marchand et al. Comput Geosci 17(2):431–442) to the non-isothermal conditions. The extended method has been implemented into the OpenGeoSys code, which allows the numerical simulation of multiphase flow processes with phase change phenomena. This new feature has been verified by two benchmark cases. The first one simulates the isothermal migration of H
2 through the bentonite formation in a waste repository. The second one models the non-isothermal multiphase flow of heat-pipe problem. The OpenGeoSys simulation results have been successfully verified by closely fitting results from other codes and also against analytical solution.