bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual Reality (VR) in Medicine: A Systematic Review of Current Applications of VR and Potential Applications to Pediatric Orthopaedic Surgery
Authors: Koshinski Jessica , Chaclas Nathan , Suk Michael , Seeley Mark 
Published: August 2023

BACKGROUND One of the most interesting emerging trends in healthcare is the use of virtual reality (VR) as a modality for pediatric pain management—with additional applications including anxiety, fear, and other strong emotions related to healthcare states. VR has been used for pain relief in chronic pathologies such as sickle cell disease, during procedures like blood draws, and post-operatively. In orthopaedics, bone pin and cast removal are common clinical procedures that are associated with anxiety and discomfort, especially in pediatric populations. Virtual reality may serve a purpose as a distraction to reduce the anxiety and fear that patients experience during those procedures. In this review, we aim to report the state of VR as it applies to pediatric healthcare and make recommendations for areas of future exploration, such as in orthopaedic surgery. Methods A systematic search query was conducted in the databases PubMed and Embase using the terms “virtual reality” AND “pediatrics” AND “pain.” Between both databases, 303 articles were returned. Titles and abstracts were reviewed to screen for relevant articles and duplicate articles were eliminated, resulting in the final inclusion of 76 articles in a summary table. Results Immersive VR was used in 64% of studies (n=49) and Gameplay VR was used in 25% of the studies (n=19). Most VR use occurred during the medical procedure (n=56). The most common application of VR to date has been pain (n=67), followed by anxiety (n=45), and then fear (n=12). The most common conditions that VR was used for were venipuncture (n=26), burn wound care (n=13), surgical procedures (n=11), and dental procedures (n=9). Conclusions While heavily reported on, procedures such as venipuncture and wound care are not the only potential application for VR intervention. Given the favorable findings of pain, anxiety and fear reduction in other areas, we recommend continuing to explore the use of VR in orthopaedic settings, such as bone pin and cast removal. There may be further benefit from VR use in fracture reduction and post-operative pain management. The potential for VR to improve clinical experiences for patients is yet to be fully appreciated and uncovering applications in new areas of medicine will help to benefit a greater patient population.
Days of Greatness: An Unlikely Journey of Discovery with Dr. Larry Dorr
Authors: Bodner Russell J. 
Published: August 2023

From January 2017 through December 2020, this author experienced the very unusual opportunity to join and collaborate with one of the greats in Orthopedic Surgery, Dr. Lawrence (Larry) Dorr, in a quest to unravel the spinopelvic postural effects on acetabular component positioning in total hip replacements. With approximately 1500 email communications, a true collaboration culminating in multiple papers including the work that brought the demise of the Lewinnek zone as a measure of safety. The journey from community private practice to elite status in arthroplasty clinical research on this topic is relived to share with readers the tremendous satisfaction possible when one follows their calling with “maximum effort”.
Natural History of Adult Spinal Deformity: How Do Patients with Less Than Optimal Surgical Outcomes Fare Relative to Non-Operative Counterparts?
Authors: Joujon-Roche Rachel , Tretiakov Peter , Krol Oscar , Williamson Tyler , Imbo Bailey , Passfall Lara , Vira Shaleen , Passias Peter G. 
Published: August 2023

Introduction Management of adult spinal deformity (ASD) increasingly favors operative intervention, however complication rates remain high. This study compares health-related-quality-of-life (HRQL) metrics of patients with suboptimal surgical outcomes to non-operative management, which approximates the natural history of ASD. Methods This is a retrospective analsis of operative and non-operative patients(≥18yo) from a single-center ASD database. Patients with baseline and 2-year follow-up were included. For non-operative patients, decision to forego surgery was made by the patient. Operative patients were selected for “suboptimal outcomes,” defined as any reoperation, major complication, or ≥2 severe SRS-Schwab modifiers at 2-years. Suboptimal operative(SOp) vs. natural history (NH) groups were propensity score matched (PSM) by age, deformity, Oswestry-Disability-Index (ODI), and comorbidities. Means comparison tests assess differences in improvement and rates of achieving minimal clinically important difference (MCID) in ODI and Scoliosis- Research-Society-22 (SRS-22). Results After PSM, 74 patients were included(37-SOp; 37-NH). SOp and NH groups were not significantly different in baseline demographics, HRQLs, or radiographic deformity(Table 1). At 2Y, SOp patients had greater improvement in ODI and higher rates of reaching MCID, both p-values<.001. SOp patients had significantly better SRS-22-Total, SRS-22-Pain and SRS-22-Satisfaction scores at 2Y, all p-values<.001. Finally, significantly more SOp patients gained ≥1 MCID in SRS-Activity and SRS-Pain, both p-values<.002. Conclusion Compared to the natural history of ASD, operative patients with suboptimal outcomes still experience significantly greater improvement in HRQLs. Such divergent outcomes at 2Y, highlight the stagnation and deterioration associated with the disease process. Spine surgeons should consider the outcomes associated with the natural history of ASD when weighing risks and benefits of operative intervention.
Assessing the Current State of Twitter Usage by Spine Surgeons in the United States
Authors: Lanzetta Nicholas , Linton Alexander , Furman Andrew , Hsu Wellington 
Published: August 2023

Background Twitter, one of the most widely used social media platforms, allows users to post short statements, media, and weblinks available for viewing and interaction. This study sought to characterize the way in which spine surgeons leverage Twitter as a professional tool and additionally, the extent to which the platform may be currently under-utilized. Methods A list of neurosurgical and orthopaedic spine surgeons was randomized and the first 500 individuals from each group were searched for on Twitter. For surgeons without accounts, it was recorded if they were mentioned in others’ tweets. Independent T-tests were performed for comparing quantitative variables between the two groups (tweets, number of followers, etc.) as well as comparing age with presence of account. Results Of all spine surgeons, 17% had accounts, 49% had no account but were mentioned, and 34% had no account but were not mentioned. There were no differences in twitter usage between genders, geographic region, nor neurosurgical and orthopaedic spine surgeons. The average age of those with and without an account was 51 and 55, respectively (p=.0004). While 22% of surgeons aged 50 and younger had accounts, only 14% of surgeons over 50 had accounts (p=.003). Conclusions In addition to younger surgeons being more likely to have an account, this study found a large discordance between the proportion of spine surgeons who actively engage on Twitter and those that are discussed on the platform by others.
Operative Treatment of Acute Traumatic Dislocation of the Proximal Tibiofibular Joint with TightRope Fixation and Primary LCL Repair Following Tibial Intramedullary Nailing
Authors: Faerber Wade , Udal Dallyn , Corrado Kayleigh 
Published: August 2023

Introduction/Objective Proximal tibiofibular joint (PTFJ) dislocation is a rare acute injury of the knee that is often misdiagnosed or overlooked. The diagnosis should be considered as part of the differential in any patient presenting with acute-onset lateral knee pain after an aggressive torsion trauma to a flexed knee. This case report detailing surgical fixation of a PTFJ dislocation is unique in that surgical lateral collateral ligament (LCL) repair was necessary and performed, and PTFJ fixation occurred following recent open reduction internal fixation (ORIF) of the tibia. This paper details specific technique and orientation of fixation to best return the PTFJ to anatomic alignment, as failure to do so can lead to instances of chronic morbidity. Case Report This case report describes surgical fixation of a traumatic posteromedial (Type III) PTFJ dislocation. During ORIF of the ipsilateral tibia, significant PTFJ laxity and displacement was noted intraoperatively. This necessitated a return to the operating room for definitive PTFJ surgical fixation with two TightRope syndesmotic suture button fixation devices with simultaneous intraoperative LCL repair with #2 Fiberwire. Discussion/Conclusions While few case reports have documented the use of TightRope syndesmotic fixation of the PTFJ, these authors present a novel method of orienting the fixation from the posterolateral fibula to the anteromedial tibia with simultaneous caudal to cranial direction in order to create orthogonal fixation of the PTFJ. This creates an orientation of fixation perpendicular to the anatomic alignment of the native PTFJ.We believe that this orientation of syndesmotic PTFJ fixation most physiologically replicates that of the native PTFJ, and will lead to effective surgical results and improved patient outcomes. We also believe that publications on this topic will help bring awareness to an underrecognized and underdiagnosed joint pathology, with the hopes that future patients will benefit and receive more thorough and efficient care.
Signal of harm in morphine use in adults with acute pulmonary oedema: A rapid systematic review
Authors: Hendrikse C , Ngah V , Kallon I I , Thom G , Leong T D , Cohen K , McCaul M 
Published: August 2023

Background. Heart failure affects nearly 65 million people globally, resulting in recurrent hospital admissions and substantial healthcare expenditure. The use of morphine in the management of acute pulmonary oedema remains controversial, with conflicting guidance and significant variation in practice. Synthesised evidence is needed to inform standard treatment guidelines and clinical practice.
Objective. To determine whether morphine should be used in the treatment of acute pulmonary oedema (APE) in adults.
Methods. A rapid review of systematic reviews of randomised controlled trials or observational studies, and then randomised controlled trials, was conducted searching three electronic databases (PubMed, Embase, Cochrane Library) and one clinical trial registry on 12 February 2022. We used a prespecified protocol following Cochrane rapid review methods and aligned to the National Standard Treatment Guidelines and Essential Medicines List methodology. We first considered relevant high-quality systematic reviews of randomised controlled trials or observational studies, then (if required) randomised controlled trials to inform time-sensitive or urgent evidence requests, clinical practice, policy, or standard treatment guidelines.
Results. We identified four systematic reviews of observational studies. The two most relevant, up-to-date, and highest-quality reviews were used to inform evidence for critical outcomes. Morphine may increase in-hospital mortality (odds ratio (OR) 1.78; 95% confidence interval (CI) 1.01 - 3.13; low certainty of evidence; six observational studies, n=151 735 participants), resulting in 15 more per 1 000 hospital deaths, ranging from 0 to 40 more hospital deaths. Morphine may result in a large increase in invasive mechanical ventilation (OR 2.72; 95% CI 1.09 - 6.80; low certainty of evidence; four observational studies, n=167 847 participants), resulting in 45 more per 1 000 ventilations, ranging from 2 more to 136 more. Adverse events and hospital length of stay were not measured across reviews or trials.
Conclusion. Based on the most recent, relevant and best-available quality evidence, morphine use in adults with APE may increase in-hospital and all-cause mortality and may result in a large increase in the need for invasive mechanical ventilation compared to not using morphine. Recommending against the use of morphine in pulmonary oedema may improve patient outcomes. Disinvesting in morphine for this indication may result in cost savings, noting the possible accrued benefits of fewer patients requiring invasive ventilation and management of morphine-related side-effects.
Polycyclic Aromatic Hydrocarbons (PAHs) in Bulgarian Coals: Occurrence, Distribution and Carcinogenicity
Authors: Kostova Irena , Apostolova Denitsa , Stefanova Maya 
Published: August 2023

The study fills the informative gap on occurrence, distribution, and carcinogenicity of polycyclic aromatic hydrocarbons (PAHs) in Bulgarian coals. It presents quantitative data for content and carcinogenicity of PAHs in different rank raw coals from eight basins with geological age from Late Carboniferous to Late Miocene, Ro=0.17–5.20%. The high amounts of alkylated naphthalene and alkylated phenanthrene determined in the bituminous coals reflect the diagenetic conversion of the plant-derived terpenoids into alkylated PAHs.
In this first systematic study of PAHs in Bulgarian raw coals three concentration ranges are established: for Miocene/Eocene age coal – from 1.08 mg/kg to 5.79 mg/kg; for Late Cretaceous/Late Carboniferous age coal – from 77.9 mg/ kg to 137.2 mg/kg; and, for the Late Carboniferous coal – 1.85 mg/kg. The relationship of the total PAHs content vs. raw coal Ro shapes as a “bell” and matches with the published data for the native PAHs from all over the world provenance. The maximal PAHs amount of 137.2 mg/kg at Ro =0.96% for the Late Cretaceous coal lies within the “oil-generation window”, Ro =0.5–1.3% for the kerogen. For all raw coal studied relatively low carcinogenicity is determined based on the well correlated values for B[a]Peq and TEQ parameters.
Evaluation of YouTube Information Quality About Pes Planus
Authors: Olçar Hacı Ali , Güngör Berna , Kuru Tolgahan , Aydın Davut , Nusran Gürdal 
Published: August 2023

Background: The aim of this study was to measure the quality of information about “flatfoot” and “pes planus” presented online on the social media site YouTube and to determine the trends of viewers to medical information on YouTube.
Methods: “Flatfoot and pes planus” was typed into the YouTube search module. From the search results, videos with 50,000 views or more, longer than 45 seconds, and containing information about flatfoot and pes planus disease were selected. DISCERN and JAMA scoring, daily average views, number of likes, and number of comments were collected from 53 videos that met the criteria. The profession of the sharer was evaluated in terms of the information quality of the sharing and the orientation of the audience.
Results: The mean number of views per day of the examined videos was 2,047. The mean video presentation time was 8 minutes 50 seconds. The mean JAMA score was 2 of 4 and the mean DISCERN score was 38.16 of 75. According to the DISCERN score according to the professions, the video quality was moderate for doctors (41.44 ± 12.99), moderate for physiotherapists (41.91 ± 9.04), poor for coaches (32.78 ± 7.87), poor for patients (34.50 ± 5.32), and weak for others (34.89 ± 14.00). According to the Spearman correlation between DISCERN score and mean daily viewing, significant relationships were found for the doctors (P = .0102) and others groups (P = .0033); however, no significant relationships were observed for the physiotherapists group (P = .1073), the flatfoot patients group (P = .5363), and the coaches group (P = .9111). There were significant relationships between like and comment counts in all groups (doctors, P = .0088; coaches, P = .0069; physiotherapists, P = .0007; others, P =.0018; and patients, P = .0066).
Conclusions: Looking at previous studies, it was observed that the quality of online health information was historically inadequate. Likewise, in our study on YouTube, we found that the quality of flatfoot and pes planus information was poor to moderate.
Potential of Typha as Plant Candidates for Sludge Treatment Wetlands
Authors: Wu Meiyin 
Published: August 2023

AbstractPhragmites austrailis have been commonly planted on sludge treatment wetlands due to its high resistance to sludge waste; thus sludge treatment wetlands are commonly referred to as “reed beds”. Phragmites’ aggressive nature and high productivity allow this invasive plant species to form monoculture stands, alter ecosystem processes, outcompete and replace native species. Thus, native alternatives plant species for sludge treatment wetlands is in urgent needs. Typha are abundant and common throughout most of the North America and have high tolerance to various environmental conditions. This study examined the potential of Typha as candidate plants for sludge treatment wetlands. The results suggested Typha has a great potential to replace the invasive Phragmites as an alternative plant species for sludge treatment wetlands due to its ability to sustain repeated sludge application and to efficiently remove solids, phosphorus and nitrogen from the sludge waste.
Antimicrobial Activity of Jackfruit’s Straws Films Which has been enriched by Temulawak (Curcuma Xanthorrhizza, ROXB.) toward Microorganism on Galamai
Authors: Murtius Wenny Surya , Rahmi Ira Desri , Neswati  
Published: August 2023

AbstractThis research was aimed to know antimicrobial activity of edible film from jackfruit’s straws. Previously, edible films has been enriched by temulawak juice with various concentration (2%, 4%, 6%, and 8%). Antimicrobial activity toward microorganism on galamai (all of microorganism and osmophilic group) has been examined using agar diffusion methode. Zone of inhibition were measured after 24 h of incubation. Diameter of zone inhibition for all of microorganism were 9.00-26.50 mm and osmophilic microorganism were 8.50-12.70 mm.
Heat Resistant Proteases Isolated from Medicinally Significant Spices: Partial Purification and Biochemical Characterization
Authors: Jabalia Neetu , Chaudhary Nidhee 
Published: August 2023

AbstractProteases or proteinases are essential constituents for all the existing live forms. They act as important industrial enzymes occupying about 60% of total enzyme market. In the present study proteases extracted from nine medicinally important spices; Carum copticum, Syzygium aromaticum, Cuminum cyminum, Nigella sativa, Cinnamomum verum, Foeniculum vulgare, Zingiber officinale, Cinnamomum tamala and Curcuma longa; used in our food and as household medicines on regular basis, have been investigated. Amongst these spices, the specific activity of the isolated protease enzyme was found to be significantly high in Nigella sativa (204 units/mg) and Curcuma longa (124 units/mg) and therefore, their extract was further partially purified and biochemically characterized. The crude extract of the two spices on being subjected to salt precipitation using (NH4)2SO4 as neutral salt, yielded three fractions at 0-30%, 30-60% and 60-90% saturation level. The specific activity of protease enzyme was found to be highest in 0-30% fraction, obtained from both the sources. The values of specific activity and purification-fold of enzyme from Nigella sativa and Curcuma longa were found to be 409 U/mg, 590 U/mg and 2.0-, 4.8-, respectively. The enzyme showed maximum activity at pH and temperature conditions of 5.0 and 40°C, respectively, at 20 min of incubation time, in both the cases. The pH stability values of protease from Nigella sativa ranged from 5.0 to 9.0 whereas in Curcuma longa values were from 4.0 to 8.0. The enzyme from Nigella sativa and Curcuma longa exhibited resistance against heat treatment upto 60°C and 50°C, respectively, increasing the industrial feasibility. The present work hereby, indicates that Nigella sativa and Curcuma longa may serve as good source of thermostable protease; an enzyme of great relevance in various chemical and bio-industries along with pharma sector.
Composite Materials Using Expanded Perlite as a Charge and Plastic Wastes as Reinforcement, Elaboration and Properties
Authors: AMRANI Sara , HALIMI Youssef , TAHIRI Mohamed 
Published: August 2023

AbstractThe optimization and streamlining of certain structures, parts manufacturing combined with high technical qualities (mechanical strength and physicochemical), recycling or reuse of solid wastes, reducing maintenance costs … have motivated the use and development of specific materials whose composition and characteristics accommodate themselves to technological constraints.The composite materials based on expanded perlite and unsaturated polyester resin (organic resins regenerated), were developed for this purpose. The basic idea is to combine in the same mass of different materials by their chemical and structural natures in order to increase mechanical, physical and / or chemical performance that can facilitate implementation. The composite materials developed during this study are developed from an organic resin associated with expanded perlite and other mineral fillers including marble powder and / or plastic wastes fibers.Different formulations are performed; taking into account both the proportion of expanded perlite, the nature of the inorganic fillers or reinforcements. The various tests carried out as mechanical and mechanic-chemical properties are reported.
Synthesis, Characterization and Biological Activity of Organotin(IV) Complexes featuring di-2-ethylhexyldithiocarbamate and N-methylbutyldithiocarbamate as Ligands
Authors: Sainorudin Muhammad Hanif , Sidek Norliawati Mohd , Ismail Noraznawati , Rozaini Mohd Zul Helmi , Harun Noor Aniza , Sabiqah Tuan Anuar Tuan Nurul , Abd Rahman Azmi Alyza Azzura , Yusoff Farhanini 
Published: August 2023

AbstractOrganotin(IV) compounds have received tremendous attention for their synthesis, characterization and biological activities and their ability to bind with sulfur ligand such as dithiocarbamate ligand. Organotin(IV) dithiocarbamate complexes can be synthesized by the reaction of carbon disulphide with secondary amine. Four new organotin(IV) dithiocarbamate complexes were successfully synthesized by the reactions between di-2-ethylhexyldithiocarbamate, C16H34NCS2 and N-methylbutyldithiocarbamate, C5H12NCS2 with dibutyltin(IV) dichloride and triphenyltin(IV) chloride, RxSnClx (R = Bu, Ph) and (x = 1, 2 or 3). These series of complexes were synthesized using “in situ” insertion method and characterized by determination of melting point, CHNS elemental analysis, infrared spectroscopy (FT-IR) and UV-vis spectroscopy. The melting points of the synthesized compounds were in the range 88.3 - 128.4 °C. The experimental CHNS data of the compounds, mostly exhibit the calculated CHNS values. Using infrared spectra (FT-IR), the formation of organotin(IV) dithiocarbamate complexes were confirmed by the presence of v(C=N+) at 1464 - 1497 cm-1, v(C-S) at 963 - 1025 cm-1 and v(Sn-S) at 412 - 445 cm-1 in all complexes. Besides that, the UV-vis analysis showed the peaks chromophore of N=C within range 259 - 260 nm, nonbonding electron on sulphur and charges transferred between the tin metal and ligand (M-L). Using TGA analysis, complex 1 and 3 show two degradation curve but complex 2 and 4 shows only one degradation curves. The antibacterial activity of all synthesized organotin(IV) dithiocarbamate complexes were then determined towards four types of bacterial strains which were Escherichia coli, Staphylococcus aureus, Salmonella thypi and Bacillus cereus. Penicillin was used as positive control and streptomycin as negative control in order to compare diameter of inhibition zone between both controls and complexes. From antibacterial test, almost all synthesized complexes were found to give positive results. Thus, it can be concluded that the complexes formed do have applications in biological and medical aspects.