bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior pedicle screw fixation combined with transpedicular bone grafting for treatment of single-level thoracolumbar fractures with the aid of a vertebroplasty tool
Authors: Wen Yuetao , Zhou Hui , Liao Youxin , He Ya , Wang Fei , Li Jingang 
Published: February 2022

Objective This study was performed to assess the efficacy of a novel tool to assist transpedicular bone grafting in short-segment pedicle screw fixation combined with pedicle fixation at the level of the fractured vertebra (six-screw fixation). Methods We retrospectively analyzed 80 patients (40 in the control group and 40 in the tool-aided group) with single-level thoracolumbar fractures. Patients in the control group underwent traditional six-screw fixation combined with transpedicular bone grafting. In the tool-aided group, we introduced a novel vertebroplasty tool to assist transpedicular bone grafting. Basic information and related indicators were recorded. Results There were no significant differences in the patients’ baseline characteristics or surgical outcomes between the control group and tool-aided group. Both traditional surgery and tool-aided surgery restored the height of the fractured vertebrae and decreased the Cobb angle, visual analog scale score, and Oswestry Disability Index. However, tool-aided surgery more effectively restored the height of the fractured vertebrae and reduced the visual analog scale score and Oswestry Disability Index than did traditional surgery. Conclusion Vertebroplasty tool-aided surgery facilitated more precise and successful grafting of bone into damaged vertebrae than did traditional surgery and therefore might be recommended for treating single-level thoracolumbar fractures.
The adjustable aiming device for caspar pin insertion in anterior cervical spine surgery
Authors: Bunmaprasert Torphong , Raphitphan Raphi , Sugandhavesa Nantawit , Riew K Daniel , Liawrungrueang Wongthawat 
Published: February 2022

Background Creating a rectangular disc space is an important step during anterior cervical discectomy and fusion or cervical total disc replacement. The study aims to determine the accuracy of Caspar pin insertion by using a novel Adjustable Caspar Pin Aiming Device in anterior cervical procedures. Methods Forty Caspar pins were placed using an Adjustable Caspar Pin Aiming Device in 20 human cadaveric cervical vertebral bodies from C3 to C7 after performing anterior discectomies. Accuracy of pin placement was assessed by lateral fluoroscopy, considering superior endplate slope (SE), inferior endplate slope (IE), Caspar pin slope (CP), and endplate-Caspar pin slope difference (SE/CP, IE/CP). Results The mean superior endplate slope (SE), inferior endplate slope (IE), and Caspar pin slope (CP) were 10.82 ± 2.3°, 10.32 ± 3.2°, and 15.58 ± 7.9°, respectively. The average superior endplate-Caspar pin slope difference (SE/CP) and inferior endplate-Caspar pin slope difference (IE/CP) were 6.6 ± 0.8° and 7.7 ± 0.8°, respectively. The greatest slope difference was observed at the superior and inferior endplates of C3. No cervical endplate violations occurred. Conclusion Adjustable Caspar Pin Aiming Device allowed for a highly accurate Caspar pin placement with the average endplate-Caspar pin slope difference of less than 7.7°. It results in accurate placement of the superior and inferior Caspar pins parallel to the index vertebral endplates. Furthermore, it appears to facilitate the safe and effective insertion of Caspar pins for anterior cervical procedures.
Occupational Injuries and Associated Factors Among Small-Scale Woodwork Industry Workers in Hawassa, Southern Ethiopia: A Cross-Sectional Study
Authors: Girma Belete , Ejeso Amanuel , Ashuro Zemachu , Birhanie Aregu Mekonnen 
Published: February 2022

Background: Occupational injuries are still a major public health problem and one of the leading causes of disability, morbidity, and mortality. This study aimed to assess occupational injuries and associated factors among workers in the small-scale woodworking industry in Hawassa city, southern Ethiopia. Materials and Methods: An institutional-based cross-sectional study was conducted among 418 randomly selected small-scale woodworking industry workers. Questionnaires and an observational checklist were used to collect data. The data was entered into Epi data version 3.1 and analyzed using SPSS version 21. Multivariate logistic regression analysis with 95% CI and P < .05 was used to identify factors associated with occupational injury. Results: The prevalence of at least one occupational injury in the previous 12 months among small-scale woodworking industry workers was 41.6% [95% CI: 36.9-46.4]. Work experience 1 to 2 years [AOR = 2.8, 95% CI: 1.49-5.2], working more than 48 hours per week [AOR = 2.2, 95% CI: 1.41-3.49], lack of occupational safety and health (OSH) training [AOR = 2.5, 95% CI: 1.35-4.75], and non-use of personal protective equipment (PPE) [AOR = 3.3, 95% CI: 1.85-5.83] were factors significantly associated with occupational injury. Conclusions: In this study, the prevalence of occupational injuries among workers in the small-scale woodworking industry was high. Lack of OSH training, non-use of PPE, work experience of 1 to 2 years, and working more than 48 hours per week were all factors that contributed to occupational injuries. Therefore, workers in the small-scale woodworking industry should receive ongoing occupational safety and health (OSH) training, and personal protective equipment (PPE) should be provided and monitored.
Short-Term Evaluation of a Novel No-Touch Technique for Harvesting Saphenous Veins With Long-Shafted Ultrasonic Scalpel
Authors: Sakurai Hironobu , Someya Takeshi , Yamamoto Satoshi , Kasahara Ichiro , Kuroki Hidehito , Shirai Toshizumi 
Published: February 2022

Objective Saphenous vein grafts (SVGs) are widely used as bypass conduits in coronary artery bypass grafting. Compared with the conventional technique, the “no-touch” technique, wherein the saphenous veins are harvested with the surrounding tissue, may improve SVG patency; however, there are concerns regarding wound complications. To address this issue, we describe our novel no-touch technique with separate skin incisions using a long-shafted ultrasonic scalpel and report the clinical outcomes. Methods We enrolled 66 male patients who underwent isolated coronary artery bypass grafting between April 2016 and April 2021. There were 30 and 36 patients treated using our no-touch technique and the conventional technique, respectively. The participants underwent coronary angiography before discharge and were followed clinically. SVG samples were taken for pathological examination. Results SVGs harvested using our no-touch technique displayed preservation of the vessel wall structure and surrounding tissues. Our no-touch technique demonstrated no inferiority in patency compared with the conventional technique, and there was no SVG occlusion in the no-touch group. The frequency of leg wound complications was higher in the no-touch group than the conventional group, but no surgical site infections and severe complications occurred in the no-touch group. Conclusions SVGs harvested using our novel no-touch technique had similar pathological characteristics to those harvested using the original no-touch technique reported previously. Our no-touch technique maintained SVG patency and caused no severe wound complications. However, a large-scale, longitudinal study is required to accurately assess the clinical outcomes of our no-touch technique.
Future Fracture Risk in Upper Extremity Fracture and Non-Fracture Patients
Authors: Seyok Thany , Collins Jamie E. , Erikson Samantha J. , Charles Julia F. , Earp Brandon E. 
Published: February 2022

Background: Upper extremity (UE) fragility fractures are common and strong predictors of subsequent fractures. To investigate the relative importance of an UE fragility fracture in determining future fracture risk, we conducted a cross-sectional study to compare future fracture risk between patients presenting for osteoporosis evaluation after an UE fragility fracture and a similarly aged cohort of patients without an UE fracture. Methods: In all, 129 UE fracture patients seen in our bone health clinic (BHC) and 114 non-fracture UE fracture patients seen in an UE clinic completed clinic intake surveys assessing for fracture risk factors. Prefracture fracture risk (PFFR) and fracture risk assessment tool (FRAX) scores estimated the future fracture risks at the timepoint before and after the UE fragility fracture event, respectively. The primary study outcome was the 10-year risk of future fracture. Results: The 10-year probability of major osteoporotic and hip fractures were significantly higher among the BHC group when estimated with FRAX. When estimated with PFFR score, there was no difference in the 10-year probability of hip fracture between the groups. Prevalence of secondary osteoporosis and glucocorticoid use was higher in the BHC group, and prevalence of rheumatoid arthritis was higher in the UE clinic group. Conclusions This study underscores the importance of an UE fragility fracture in determining the risk of future fracture. A fragility fracture of the UE should be considered a sentinel event and physicians who evaluate these patients should recognize them as a high-risk group for future hip fracture.
Developing a structural equation model for the life cycle of generic pharmaceutical products
Authors: Mousavi Atefeh , Monadizadeh Marjan , Mohammadzadeh Mehdi 
Published: February 2022

Objective Product life cycle (PLC) refers to the time ranging from when a product is introduced into the market until it is taken off the shelves. Product life cycle management can guarantee product survival and prevent it from declining. The purpose of this study is to explore factors influencing the life cycle of generic pharmaceutical product and their effect sizes to shed light on better approaches for the life cycle management of such products. Method To this end, a standard questionnaire containing six dimensions and 47 items was used to collect data from 302 industrial pharmacists. The research hypotheses were tested using structural equation modeling to quantify the relationship between each dimension and its associated factors with the PLC. Key finding The results indicated that government interventions (Standard estimate (SE) = 0.63) and technology advancement (SE = 0.60) as environmental factors, quality (SE = 0.60) and price (SE = 0.62) satisfaction, patient adherence (SE = 0.68), physicians' awareness (SE = 0.64), market saturation (SE = 0.60); and demand rate (SE = 0.62) as demand factors, brand power (SE = 0.92); and availability of imported competitors (SE = 0.59) as competition factors, drug safety (SE = 0.63), product appearance (SE = 0.57); and ease of administration (SE = 0.61) as product-related factors, manufacturer reputation (SE = 0.63); and production continuity (SE = 0.64) as producer-related factors, and distributors number (SE = 0.54); and on-time delivery and availability of products (SE = 0.69) as distributor-related factors at 5% significance levels had the most effect on generic pharmaceutical PLC in Iran. Conclusion For the first time, this study offers a structural equation modeling framework for better managing the PLC of generic pharmaceutical products to help the company’s performance and survival.
Improvement in pain-related quality of life in patients with hemophilia A treated with rFVIIIFc individualized prophylaxis: post hoc analysis from the A-LONG study
Authors: Pasi John , Hermans Cédric , Hakimi Zalmai , Nazir Jameel , Aballéa Samuel , Ezzalfani Monia , Fatoye Francis 
Published: February 2022

Background: Pain, a common symptom of hemophilia, begins early in life primarily due to joint bleeding. Recurrent bleeding adversely affects patients’ pain-related physical functioning, which can negatively impact their quality of life (QoL). Objective: Post hoc analysis of data from the A-LONG study (NCT01181128), to assess change over time in pain-related QoL in patients with severe hemophilia A treated prophylactically with recombinant factor VIII Fc fusion protein (rFVIIIFc). Methods: Patients who completed Haem-A-QoL (17–65 years) and EQ-5D-3L (⩾12–65 years) questionnaires at baseline (BL) and end of study (EoS). Individual-level changes were assessed using three pain-related items of the Haem-A-QoL ‘Physical Health’ domain and the pain/discomfort item of EQ-5D-3L. Distributions of responses (EoS versus BL) were compared using McNemar’s test. Results: A significantly greater proportion of patients reported they did not experience painful swellings ( n = 87; 66% versus 46%, p <  0.01) or pain in their joints ( n = 89; 42% versus 27%; p <  0.05) at EoS versus BL. The proportion of patients who did not find it painful to move numerically increased at EoS versus BL ( n = 86; 47% versus 38%; p = NS). A significantly greater proportion of patients reported no pain/discomfort at EoS versus BL ( n = 116; 45% versus 34%; p <  0.05). Conclusion: This study reports the effect of FVIII prophylaxis on patient-reported measures of pain over time in patients with severe hemophilia A. The results of this post hoc analysis showed improvements in pain from BL to EoS in patients receiving rFVIIIFc individualized prophylaxis indicating effective pain management, a key component of patient care.
Analysis of colistin resistance in carbapenem-resistant Enterobacterales and XDR Klebsiella pneumoniae
Authors: Bir Raunak , Gautam Hitender , Arif Nazneen , Chakravarti Priyanka , Verma Jyoti , Banerjee Sayantan , Tyagi Sonu , Mohapatra Sarita , Sood Seema , Dhawan Benu , Chaudhry Rama , Kapil Arti , Das Bimal Kumar , Das Bhabatosh 
Published: February 2022

Introduction: Increasing occurrence of infections caused by multidrug-resistant Gram-negative bacteria resulted in colistin being the last agent for treatment. Apart from plasmid-mediated mcr genes, mutations involving several genes like mgrB, phoP/phoQ, pmrA, pmrB, pmrC, and crrABC genes, are leading causes of colistin resistance. Four colistin susceptibility testing methods were compared against broth microdilution (BMD) and determined the presence of the mcr1-5 gene. Methodology: A total of 100 carbapenem-resistant Enterobacterales isolates were tested for colistin susceptibility by commercial broth microdilution (cBMD), E-test, VITEK-2, and rapid polymyxin NP assay (RPNP) and compared with BMD. The presence of the mcr1-5 gene was determined by modified RPNP and PCR. Two non- mcr colistin-resistant XDR isolates were subjected to whole-genome sequencing using Illumina MiSeq sequencing platform. Results: Among 100 carbapenem-resistant Enterobacterales isolates, 15% were resistant to colistin. Essential agreement, categorical agreement, major error, and very major error for cBMD/E-test/VITEK-2/RPNP were 96%/73%/82%/NA; 99%/86%/88%/91%, 1.2%/9.4%/11.8%/8.2% and 0%/40%/13.3%/13.3%, respectively. Only one Klebsiella pneumoniae isolate harbored the mcr-1 gene, observed by both methods. Whole-genome sequencing of two non- mcr XDR Klebsiella pneumoniae showed multiple mutations in 10 genes responsible for lipopolysaccharide biosynthesis. Conclusions: The performance of cBMD was excellent, whereas the E-test was unacceptable. VITEK-2 and RPNP performed better but remained unreliable due to high error rates. Multiple mutations in the target proteins involving lipopolysaccharide formation, modification, and regulation were seen, resulting in colistin resistance.
1H-MR spectroscopy in grading of cerebral glioma: A new view point, MRS image quality assessment
Authors: Shakir Tahir M , Fengli Liang , Chenguang Guo , Chen Niu , Zhang Ming , Shaohui Ma 
Published: February 2022

Background Noninvasive preoperative prediction of histological grading is essential for clinical management of cerebral glioma. Purpose This study aimed to investigate the association between the image quality assessment of 1H magnetic resonance spectroscopy and accurate grading of glioma. Materials and Methods 98 glioma patients confirmed by pathology were retrospectively recruited in this single-center study. All patients underwent 1H-MRS examination at 3.0T before surgery. According to WHO standards, all cases were divided into two groups: low-grade glioma (grade I and II, 48 cases) and high-grade glioma (grades III and IV, 50 cases). The metabolite ratios in both grades were calculated before and after image quality assessment. The area under the receiver operating characteristic (ROC) curve was used to evaluate the capacity of each ratio in glioma grading. Results The Cho/Cr, Cho/NAA and NAA/Cr metabolite ratios had certain differences in each glioma group before and after MRS image quality assessment. In the low-grade glioma group, there was a dramatic difference in the Cho/Cr ratio before and after image quality assessment ( p = 0.011). After MRS image quality assessment, the accuracy of glioma grading was significantly improved. The Cho/Cr ratio with 83.3% sensitivity and 93.7% specificity is the best index of glioma grading, with the optimal cutoff value of the Cho/Cr ratio being 3.72. Conclusion The image quality of MRS does affect the metabolite ratios and the results of glioma grading. MRS image quality assessment can observably improve the accuracy rate of glioma grading. The Cho/Cr ratio has the best diagnostic performance in differentiating high-grade from low-grade glioma.
Long-Term Effects on Sexual Function in Women Treated With Scoliosis Correction for Adolescent Idiopathic Scoliosis
Authors: Schroeder Josh E. , Michaeli Tal , Luria Mijal , Itshayek Eyal , Kaplan Leon 
Published: February 2022

Study design Retrospective cohort study with a cross-sectional comparison. Objectives To assess sexual function and experience in adult women who had scoliotic correction for adolescent idiopathic scoliosis (AIS). Methods Women ages 18–40 years with a history of scoliosis, who were braced or underwent uncomplicated posterior scoliosis correction for AIS, followed for two years or more since treatment were included. Sexual function was assessed using the Female Sexual Distress Scale-Revised (FSDS-R) and the Female Sexual Function Index (FSFI) questionnaires. Participants’ scores were compared to those of a control group consisting of age-matched healthy women. Results Of 115 women who responded to the questionnaires, 40 (35%) had surgical treatment (mean age 25.1; range 19–35 years; mean time since surgery 8.2 years; range 3–12 years) and 35 (30%) were braced (mean age 23.3; range 18–27 years; mean time since treatment 3.6 years; range 3–5 years). The control group consisted of a cohort of 40 (35%) aged-matched healthy women. According to the FSDS-R, significantly more women with scoliotic correction for AIS reported sexual distress compared to healthy controls (25% vs 12%, respectively), and the difference in the total mean scores (7.05 vs 5.34, respectively), was significant (P < .001). Additionally, the mean overall FSFI score for scoliotic-corrected women was 24.2 (range 17.5–29.1) within the pathological range (<26.55) of sexual dysfunction. Conclusions High rates of sexual distress and dysfunction were reported in women with a history of AIS, thus, there appears to be long-term consequences years after deformity correction by brace or surgical correction.
Ex vivo biomechanical analysis of flexible versus rigid annuloplasty rings in mitral valves using a novel annular dilation system
Authors: Zhu Yuanjia , Imbrie-Moore Annabel M. , Wilkerson Robert J. , Paulsen Michael J. , Park Matthew H. , Woo Y. Joseph 
Published: February 2022

Abstract
Background
Mitral annuloplasty rings restore annular dimensions to increase leaflet coaptation, serving a fundamental component in mitral valve repair. However, biomechanical evaluations of annuloplasty rings are lacking. We aim to biomechanically analyze flexible and rigid annuloplasty rings using an ex vivo mitral annular dilation model.

Methods
Juvenile porcine mitral valves (n = 4) with intercommissural distance of 28 mm were dilated to intercommissural distances of 40 mm using a 3D-printed dilator and were sewn to an elastic mount. Fiber bragg grating sensors were anchored to native chordae to measure chordal forces. The valves were repaired using size 28 rigid and flexible annuloplasty rings in a random order. Hemodynamic data, echocardiography, and chordal force measurements were collected.

Results
Mitral annular dilation resulted in decreased leaflet coaptation height and increased mitral regurgitation fraction. Both the flexible and rigid annuloplasty rings effectively increased leaflet coaptation height compared to that post dilation. Rigid ring annuloplasty repair significantly decreased the mitral regurgitation fraction. Flexible annuloplasty ring repair reduced the chordal rate of change of force (7.1 ± 4.4 N/s versus 8.6 ± 5.9 N/s, p = 0.02) and peak force (0.6 ± 0.5 N versus 0.7 ± 0.6 N, p = 0.01) compared to that from post dilation. Rigid annuloplasty ring repair was associated with higher chordal rate of change of force (9.8 ± 5.8 N/s, p = 0.0001) and peak force (0.7 ± 0.5 N, p = 0.01) compared to that after flexible ring annuloplasty repair.

Conclusions
Both rigid and flexible annuloplasty rings are effective in increasing mitral leaflet coaptation height. Although the rigid annuloplasty ring was associated with slightly higher chordal stress compared to that of the flexible annuloplasty ring, it was more effective in mitral regurgitation reduction. This study may help direct the design of an optimal annuloplasty ring to further improve patient outcomes.
A novel use of small ballons to reduce the risk of subintimal hematoma formation during recanalization of chronic total occlusion: two case reports
Authors: Ma Yanzhuo , Song Xinxing , Kong Lingfeng , Wang Gang , Wang Xiaoye , Ru Leisheng 
Published: February 2022

Abstract
Background
Subintimal hematoma remains a major challenge associated with unnecessary technical complexity, failure of the antegrade approach or imperfection of revascularization in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Some techniques and devices release the hematoma after its formation. Here, we describe a novel use of small ballons to prevent the hematoma formation during antegrade approach in two cases.

Case presentation
We report two cases of CTO-PCI in which balloon occlusion was successfully applied to prevent haematoma formation. The first case, a 72-year-old female with diabetes, was hospitalized because of unstable angina. Angiography showed right coronary artery (RCA) CTO, which initiated from the proximal part to the trifurcation at the distal part of the RCA. Considering the high likelihood and serious consequences of subintimal haematoma, a small balloon is employed to prevent subintimal hematoma formation. A balloon and microcatheter or double-lumen microcatheter are placed in the proximal coronary CTO lesion; then the balloon was dilated beside the catheter, most of the antegrade blood flow was sealed which reduced the likelihood of haematoma formation. The procedure was successfully completed without subintimal hematoma formation. The second case a 62-year-old male with unstable angina, was hospitalized for PCI. Angiography showed left anterior descending coronary artery CTO. Similar to case 1, we also used a small balloon to prevent hematoma formation. Both patients underwent PCI, which employed a small balloon to prevent hematoma formation and both procedures were successful without complications.

Conclusion
In patients who underwent CTO-PCI, balloon occlusion offers an alternative for reducing the incidence of subintimal haematomas.