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Medical Biostatistics as a Science of Managing Medical Uncertainties.

Authors:
Abhaya Indrayan

Indian J Community Med 2021 Apr-Jun;46(2):182-185. Epub 2021 May 29.

Department of Clinical Research, Max Healthcare Institute, New Delhi, India.

Biostatistics is generally understood as the branch of statistics that deals with data relating to biological processes. While this remains the core of biostatistics activities, medical biostatistics has additional features. It is rarely realized that the ultimate function of medical biostatistics is to manage medical uncertainties, particularly those that are data based. Read More

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Improved access to the bone marrow space by multiple perforations of the alveolar bundle bone after tooth extraction-A case report.

Clin Exp Dent Res 2021 Jul 23. Epub 2021 Jul 23.

Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.

Objectives: The dental alveolus is lined by a thin cortical layer ("bundle bone", "alveolar bone proper", "cribriform plate", "lamina dura"), that can impede access to the bone marrow and its vasculature. During unassisted socket healing, the alveolar bundle bone is gradually resorbed allowing tissue resources from the bone marrow to enter into the socket space. An optimized wound healing process, either during unassisted socket healing or during ridge preservation procedures, with autogenous bone and/or any bone/collagen substitute material, depends at least partly on an adequate vascularization of the socket space. Read More

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Sutureless Thyroidectomy With Intraoperative Neuromonitoring and Energy-Based Device Without Sternotomy for Symptomatic Substernal Goiter Harboring Thyroiditis of Gland Parenchyma.

Cureus 2021 Jul 8;13(7):e16258. Epub 2021 Jul 8.

General Surgery, Giresun University Faculty of Medicine, Giresun, TUR.

Since substernal goiter first being described by Haller in 1749, a consensus on the definition of this entity has not been ensured, yet. Despite substernal goiter or retrosternal goiter is delineated as an enlarged thyroid gland with a component extending into the mediastinum, at least 10 definitions have described being able to depict the most accurate definition for substernal goiter. Of note, no consensus still has been declared on the therapeutic management of asymptomatic substernal goiter. Read More

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All-Inside Knotless Remplissage Technique.

Arthrosc Tech 2021 Jun 7;10(6):e1479-e1484. Epub 2021 May 7.

Oregon Shoulder Institute, Medford, Oregon, U.S.A.

Remplissage decreases the risk of recurrence after arthroscopic stabilization for recurrent anterior instability. Traditionally, the procedure requires accessing the subacromial space, which adds time and morbidity to the procedure. This Technical Note describes an all-inside technique for knotless remplissage with 2 interconnected anchors. Read More

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Arthroscopically Assisted Fixation of Terrible Triad Variant Injuries of the Elbow With Small-Bore Needle Arthroscopy.

Arthrosc Tech 2021 Jun 10;10(6):e1469-e1474. Epub 2021 May 10.

Mammoth Orthopedic Institute, Mammoth Hospital, Mammoth Lakes, California, U.S.A.

The range of diagnostic and therapeutic applications of needle arthroscopy (NA) continue to expand due to advances in image quality and resolution. Minimally invasive techniques can be augmented by the smaller camera size and reduced fluid use made possible by NA. Small-bore arthroscopy presents opportunities for use in smaller joints, such as the elbow, where applications of standard arthroscopic equipment may be limited by small anatomic spaces and fluid extravasation. Read More

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Magnetic resonance imaging-guided lumbar nerve root infiltrations: optimization of an in-house protocol.

BMC Med Imaging 2021 Jul 12;21(1):110. Epub 2021 Jul 12.

Division of Radiology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.

Background: For the treatment of radicular pain, nerve root infiltrations can be performed under MRI guidance in select, typically younger, patients where repeated CT exams are not desirable due to associated radiation risk, or potential allergic reactions to iodinated contrast medium.

Methods: Fifteen 3 T MRI-guided nerve root infiltrations were performed in 12 patients with a dedicated surface coil combined with the standard spine coil, using a breathhold PD sequence. The needle artifact on the MR images and the distance between the needle tip and the infiltrated nerve root were measured. Read More

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Emphasizing Choice and Autonomy in Personal Hygiene, Menstrual Health, and Sexual Health Product Distribution to People Experiencing Homelessness in Atlanta, Georgia During COVID-19.

Health Promot Pract 2021 Jul 7:15248399211024996. Epub 2021 Jul 7.

Emory University Rollins School of Public Health, Atlanta, GA, USA.

The Dignity Pack Project is a small-scale, crisis-oriented supply chain in Atlanta, Georgia, designed to meet the acute personal hygiene,menstrual health, and sexual health needs of people experiencing homelessness (PEH). It was organized in response to conditions during the COVID-19 pandemic that continue to illuminate and exacerbate the distinct and complex challenges PEH face when trying to meet their basic needs and maintain their health. In addition to being particularly vulnerable to COVID-19 due to underlying conditions, crowding, and shared living spaces, the pandemic makes it harder for PEH to access already scant resources. Read More

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Italian Tracing System for Water Buffalo Milk and Processed Milk Products.

Animals (Basel) 2021 Jun 11;11(6). Epub 2021 Jun 11.

National Reference Laboratory for Hygiene and Technology of Breeding and Buffalo Production, Istituto Zooprofilattico Sperimentale del Mezzogiorno, 84131 Salerno, Italy.

This document describes the development of a tracing system for the buffalo supply chain, namely an online computer system in which farmers, dairies, and brokers must maintain records of the production of milk through to the production of derivatives. The system is jointly used throughout the Italian national territory by the Istituto Zooprofilattico Sperimentale del Mezzogiorno (IZSM) and the Sistema Informativo Agricolo Nazionale Italiano (SIAN), after being made mandatory and regulated with the publication of the Ministerial Decree of 9 September 2014. Farmers are obligated to communicate their daily production of bulk milk, the number of animals milked, the number of the delivery note of the sale, and the name of the purchaser; within the first week of the month, they must communicate the milk production of each animal milked. Read More

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Acute liver failure requiring transplantation: A possible link to ulipristal acetate treatment?

Basic Clin Pharmacol Toxicol 2021 Jun 29. Epub 2021 Jun 29.

Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

The present case describes in detail a 55-year-old woman diagnosed with acute liver injury 3 days after completion of the first treatment course with ulipristal acetate (UPA), 5 mg/day orally for uterine fibroids causing persistent bleeding (treatment duration of 109 days). Liver transplantation was performed approximately 6 weeks after UPA suspension, and a photograph of the explanted liver is presented. Of note, other common causes of acute liver injury, such as history of alcohol or other psychoactive substances abuse, viral hepatitis and autoimmune hepatitis or preexisting liver disease were all excluded. Read More

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Note on a stepwise procedure for rejecting at least k out of m hypotheses: A simple Holm-type formulation and proof.

Biom J 2021 Jun 26. Epub 2021 Jun 26.

Såningsvägen 1, 74 944, Enköping, Sweden.

Mielke et al. (2021) proposed a stepwise multiple testing procedure (MTP) based on marginal p-values for rejecting at least k out of m null hypotheses. Briefly, the MTP cannot reject less than k hypotheses, but this property improves the power to reject k or more hypotheses relative to the stepdown MTP of Holm (1979). Read More

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The Casuccio-Santacroce-Banfo knee arthroscope: an avant-garde Italian tale in the history of arthroscopy.

Int Orthop 2021 Jun 23. Epub 2021 Jun 23.

1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.

Purpose: This brief historical note describes an arthroscopic instrument presented in Italy in 1950, and still preserved to this day at the library of the Rizzoli Orthopedic Institute in Bologna, Italy.

Material And Methods: A research on Casuccio, Santacroce, and Banfo prolific scientific collaboration was performed.

Results: The arthroscopic instrument was designed and utilized at the Orthopedic Clinic of the University of Bari, directed by Professor Casuccio, in collaboration with his assistant, Antonio Santacroce, and Giorgio Banfo, an orthopedist, entrepreneur, and owner of a modern establishment dedicated to the production of orthopaedic products and medical instruments. Read More

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An upper bound visualization of design trade-offs in adsorbent materials for gas separations: alkene/alkane adsorbents.

Chem Commun (Camb) 2021 Jul 22;57(57):6950-6959. Epub 2021 Jun 22.

MacDiarmid Institute for Advanced Materials and Nanotechnology, Department of Chemical and Process Engineering, University of Canterbury, Christchurch, 8140, New Zealand.

The last 20 years has seen an explosion in the number of publications investigating porous solids for gas adsorption and separation. The combination of external drivers such as anthropogenic climate change and industrial efficiency has been coupled with discovery of new materials such as synthetic zeolites, metal-organic frameworks, covalent organic frameworks, and non-porous adsorbents. Numerous reviews catalogue these materials and their properties. Read More

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Technical Note: Dose prediction for head and neck radiotherapy using a three-dimensional dense dilated U-net architecture.

Med Phys 2021 Jun 22. Epub 2021 Jun 22.

Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Purpose: Radiation therapy treatment planning is a time-consuming and iterative manual process. Consequently, plan quality varies greatly between and within institutions. Artificial intelligence shows great promise in improving plan quality and reducing planning times. Read More

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'Translating' All-Cause Mortality-Rate-Ratios or Hazard Ratios to Age-, Longevity-, and Probability-Based Measures.

Am J Epidemiol 2021 Jun 21. Epub 2021 Jun 21.

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.

Epidemiologists commonly use an adjusted hazard ratio or incidence density ratio, or a standardized mortality ratio, to measure a difference in all-cause mortality rates. They seldom translate it into an age- or time- or probability-based measure that would be easier to communicate and to relate to. Several articles have shown how to translate from a standardized mortality ratio or hazard ratio to a longevity difference, a difference in actuarial ages, or a probability of being outlived. Read More

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Reconstruction of Chronic Proximal Hamstring Tear: Description of a Surgical Technique.

Arthrosc Tech 2021 May 18;10(5):e1307-e1313. Epub 2021 Apr 18.

Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia.

While proximal hamstring tears at the myotendinous junction are common sports-related injuries that are often successfully treated nonoperatively, complete avulsions from the origin on the ischial tuberosity are less common and better treated with surgical repair to prevent significant functional limitations and ongoing weakness. The diagnosis can be easily missed, leading patients to present several months after the initial injury. In addition, some patients decide on nonoperative management initially but later present requesting surgical intervention. Read More

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Posterior Glenoid Reconstruction Using a Distal Tibial Allograft.

Arthrosc Tech 2021 May 3;10(5):e1227-e1232. Epub 2021 Apr 3.

Steadman Philippon Research Institute, Vail, Colorado, U.S.A.

Posterior shoulder instability is increasingly recognized and diagnosed in young athletes. These patients often present with vague shoulder pain rather than the frank instability commonly seen with anterior instability. Three common causes of posterior shoulder instability are congenital retroversion, a single traumatic event, or repetitive microtrauma with erosive effects. Read More

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Modification of the Matalon-Packter Law for Self-Organized Periodic Precipitation Patterns by Incorporating Time-Dependent Diffusion Flux.

J Phys Chem B 2021 Jun 16. Epub 2021 Jun 16.

Faculty of Science, Yamagata University, 1-4-12, Kojirakawa, Yamagata 990-8560, Japan.

Spontaneous pattern formation is common in both inanimate and living systems. Although the Liesegang pattern (LP) is a well-studied chemical model for precipitation patterns, various recent LP systems based on artificial control could not be easily evaluated using classical tools. The Matalon-Packter (MP) law describes the effect of the initial electrolyte concentration, which governs the diffusion flux (), on the spatial distribution of LP. Read More

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GnRH-Related Neurohormones in the Fruit Fly .

Int J Mol Sci 2021 May 10;22(9). Epub 2021 May 10.

Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.

Genomic and phylogenetic analyses of various invertebrate phyla revealed the existence of genes that are evolutionarily related to the vertebrate's decapeptide gonadotropin-releasing hormone (GnRH) and the GnRH receptor genes. Upon the characterization of these gene products, encoding peptides and putative receptors, GnRH-related peptides and their G-protein coupled receptors have been identified. These include the adipokinetic hormone (AKH) and corazonin (CRZ) in insects and their cognate receptors that pair to form bioactive signaling systems, which network with additional neurotransmitters/hormones (e. Read More

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A simple electrical approach to diagnosing a suspected lead break in patients with implanted vagus nerve stimulators - Technical note.

Clin Neurol Neurosurg 2021 Jul 21;206:106707. Epub 2021 May 21.

Department of Neurosurgery, Landstrasse Municipal Hospital, Vienna Health Care Network, Vienna, Austria and Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria.

Purpose: Vagus nerve stimulation (VNS) is an effective adjunctive treatment for patients with drug-resistant epilepsy (DRE) or difficult-to-treat depression (DTD). The implanted system consists of a titanium-cased generator and a lead with platinum electrodes, placed around the cervical vagus nerve. In rare cases a lead may break, causing the patient to receive insufficient therapy or no therapy at all, with potentially dangerous consequences. Read More

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Supporting the Patient on LSD Day.

Authors:
Betsy Todd

Am J Nurs 2021 06;121(6):42-44

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. Read More

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Validation Evidence using Generalizability Theory for an Objective Structured Clinical Examination.

Innov Pharm 2021 26;12(1). Epub 2021 Feb 26.

University of Toledo College of Pharmacy & Pharmaceutical Sciences, Toledo, OH.

Objectives: Performance-based assessments, including objective structured clinical examinations (OSCEs), are essential learning assessments within pharmacy education. Because important educational decisions can follow from performance-based assessment results, pharmacy colleges/schools should demonstrate acceptable rigor in validation of their learning assessments. Though G-Theory has rarely been reported in pharmacy education, it would behoove pharmacy educators to, using G-Theory, produce evidence demonstrating reliability as a part of their OSCE validation process. Read More

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February 2021

Precision silver nitrate cautery of the posterior nasal cavity.

Authors:
J Watson P Nix

J Laryngol Otol 2021 Jun 17;135(6):545-546. Epub 2021 May 17.

Department of ENT, Leeds Teaching Hospitals NHS Trust, UK.

Background: This technical note describes a novel method of cauterising the posterior nasal cavity through the use of a plastic straw and silver nitrate.

Objective: This technique aims to prevent unwanted damage to surrounding nasal mucosa.

Methods: Once the nasal cavity has been prepared for cauterisation, the silver nitrate stick is navigated to the bleeding point covered by the plastic straw. Read More

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COVID-19 and Parkinson's disease: Defects in neurogenesis as the potential cause of olfactory system impairments and anosmia.

J Chem Neuroanat 2021 09 11;115:101965. Epub 2021 May 11.

Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, Tamil Nadu, India; School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, Tamil Nadu, India; Faculty Recharge Programme, University Grants Commission (UGC-FRP), New Delhi, 110002, India. Electronic address:

Anosmia, a neuropathogenic condition of loss of smell, has been recognized as a key pathogenic hallmark of the current pandemic SARS-CoV-2 infection responsible for COVID-19. While the anosmia resulting from olfactory bulb (OB) pathology is the prominent clinical characteristic of Parkinson's disease (PD), SARS-CoV-2 infection has been predicted as a potential risk factor for developing Parkinsonism-related symptoms in a significant portion of COVID-19 patients and survivors. SARS-CoV-2 infection appears to alter the dopamine system and induce the loss of dopaminergic neurons that have been known to be the cause of PD. Read More

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September 2021

Quadriceps Tendon-Bone Full-Thickness Autograft: Reproducible and Easy Harvesting Technique Using Simple Surgical Tools.

Arthrosc Tech 2021 Apr 18;10(4):e1165-e1172. Epub 2021 Mar 18.

ORTIM Orthopaedic Clinic, Bialystok, Poland.

Autogenous quadriceps tendon-bone graft is a great choice for knee reconstruction procedures, including primary and revision reconstructions of both anterior cruciate ligament (ACL) and posterior cruciate ligament. In primary ACL reconstruction, one of the most frequently performed procedures in orthopaedic surgery, it is gaining more and more popularity owing to improved or similar biomechanical, anatomic, and histological properties than bone-patellar tendon-bone graft. The clinical outcomes of quadriceps tendon-bone graft in ACL reconstruction are similar to bone-patellar tendon-bone graft, however, lowering the inconvenience associated with donor-site morbidity and making it possible to adjust graft length and diameter. Read More

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Arthroscopic ACL Reconstruction After Failed ACL Repair.

Arthrosc Tech 2021 Apr 12;10(4):e1001-e1005. Epub 2021 Mar 12.

Centre Orthopédique Santy, FIFA Medical Center of Excellence, Groupe Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Lyon, France.

For some authors, repair of the torn anterior cruciate ligament (ACL) in selected patients can be considered a valuable surgical treatment option. One of the main advantages is that it leaves all grafts available for any type of reconstruction in case the repair fails. This Technical Note describes arthroscopic ACL reconstruction after failure of an ACL repair. Read More

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Large-Diameter Anterior Cruciate Ligament Reconstruction Technique With 8-Strand Semitendinosus and Gracilis Graft.

Arthrosc Tech 2021 Apr 1;10(4):e981-e986. Epub 2021 Mar 1.

Department of Orthopedics and Traumatology, Hospital of Lithuanian University of Health Sciences (LSMU), Kaunas Clinics, Kaunas, Lithuania.

Anterior cruciate ligament (ACL) reconstruction using a single 4-strand semitendinosus graft is a popular technique; unfortunately, the size (diameter) of the graft varies between 7 and 9 mm in many cases. The literature reveals that smaller diameter of the graft determines poorer Knee injury and Osteoarthritis Outcome Score sport/recreation functional scores and leads to revision surgery. Our Technical Note describes a method of preparing >10-mm size hamstring autografts in all cases while increasing the strength of fixation and covering as much of the anatomical ACL attachment footprint area as possible. Read More

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Arthroscopic Biceps Tenodesis by Bicortical Drilling Technique.

Arthrosc Tech 2021 Apr 2;10(4):e941-e948. Epub 2021 Mar 2.

Department of Orthopaedics, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand.

Pain arising from the long head of biceps tendon can cause significant disability of the shoulder. In young and physically demanding patients, biceps tenodesis is advised, in which the biceps tendon is cut from the native origin and fixed distally. Many methods have been proposed for this. Read More

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Dataset of Historical Elections in Catalonia (DHEC): Micro-level Historical Results (1890-1923).

Authors:
Pau Vall-Prat

Data Brief 2021 Jun 29;36:107017. Epub 2021 Mar 29.

Department of Political Science, Universitat de Barcelona, Av. Diagonal 684, 08034, Barcelona, Spain.

The Dataset of Historical Elections in Catalonia covers the most detailed information available for elections that took place in Catalonia during the period 1890-1923. It describes all the specificities of a unique dataset encompassing census tract electoral returns, together with candidate-level data and GIS information. This note presents the context of the electoral data by describing the electoral system and political characteristics of Catalonia and Spain for the period of interest. Read More

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Digital/Computational Technology for Molecular Cytology Testing: A Short Technical Note with Literature Review.

Acta Cytol 2021 Apr 30:1-6. Epub 2021 Apr 30.

Digital Healthcare Business Development Office, NEC Corp, Tokyo, Japan.

This short article describes the method of digital cytopathology using Z-stack scanning with or without extended focusing. This technology is suitable to observe such thick clusters as adenocarcinoma on cytologic specimens. Artificial intelligence (AI) has been applied to histological images, but its application on cytologic images is still limited. Read More

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Image- and Fluorescence-Based Test Shows Oxidant-Dependent Damages in Red Blood Cells and Enables Screening of Potential Protective Molecules.

Int J Mol Sci 2021 Apr 20;22(8). Epub 2021 Apr 20.

Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, CH-1066 Epalinges, Switzerland.

An increase of oxygen saturation within blood bags and metabolic dysregulation occur during storage of red blood cells (RBCs). It leads to the gradual exhaustion of RBC antioxidant protective system and, consequently, to a deleterious state of oxidative stress that plays a major role in the apparition of the so-called storage lesions. The present study describes the use of a test (called TSOX) based on fluorescence and label-free morphology readouts to simply and quickly evaluate the oxidant and antioxidant properties of various compounds in controlled conditions. Read More

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