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Dural Tear Does Not Increase the Rate of Venous Thromboembolic Disease in Patients Undergoing Elective Lumbar Decompression with Instrumented Fusion.

World Neurosurg 2021 Jul 28. Epub 2021 Jul 28.

Department of Orthopaedic Surgery, University of Maryland Medical Center, Baltimore, MD. Electronic address:

Objective: Evaluate if dural tears (DT) are an indirect risk factor for venous thromboembolic disease through increased recumbency in patients undergoing elective lumbar decompression and instrumented fusion.

Methods: A retrospective cohort study of consecutive patients undergoing elective lumbar decompression and instrumented fusion at a single institution between 2016 and 2019. Patients were divided into cohorts: those who sustained a dural tear and those who did not. Read More

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Two centres experience of lung cancer resection in patients with advanced non-small cell lung cancer upon treatment with immune checkpoint inhibitors: safety and clinical outcomes.

Eur J Cardiothorac Surg 2021 Jul 31. Epub 2021 Jul 31.

Department of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA.

Objectives: Recent trials have begun to explore immune checkpoint inhibitors for non-small cell lung cancer in the neoadjuvant setting, but data on tumour response and surgical outcome remain limited.

Methods: Retrospective evaluation of clinical data from patients with non-small cell lung cancer treated with immune checkpoint inhibitors followed by lung resection was performed at 2 large volume institutions (1 North American, 1 European). Data were analysed using Chi-squared, Fisher's and Wilcoxon rank-sum tests where appropriate. Read More

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Trends in regional enterococci levels at marine beaches and correlations with environmental, global oceanic changes, community populations, and wastewater infrastructure.

Sci Total Environ 2021 Jun 24;793:148641. Epub 2021 Jun 24.

Department of Civil, Architectural, and Environmental Engineering, University of Miami, Coral Gables, FL 33146, USA. Electronic address:

An increase in the number of advisories issued for recreational beaches across south Florida (due to the fecal indicator bacteria, enterococci) has been observed in recent years. To evaluate the possible reasons for this increase, we reviewed weekly monitoring data for 18 beaches in Miami-Dade County, Florida, for the years 2000-2019. Our objective was to evaluate this dataset for trends in enterococci levels and correlations with various factors that might have influenced enterococci levels at these beaches. Read More

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[Significance of patient-specific risk factors for regional cerebral oxygen saturation in beach chair position].

Anaesthesist 2021 Jul 30. Epub 2021 Jul 30.

Klinik für Anaesthesiologie, operative Intensivmedizin und Schmerztherapie, München Klinik Bogenhausen, Lehrkrankenhaus der technischen Universität München, Englschalkinger Straße 77, 81925, München, Deutschland.

Background: Despite numerous studies on the regional cerebral oxygen saturation (rSO) measured by near infrared spectroscopy (NIRS) in orthopedic patients in the beach chair position, it is still unclear whether patient-specific factors, such as concomitant cardiovascular diseases, are more frequently associated with the occurrence of cerebral desaturation events (CDE).

Objective: The aim of the present study was therefore to identify possible patient-specific risk factors that enable prediction of CDE.

Methods: Data were collected on 397 orthopedic patients undergoing shoulder surgery in the beach chair position. Read More

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Association between thiamine decrease and neuropsychiatric symptoms in gastrointestinal and hematological cancer patients receiving chemotherapy.

Biomed Pharmacother 2021 Jul 15;141:111929. Epub 2021 Jul 15.

Departmentof Pharmacy, The IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan.

Background: Clinical evidence of thiamine-related neuropsychiatric symptoms, including the initial stage, is limited because serum thiamine levels tend to be evaluated only for patients who develop severe neuropsychiatric symptoms suspected to be related to severe thiamine deficiency. This study aimed to evaluate the relationship between thiamine decline and neuropsychiatric symptoms, including initial symptoms, and the effect of chemotherapy on serum thiamine levels in gastrointestinal and hematological cancer patients receiving chemotherapy.

Method: We retrospectively identified 87 patients who were diagnosed with gastrointestinal and hematological cancers at our hospital. Read More

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Inflammatory breast cancer appearance at presentation is associated with overall survival.

Cancer Med 2021 Jul 30. Epub 2021 Jul 30.

Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.

Background: Inflammatory breast cancer (IBC) is a clinical diagnosis. Here, we examined the association of a "classic" triad of clinical signs, swollen involved breast, nipple change, and diffuse skin change, with overall survival (OS).

Method: Breast medical photographs from patients enrolled on a prospective IBC registry were scored by two independent reviewers as classic (triad above), not classic, and difficult to assign. Read More

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Impact of SARS-CoV-2 on training and mental well-being of surgical gynecological oncology trainees.

Int J Gynecol Cancer 2021 Jul 29. Epub 2021 Jul 29.

Department of Gynaecological Oncology, Barts and The London NHS Trust, London, UK

Introduction: The SARS-CoV-2 global pandemic has caused a crisis disrupting health systems worldwide. While efforts are being made to determine the extent of the disruption, the impact on gynecological oncology trainees/training has not been explored. We conducted an international survey of the impact of SARS-CoV-2 on clinical practice, medical education, and mental well-being of surgical gynecological oncology trainees. Read More

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Circulating angiogenic factors and HIV among pregnant women in Zambia: a nested case-control study.

BMC Pregnancy Childbirth 2021 Jul 28;21(1):534. Epub 2021 Jul 28.

Division of Global Women's Health, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Background: Maternal HIV increases the risk of adverse birth outcomes including preterm birth, fetal growth restriction, and stillbirth, but the biological mechanism(s) underlying this increased risk are not well understood. We hypothesized that maternal HIV may lead to adverse birth outcomes through an imbalance in angiogenic factors involved in the vascular endothelial growth factor (VEGF) signaling pathway.

Methods: In a case-control study nested within an ongoing cohort in Zambia, our primary outcomes were serum concentrations of VEGF-A, soluble endoglin (sEng), placental growth factor (PlGF), and soluble fms-like tyrosine kinase-1 (sFLT-1). Read More

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Visuomotor Synchronization: Military Normative Performance.

Mil Med 2021 Jul 28. Epub 2021 Jul 28.

Brain Trauma Foundation, Palo Alto, CA 94301, USA.

Introduction: Cognitive processes such as perception and reasoning are preceded and dependent on attention. Because of the close overlap between neural circuits of attention and eye movement, attention may be objectively quantified with recording of eye movements during an attention-dependent task. Our previous work demonstrated that performance scores on a circular visual tracking task that requires dynamic synchronization of the gaze with the target motion can be impacted by concussion, sleep deprivation, and attention deficit/hyperactivity disorder. Read More

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Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease.

Sci Rep 2021 Jul 27;11(1):15261. Epub 2021 Jul 27.

Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland.

Autoimmune hepatitis (AIH) and autoimmune sclerosing cholangitis (ASC) are two very closely related autoimmune liver diseases with overlapping clinical features and similar management strategies. The purpose of this study was to assess the utility of quantitative imaging markers to distinguish ASC from AIH in paediatrics. 66 participants (N = 52 AIH, N = 14 ASC) aged 14. Read More

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Immediate Effects of a Continuous Peripheral Nerve Block on Postamputation Phantom and Residual Limb Pain: Secondary Outcomes From a Multicenter Randomized Controlled Clinical Trial.

Anesth Analg 2021 Jul 27. Epub 2021 Jul 27.

Departments of General Anesthesia and Outcomes Research, Cleveland Clinic, Cleveland, Ohio.

Background: We recently reported that a 6-day continuous peripheral nerve block reduced established postamputation phantom pain 3 weeks after treatment ended. However, the immediate effects of perineural infusion (secondary outcomes) have yet to be reported.

Methods: Participants from 5 enrolling academic centers with an upper or lower limb amputation and established phantom pain received a single-injection ropivacaine peripheral nerve block(s) and perineural catheter insertion(s). Read More

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Hyperpolarized Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Nonspecific Interstitial Pneumonia.

Radiology 2021 Jul 27:204149. Epub 2021 Jul 27.

From the Department of Radiology (D.G.M., J.K., B.D., J.G.M.), Center for In Vivo Microscopy (D.G.M., B.D.), Department of Biomedical Engineering (E.A.B., Z.W., B.D.), Department of Medicine (L.M., C.B., H.P.M., R.T.), and Department of Medical Physics (B.D.), Duke University, DUMC Box 3302, Durham, NC 27710.

Background Recent studies demonstrate that antifibrotic drugs previously reserved for idiopathic pulmonary fibrosis (IPF) may slow progression in other interstitial lung diseases (ILDs), creating an urgent need for tools that can sensitively assess disease activity, progression, and therapy response across ILDs. Hyperpolarized xenon 129 (Xe) MRI and spectroscopy have provided noninvasive measurements of regional gas-exchange abnormalities in IPF. Purpose To assess gas exchange function using Xe MRI in a group of study participants with nonspecific interstitial pneumonia (NSIP) compared with healthy control participants. Read More

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Population-based utility scores for HPV infection and oropharyngeal squamous cell carcinoma among Indigenous Australians.

BMC Public Health 2021 Jul 26;21(1):1455. Epub 2021 Jul 26.

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide Health & Medical Sciences Building, Adelaide, 5005, Australia.

Background: Oropharyngeal squamous cell carcinoma (OPSCC) is associated with high mortality. Human papillomavirus (HPV) infection is a significant risk factor for OPSCC. Utilities are fundamental values representing the strength of individuals' preferences for specific health-related outcomes. Read More

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Bone turnover in pregnancy, measured by urinary C-terminal telopeptide of type I collagen (CTX), is influenced by vitamin D supplementation and is associated with maternal bone health: Findings from the MAVIDOS trial.

Am J Clin Nutr 2021 Jul 23. Epub 2021 Jul 23.

MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.

Background: The pattern of change in maternal bone turnover throughout pregnancy is poorly characterized.

Objective: We investigated changes across pregnancy in a marker of maternal bone resorption, urinary C-terminal telopeptide of type I collagen (CTX), the influence of gestational vitamin D supplementation, and associations between CTX and maternal postnatal bone indices.

Design: The Maternal Vitamin D Osteoporosis Study (MAVIDOS) is a randomized, double-blind, placebo-controlled trial of 1000 IU/day cholecalciferol vs placebo from 14 weeks' gestation to birth. Read More

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Short-Term Repeatability of in Vivo Cardiac Intravoxel Incoherent Motion Tensor Imaging in Healthy Human Volunteers.

J Magn Reson Imaging 2021 Jul 23. Epub 2021 Jul 23.

Imaging Center, Harbin Medical University Cancer Hospital, Harbin, China.

Background: Intravoxel incoherent motion (IVIM) tensor imaging is a promising technique for diagnosis and monitoring of cardiovascular diseases. Knowledge about measurement repeatability, however, remains limited.

Purpose: To evaluate short-term repeatability of IVIM tensor imaging in normal in vivo human hearts. Read More

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Differential impact of tumor suppressor gene (TP53, PTEN, RB1) alterations and treatment outcomes in metastatic, hormone-sensitive prostate cancer.

Prostate Cancer Prostatic Dis 2021 Jul 22. Epub 2021 Jul 22.

Division of Hematology and Medical Oncology, Phoenix, AZ, USA.

Background: Altered tumor suppressor genes (TSG-alt) in prostate cancer are associated with worse outcomes. The prognostic value of TSG-alt in metastatic, hormone-sensitive prostate cancer (M1-HSPC) is unknown. We evaluated the effects of TSG-alt on outcomes in M1-HSPC and their prognostic impact by first-line treatment. Read More

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Artifacts in contrast-enhanced mammography: are there differences between vendors?

Clin Imaging 2021 Jul 8;80:123-130. Epub 2021 Jul 8.

University of Western Australia Medical School, Perth, Western Australia 6009, Australia; Department of Radiology, Royal Perth Hospital, Perth, Western Australia 6000, Australia. Electronic address:

Purpose: Contrast-Enhanced Mammography (CEM) produces a dual-energy subtracted (DES) image that demonstrates iodine uptake (neovascularity) in breast tissue. We aim to review a range of artifacts on DES images produced using equipment from two different vendors and compare their incidence and subjective severity.

Methods: We retrospectively reviewed CEM studies performed between September 2013 and March 2017 using GE Senographe Essential (n = 100) and Hologic Selenia Dimensions (n = 100) equipment. Read More

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Concurrent Nab-paclitaxel and Radiotherapy: Novel Radiosensitization for Borderline Resectable or Unresectable Pancreatic Cancer.

Am J Clin Oncol 2021 Jul 26. Epub 2021 Jul 26.

Departments of Radiation Oncology Medical Oncology Pathology Surgery, University of Pennsylvania Cancer Treatment Centers of America, Philadelphia, PA Compass Oncology, Tigard, OR The University of Texas MD Anderson Cancer Center, Houston, TX Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Purpose: This study evaluates the toxicity and tumor response with concurrent nab-paclitaxel chemoradiotherapy (CRT) compared with standard (5-fluorouracil or gemcitabine) CRT.

Materials And Methods: Fifty patients with borderline resectable or unresectable pancreatic adenocarcinoma from 2014 to 2017 were divided into 2 groups: concurrent nab-paclitaxel (100 to 125 mg/m2 weekly) CRT (median: 2.1 Gy fraction size and 52. Read More

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Body Composition Variables as Radiographic Biomarkers of Clinical Outcomes in Metastatic Renal Cell Carcinoma Patients Receiving Immune Checkpoint Inhibitors.

Front Oncol 2021 9;11:707050. Epub 2021 Jul 9.

Winship Cancer Institute of Emory University, Department of Hematology and Medical Oncology, Atlanta, GA, United States.

Background: Immune checkpoint inhibitors (ICI) have revolutionized the treatment of metastatic renal cell carcinoma (mRCC). Biomarkers for mRCC patients treated with ICI are limited, and body composition is underutilized in mRCC. We investigated the association between body composition and clinical outcomes in ICI-treated mRCC patients. Read More

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Development and validation of a pregnancy prediction model based on ultrasonographic features related to endometrial receptivity.

Am J Transl Res 2021 15;13(6):6156-6165. Epub 2021 Jun 15.

Department of Ultrasound, Wenzhou People's Hospital Wenzhou, China.

Objective: Our aim was to identify multiple endometrial receptivity related factors by applying non-invasive, repeatable multimodal ultrasound methods. We further established a practical prediction model for pregnancy prediction.

Materials And Methods: Our study included 152 participants from Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, and the Third Affiliated Hospital of Wenzhou Medical University. Read More

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[The cervical microbiota characteristics in patients with human papillomavirus infection].

Zhonghua Yu Fang Yi Xue Za Zhi 2021 Jul;55(7):867-874

Department of Microbiology,School of Public Health, Southern Medical University, Guangzhou 510515, China Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.

To investigate the characteristics of cervical microbiota in patients with HPV (Human Papillomavirus) infection, and to analyze the associations of cervical microbiota and HPV infection or cervicitis. 300 samples underwent HPV nucleic acid testing was collected in this case-control study from June 2019 to April 2020 in the Zhujiang Hospital of Southern Medical University, there were 150 cases allocated in HPV infection group (HPV+), and 150 cases of negative nucleic acid test were non-infectious Group (HPV-). Next-generation sequencing was used to sequence the V4 region of the bacterial 16S rRNA gene, and QIIME pipeline was used to analysis the microbiota composition of the two groups. Read More

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[Clinical efficacy of the combined diagnosis and management for children with airway allergic diseases].

Zhonghua Yu Fang Yi Xue Za Zhi 2021 Jul;55(7):818-826

Key Laboratory of Major Diseases in Children, Ministry of Education, Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.

To evaluate the clinical efficacy of the combined diagnosis and management in children with airway allergic diseases(bronchial asthma, allergic rhinitis). This observational study belongs to cluster sampling cases, which included the clinical data from children with airway allergic diseases in Allergy Department and Otorhinolaryngology Department of Beijing Children's Hospital from April to December in 2015. They were followed up every three months during 12 months. Read More

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Comparison of Oral Loading Dose to Intravenous Acetaminophen in Children for Analgesia After Tonsillectomy and Adenoidectomy: A Randomized Clinical Trial.

Anesth Analg 2021 Jul 23. Epub 2021 Jul 23.

From the Department of Anesthesiology and Pain Medicine.

Background: Acetaminophen is a frequently used adjunct analgesic in pediatric patients undergoing tonsillectomy and adenoidectomy. We compared opioid administration following preoperative intravenous (IV) or oral acetaminophen in addition to a standard multimodal regimen to test the hypothesis that 1 loading dose approach would provide superior opioid sparing effects among pediatric surgical patients undergoing tonsillectomy and adenoidectomy.

Methods: This single-center, double-blind, double-dummy prospective randomized study was conducted in patients ages 3 to 15 years undergoing tonsillectomy and adenoidectomy with or without myringotomy and tube placement between September 2017 and July 2019. Read More

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Development and field testing of a patient decision aid for management of acute Achilles tendon rupture: a study protocol.

BMC Med Inform Decis Mak 2021 Jul 24;21(1):225. Epub 2021 Jul 24.

Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, Canada.

Background: Achilles tendon ruptures are common injuries in an otherwise healthy, active population. Several treatment options exist, with both surgical and non-surgical options. Each treatment option has a unique set of risks and harms, which may present patients with decisional conflict. Read More

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Impact of Opioid-Minimizing Pain Protocols after Burn Injury.

J Burn Care Res 2021 Jul 24. Epub 2021 Jul 24.

Center for Translational Injury Research, the McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas.

In 2019, we implemented a pill-based, opioid-minimizing pain protocol and protocolized moderate sedation for dressing changes in order to decrease opioid exposure in burn patients. We hypothesized that these interventions would reduce inpatient opioid exposure without increasing acute pain scores. Two groups of consecutive patients admitted to the burn service were compared: Pre (01/01/2018 to 07/31/2019) and Post (01/01/2020 to 06/30/2020) implementation of the protocols (08/01/2019 to 12/31/2019). Read More

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Spatiotemporal variation in residential PM2.5 and PM10 concentrations in China: National on-site survey.

Environ Res 2021 Jul 20;202:111731. Epub 2021 Jul 20.

China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China. Electronic address:

Background: Significant efforts have been directed toward addressing the adverse health effects of particulate matter, while few data exist to evaluate indoor exposure nationwide in China.

Objectives: This study aimed to investigate dwellings particulate matter levels in the twelve cities in China and provide large data support for policymakers to accelerate the legislative process.

Methods: The current study was based on the CIEHS 2018 study and conducted in 12 cities of China. Read More

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Crown-like structures in breast adipose tissue of breast cancer patients: associations with CD68 expression, obesity, metabolic factors and prognosis.

NPJ Breast Cancer 2021 Jul 22;7(1):97. Epub 2021 Jul 22.

Department of Medicine, University of Toronto, Toronto, ON, Canada.

Crown-like structures of the breast (CLS-B), defined by the clustering of macrophages (identified using CD68 immunohistochemical staining) to surround a dying adipocyte, are a sign of adipose-tissue inflammation. In human cohorts, CLS-B positively correlates with older age, obesity, dyslipidemia and higher levels of glucose, insulin, C-reactive protein and IL-6. In an existing cohort of early-stage breast cancer patients, CLS-B were identified using H&E stained histologic sections (hCLS-B), and by CD68 immunohistochemistry (CD68 + CLS-B). Read More

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Urology 2021 Jul 19. Epub 2021 Jul 19.

Department of Urology, Emory University School of Medicine, 1365 Clifton Road NE, Building B, Suite 1403, Atlanta GA 30322. Electronic address:

Objective: To investigate the association between paternal race and reproductive outcomes following in vitro fertilization (IVF).

Materials And Methods: We compared demographic and clinical characteristics, IVF cycle characteristics, and reproductive outcomes (pregnancy, miscarriage, and live birth), stratified by male and female partner race, for all IVF cycles performed at our institution between 2014-2019. Wilcoxon Rank Sum test and Pearson's Chi Square test were used to compare continuous and categorical data, respectively. Read More

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Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.

PLoS One 2021 22;16(7):e0254575. Epub 2021 Jul 22.

Adelaide Dental School, Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, Australia.

Objective: Working in partnership with Indigenous communities in South Australia, we aimed to develop, pilot test and estimate utility scores for health states relating to cervical cancer screening, precancer, and invasive cervical cancer and precancer/cancer treatment among Indigenous women.

Methods: Development and pilot testing of hypothetical cervical cancer health states, specifically through the lens of being an Indigenous Australian woman, was done with an Indigenous Reference Group in conjunction with five female Indigenous community members. Six health states were developed. Read More

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Assessing Orthopedic Patient Preferences for Mandated Virtual Care During the COVID-19 Pandemic and Elective Virtual Care in Non-Pandemic Circumstances.

Orthopedics 2021 Jul-Aug;44(4):e471-e476. Epub 2021 Jul 1.

The purpose of this study was to compare orthopedic patient preferences for mandated virtual care during the coronavirus disease 2019 (COVID-19) pandemic and elective virtual care during non-pandemic circumstances. An orthopedic virtual care questionnaire was administered to adult orthopedic patients undergoing their first orthopedic virtual visit between March 15, 2020, and May 18, 2020. The questionnaire had 13 items rated on a 1-to-5 Likert scale ("strongly agree" to "strongly disagree"). Read More

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