bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conversion total hip arthroplasty with a proximally modular, distal fixation reconstruction prosthesis following cephalomedullar nail failure
Authors: Godoy-Monzon Daniel , Diaz Dilernia Fernando , Piccaluga Francisco , Cid Casteulani Alberto , Turus Luis , Buttaro Martin 
Published: September 2020

Background: The goals of intertrochanteric hip fracture (IHF) treatment are stable fixation, early mobilisation and function restoration. If the attempt to reduce, stabilise and fracture healing utilising a femoral cephalomedullar nail (CMN) fails, options for subsequent attempts are limited. Purpose: Evaluate the clinical and radiographic outcomes of conversion total hip arthroplasty (THA) using a modular stem following a CMN failure. Materials and methods: We retrospectively reviewed a consecutive series of patients with an IHF between 2012 and 2014 to identify CMN patients that went on to the subsequent failure and conversion to THA utilising a modular femoral stem (MFS). In all cases, MP Reconstruction Prosthesis (Waldemar Link, Hamburg, Germany) was implanted. Primary clinical outcomes were assessed using Harris Hip Score (HSS) before conversion procedure, 3 months, 6 months and recent office visit post-conversion THA thereafter. The secondary outcome was to analyse intra and postoperative complications. Serial radiographs at each follow-up interval were assessed for clinical success or to confirm adverse events. Results: 28 patients were included in the study; 17 were females. The average age was 72.7 years (SD ± 10.5); the average time from the index procedure to conversion THA was 12.6 months (SD ± 3.5). At baseline, average HHS was 42.1 (SD ± 3.6), improved to 80.7 (SD ± 5.1) at 3 months, 86.0 (SD ± 3.9) at 6-months which levelled off to 86.1 (SD ± 4.0) at final follow-up. There were 4 (14%) post-conversion complications: 2 dislocations, 1 superficial wound infection, 1 patient with symptomatic abductor deficiency. All 4 cases were conservatively treated successfully, the implants were retained, and the patients progressed without further issue. Conclusions: MFSs allow to successfully treat failed CMN and adverse variations in femoral anatomy with a device that will permit simultaneous correction of leg length, offset and version to relieve pain, restore function and create a durable prosthetic to host composite.
Revision total hip arthroplasty is associated with significantly higher opioid consumption as compared to primary total hip arthroplasty in the acute postoperative period
Authors: Bernstein Jenna A , Feng James , Mahure Siddharth A , Schwarzkopf Ran , Long William J 
Published: September 2020

Background: There are currently a lack of investigations that characterised narcotic utilisation following revision total hip arthroplasty (THA). We sought to determine if immediate post-surgical opioid use was different between revision THA and primary THA. Methods: A single institution total joint arthroplasty database was used to identify adult patients who underwent revision THA or primary THA from 2016 to 2019. Morphine milligram equivalents (MME) were calculated for different time periods. Results: 6977 patients were identified, 89.72% primary THA and 10.28% revision THA. Aggregate opioid consumption was higher for revision THA patients (317.40 MME vs. 93.01 MME), as was opioid consumption in the first 24 hour and second 24-hour periods. Visual analogue pain (VAS) scores were significantly higher in the 0–12 hour postoperative and the 12–24 hours postoperative periods in the revision THA group. Conclusions: Patients undergoing revision THA had significantly higher narcotic utilisation than those undergoing primary THA, particularly in the first 24 hours postoperatively.
Migration After Endovasclar Aneurysm Sealing in Conjunction With Chimney Grafts
Authors: Zoethout Aleksandra C. , Sheriff Arshad , Zeebregts Clark J. , Reijnen Michel M. P. J. , Hill Andrew , Holden Andrew 
Published: September 2020

Purpose To assess the incidence of migration after endovascular aneurysm sealing (EVAS) in conjunction with chimney grafts (chEVAS) for repair of abdominal aortic aneurysms (AAAs). Materials and Methods A retrospective, observational cohort study was conducted of 31 patients (mean age 75.7 years; 27 men) treated for juxtarenal AAA between April 2013 and December 2018 at single centers in New Zealand and the Netherlands. The majority of patients received >1 chimney graft (13 single, 13 double, and 5 triple) during chEVAS. Six patients had only the first postoperative scan, so the migration analysis was based on 25 patients. Results Median seal length assessed on the first postoperative computed tomography scan was 36.5 mm. The assisted technical success rate was 93.5% with 2 technical failures. Median time to final imaging follow-up was 17 months in 25 patients. At the latest follow-up, there were no cases of caudal migration >10 mm. Freedom from caudal movement of 5 to 9 mm was estimated as 86.1% at 1 year and 73.9% at 2 years; freedom from clinically relevant migration (movement requiring reintervention) was 100% at both time intervals. However, at 3 years there were 2 cases of caudal movement of 5 to 9 mm and a type Ia endoleak warranting reintervention. No correlation between migration and aneurysm growth (p=0.851), endoleak (p=0.562), or the number of chimney grafts (p=0.728) was found. During follow-up, 2 patients (7%) had aneurysm rupture and 10 (33%) had reinterventions. Eight patients (27%) died; 2 were aneurysm-related (7%) and due to the consequences of a reintervention. Conclusion In the 2 years following chEVAS, there was no caudal migration >10 mm, but nearly a quarter of patients had caudal movement of 5 to 9 mm. A trend was observed toward ongoing migration that required intervention at 3-year follow-up. chEVAS is technically challenging and should be considered only for patients with no viable alternative treatment option.
Comparison of Clinical Outcomes in Patients Selected for Infra-Popliteal Bypass or Plain Balloon Angioplasty for Chronic Limb Threatening Ischemia Between 2009 and 2013
Authors: Popplewell Matthew A. , Davies Huw O. B. , Meecham Lewis , Bate Gareth , Bradbury Andrew W. 
Published: September 2020

Introduction: A published subgroup analysis of the Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL)-1 trial suggests that, in patients with chronic limb threatening ischemia (CLTI) due to infra-popliteal (IP) disease, clinical outcomes are better following vein bypass surgery (BS) than after plain balloon angioplasty (PBA). The aim of the present study is to determine if clinical outcomes following IP revascularization in our unit are concordant with those found in BASIL-1. Methods: We analyzed prospectively gathered data pertaining to 137 consecutive CLTI patients undergoing IP PBA or BS between 2009 and 2013. We compared 30-day morbidity and mortality, days in hospital (index admission and out to 12-months), amputation free survival (AFS), overall survival (OS), limb salvage (LS), and freedom from arterial re-intervention (FFR). Patient outcomes were censored on 1 February 2017, providing a minimum 3 years follow-up. Results: Patients undergoing BS (73/137, 47%) tended to be younger, have less comorbidity, and were more likely to be on best medical therapy (BMT). BS patients spent more days in hospital during the index admission (median 9 vs 5, p = .003), but not out to 12 months (median 15 vs 13, NS). BS patients suffered more 30-day morbidity (36% vs 10%, p < .001), mainly due to infective complications, but not mortality (3.1% vs 6.8%, NS). AFS (p = .001) and OS (p < .001), but not LS or FFR, were better after BS. Conclusions: CLTI patients selected for revascularization by means of IP BS had better long-term outcomes in terms of AFS and OS, but not FFR or LS. Although we await the results of the BASIL-2 trial, current data support the BASIL-1 sub-group analysis which suggests that patients requiring revascularization for IP disease should have BS where possible and that PBA should usually be reserved for patients who are not suitable for BS.
‘You are Okay’: Effects of a support and educational program for children with mild intellectual disability and their parents with mental health concerns
Authors: Riemersma Ivon , Van Santvoort F , Van Doesum KTM , Hosman CMH , Janssens JMAM , Van der Zanden RAP , Otten R 
Published: September 2020

Background: Children with mild intellectual disabilities and emotional and behavioural problems whose parents have mental health concerns are at an increased risk of developing problems themselves. This study analysed the effectiveness of the ‘You are Okay’-program aimed to support these children and parents and to reduce the risk of problem development in children. Method: A quasi-experimental design was used to compare the experimental group (‘care as usual’ and ‘You are Okay’) with the control group (‘care as usual’) on the main outcome of emotional and behavioural problems and proposed intermediate outcomes. Results: Children in the experimental group reported a significant medium to large decrease in emotional and behavioural problems compared to the control group. The effects on the intermediate outcomes were non-significant. Conclusions: This specific study population comprising a vulnerable group of children seems to benefit from this specially adapted ‘You are Okay’-program. More research is necessary to draw further conclusions.
Use the Environment to Prevent and Control COVID-19 in Senior-Living Facilities: An Analysis of the Guidelines Used in China
Authors: Wang Zhe 
Published: September 2020

Objective: To identify the environmental factors essential for infection control in senior-living facilities. Background: In the COVID-19 pandemic, older adults are more likely to be infected and develop serious outcomes than young people. Worldwide, senior-living facilities face a battle to protect their residents. Compared with age-related declines, the built environment is more modifiable and can be used for infection control. Methods: This research conducted content analysis of the guidelines on COVID-19 control issued by the State Council of China in February 2020 for senior-living facilities. Six senior-living facility managers in China were interviewed and shared their experiences using these guidelines. Quantitative and qualitative analyses were conducted to identify the essential environmental factors for infection control. Results: Environmental factors suggested in the guidelines were analyzed for three groups of infection-control strategies: keep COVID-19 from entering the facility, prevent COVID-19 spread in the facility, and manage infection and illness. Key topics of experience using the guidelines were identified, including residents’ needs for social interaction and the difficulties of providing dedicated air-conditioning and circulation systems. Based on these analyses, from the perspective of environmental design, environmental factors essential for COVID-19 control in senior-living facilities were summarized at the site, building, and room levels. Conclusion: Proper planning and design of the built environment promote strategies for infection control in senior-living facilities. Findings can be used to guide the new design, renovation, and modification of senior-living facilities for COVID-19 control and future public health emergencies.
Application of non-mydriatic fundus examination and artificial intelligence to promote the screening of diabetic retinopathy in the endocrine clinic: an observational study of T2DM patients in Tianjin, China
Authors: Hao Zhaohu , Cui Shanshan , Zhu Yanjuan , Shao Hailin , Huang Xiao , Jiang Xia , Xu Rong , Chang Baocheng , Li Huanming 
Published: September 2020

Background: We aimed to determine the role of non-mydriatic fundus examination and artificial intelligence (AI) in screening diabetic retinopathy (DR) in patients with diabetes in the Metabolic Disease Management Center (MMC) in Tianjin, China. Methods: Adult patients with type 2 diabetes mellitus who were first treated by MMC in Tianjin First Central Hospital and Tianjin 4th Center Hospital were divided into two groups according to the time that MMC was equipped with the non-mydriatic ophthalmoscope and AI system and could complete fundus examination independently (the former was the control group, the latter was the observation group). The observation indices were as follows: the incidence of DR, the fundus screening rate of the two groups, and fundus screening of diabetic patients with different course of disease. Results: A total of 5039 patients were enrolled in this study. The incidence rate of DR was 18.6%, 29.8%, and 49.6% in patients with diabetes duration of ⩽1 year, 1–5 years, and >5 years, respectively. The screening rate of fundus in the observation group was significantly higher compared with the control group (81.3% versus 28.4%, χ2 = 1430.918, p < 0.001). The DR screening rate of the observation group was also significantly higher compared with the control group in patients with diabetes duration of ⩽1 year (77.3% versus 20.6%; χ2 = 797.534, p < 0.001), 1–5 years (82.5% versus 31.0%; χ2 = 197.124, p < 0.001) and ⩾5 years (86.9% versus 37.1%; χ2 = 475.609, p < 0.001). Conclusions: In the case of limited medical resources, MMC can carry out one-stop examination, treatment, and management of DR through non-mydratic fundus examination and AI assistance, thus incorporating the DR screening process into the endocrine clinic, so as to facilitate early diagnosis.
Rates and correlates of pharmacotherapy-related problems among psychiatric inpatients: a representative Danish study
Authors: Kibsdal Karina Porsborg , Andersen Sabina , Gazerani Parisa , Plet Hanne 
Published: September 2020

Background: Drug related problems (DRPs) occur frequently among psychiatric patients due to common prescribing errors and complex treatment schedules. Clinical pharmacists (CPs) are thought to play an important role in preventing DRPs and, consequently, to increasing the quality of inpatient care. There is, however, limited information available on DRPs within the psychiatric field in Denmark. The aim of this study was to identify rates and correlates of pharmacotherapy-related problems among psychiatric inpatients in a Danish psychiatric hospital. Methods: A retrospective descriptive study was conducted by two CPs and data were obtained from the medical records available in two psychiatric wards. Chart-reviews were conducted for the period of June 2015 to February 2017. The analyses focussed on the prevalence of DRP categories, implementation and acceptance rates, and drugs associated with the DRPs. Extracted data were discussed with the wards’ physicians and registered in a DRP-database. Results: In total, 607 medical records were reviewed and, on average, 2.5 DRPs per medication review were found. There was a positive correlation between the number prescribed drugs and the average number of DRPs. The most frequent categories of DRPs were ‘drug dosage’, ‘inappropriate drug’ and ‘interactions’. The drugs represented most frequently in DRPs were olanzapine, quetiapine and pantoprazole. The overall acceptance rate was 49% with 33% of those implemented clinically. Conclusion: DRPs were commonly observed among psychiatric patients, particularly in those with multiple prescriptions, in relation to drugs dosage, inappropriate prescriptions and drug interactions. Particular attention must be paid to olanzapine, quetiapine and pantoprazole. Strategies to minimise DRPs among psychiatric patients are warranted and CPs can play an important role.
The Mesoarchean Amikoq Layered Complex of SW Greenland: Part 1. Constraints on theP–Tevolution from igneous, metasomatic and metamorphic amphiboles
Authors: Aarestrup Emil , Jørgensen Taus R. C. , Armitage Paul E.B. , Nutman Allen P. , Christiansen Ole , Szilas Kristoffer 
Published: September 2020

AbstractThe metamorphic history of the Mesoarchean Amikoq Layered Complex within the Akia terrane of SW Greenland was characterised by electron microprobe mineral data and detailed petrography on 12 representative samples, integrated with zircon U–Pb geochronology and petrology. The complex intruded into a >3004 Ma supracrustal association now consisting of granoblastic metabasites with subordinate quartz-rich gneiss. Supracrustal host rocks contain a relict high-temperature assemblage of orthopyroxene–clinopyroxene (± pigeonite exsolution lamellae, exsolved at ~975–1010°C), which is interpreted to pre-date the Amikoq intrusion. Cumulate to granoblastic-textured rocks of the main Amikoq Layered Complex range modally from leuconorite to melanorite, orthopyroxenite to harzburgite/dunite and rare hornblende melagabbro. Observed mineralogy of main complex noritic lithologies is essentially relict igneous with orthopyroxene–biotite and hornblende–plagioclase thermometers yielding temperatures of ~800–1070°C. An anatectic zircon megacryst from a patchy quartzo–feldspathic leucosome hosted in an orthopyroxene-dominated Amikoq rock reflects local anatexis at peak metamorphicP–Tconditions and yields an intrusion minimum age of 3004 ± 9 Ma. Field observations indicate local anatexis of orthopyroxene-dominated lithologies, possibly indicating a post-intrusion peak temperature of >900°C. The last preserved stages of retrogression are recorded in paragneiss plagioclase–garnet, biotite–garnet and host rock ilmenite–magnetite pairs (≤3 kbar and ~380–560°C).The Amikoq Complex intruded a MORB-like crustal section and the former remained relatively undisturbed in terms of modal mineralogy. Preservation of igneous textures and mineralogy are related to an anhydrous, high-grade metamorphic history that essentially mimics igneous crystallisation conditions, whereas local high-strain zones acted as fluid pathways resulting in hydrous breakdown of igneous minerals. There is no evidence of equilibration of the intrusion at sub-amphibolite-facies conditions.
COVID-19 and pneumothorax: a multicentre retrospective case series
Authors: Martinelli Anthony W. , Ingle Tejas , Newman Joseph , Nadeem Iftikhar , Jackson Karl , Lane Nicholas D. , Melhorn James , Davies Helen E. , Rostron Anthony J. , Adeni Aldrin , Conroy Kevin , Woznitza Nick , Matson Matthew , Brill Simon E. , Murray James , Shah Amar , Naran Revati , Hare Samanjit S. , Collas Oliver , Bigham Sarah , Spiro Michael , Huang Margaret M. , Iqbal Beenish , Trenfield Sarah , Ledot Stephane , Desai Sujal , Standing Lewis , Babar Judith , Mahroof Razeen , Smith Ian , Lee Kai , Tchrakian Nairi , Uys Stephanie , Ricketts William , Patel Anant R.C. , Aujayeb Avinash , Kokosi Maria , Wilkinson Alexander J.K. , Marciniak Stefan J. 
Published: September 2020

IntroductionPneumothorax and pneumomediastinum have both been noted to complicate cases of coronavirus disease 2019 (COVID-19) requiring hospital admission. We report the largest case series yet described of patients with both these pathologies (including nonventilated patients).MethodsCases were collected retrospectively from UK hospitals with inclusion criteria limited to a diagnosis of COVID-19 and the presence of either pneumothorax or pneumomediastinum. Patients included in the study presented between March and June 2020. Details obtained from the medical record included demographics, radiology, laboratory investigations, clinical management and survival.Results71 patients from 16 centres were included in the study, of whom 60 had pneumothoraces (six with pneumomediastinum in addition) and 11 had pneumomediastinum alone. Two of these patients had two distinct episodes of pneumothorax, occurring bilaterally in sequential fashion, bringing the total number of pneumothoraces included to 62. Clinical scenarios included patients who had presented to hospital with pneumothorax, patients who had developed pneumothorax or pneumomediastinum during their inpatient admission with COVID-19 and patients who developed their complication while intubated and ventilated, either with or without concurrent extracorporeal membrane oxygenation. Survival at 28 days was not significantly different following pneumothorax (63.1±6.5%) or isolated pneumomediastinum (53.0±18.7%; p=0.854). The incidence of pneumothorax was higher in males. 28-day survival was not different between the sexes (males 62.5±7.7%versusfemales 68.4±10.7%; p=0.619). Patients aged ≥70 years had a significantly lower 28-day survival than younger individuals (≥70 years 41.7±13.5% survivalversus<70 years 70.9±6.8% survival; p=0.018 log-rank).ConclusionThese cases suggest that pneumothorax is a complication of COVID-19. Pneumothorax does not seem to be an independent marker of poor prognosis and we encourage continuation of active treatment where clinically possible.
Design of Vegetable Pot Seedling Pick-up Mechanism with Planetary Gear Train
Authors: Tong Zhipeng , Yu Gaohong , Zhao Xiong , Liu Pengfei , Ye Bingliang 
Published: September 2020

AbstractIt has been challenging to design seedling pick-up mechanism based on given key points and trajectories, because it involves dimensional synthesis and rod length optimization. In this paper, the dimensional synthesis of seedling pick-up mechanism with planetary gear train was studied based on the data of given key points and the trajectory of the endpoint of seedling pick-up mechanism. Given the positions and orientations requirements of the five key points, the study first conducted a dimensional synthesis of the linkage size and center of rotation. The next steps were to select a reasonable solution and optimize the data values based on the ideal seedling trajectory. The link motion was driven by the planetary gear train of the two-stage gear. Four pitch curves of noncircular gears were obtained by calculating and distributing the transmission ratio according to the data. For the pitch curve with two convex points, the tooth profile design method of incomplete noncircular gear was applied. The seedling pick-up mechanism was tested by a virtual prototype and a physical prototype designed with the obtained parameter values. The results were consistent with the theoretical design requirements, confirming that the mechanism meets the expected requirements for picking seedlings up. This paper presents a new design method of vegetable pot seedling pick-up mechanism for an automatic vegetable transplanter.
Who’s related to whom? Use published phylogenies and make customized tree-thinking assessments
Authors: Blacquiere Luke D. , Fawaz Allia , Hoese William J. 
Published: September 2020

AbstractA phylogeny depicts the hypothesized evolutionary relationships among taxa as a nested hierarchical branching diagram. Interpreting the relationships among taxa on a phylogeny is part of a set of skills called tree-thinking. Because published phylogenies are not constructed for the purpose of tree-thinking pedagogy, the information can be difficult for students to interpret and explicit instruction is required for mastery of the tree-thinking skill-set. We present a process to construct customizable assessment questions using published phylogenies, to assess a key tree-thinking skill, determining relatedness among taxa on a phylogeny. We detail how to construct two types of forced-choice questions: binary-choice and four-choice. In both question types, students are presented with a phylogeny and are instructed to determine which taxon from a list of taxa is most closely related to a focal taxon. The list of taxa includes distracters as possible responses explicitly selected based on common alternative strategies (similarity,proximity,node counting), in addition to the correct response. Instructors can select taxa of their own choosing in order to customize assessments. These assessment questions can be utilized during instruction as a formative assessment to enhance learning or in a summative assessment.