bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study of Intramedullary Nail Strengthened with Auxiliary Locking Plate or Steel Wire in the Treatment of Unstable Trochanteric Fracture of Femur
Authors: Wang Zheng‐hao , Li Kai‐nan , Lan Hai , Wang Xiao‐dong 
Published: December 2019

ObjectiveTo compare the clinical outcomes of unstable femoral trochanteric fracture treated by proximal femoral intramedullary nail enhanced with lateral locking plate versus cerclage steel wire.MethodsA retrospective study was conducted on 83 patients who received open reduction and internal fixation with proximal femoral intramedullary nail combined with lateral enhanced fixations for unstable femoral trochanteric fractures from March 2015 to January 2017 in our hospital. Of these patients, 39 received the lateral enhanced fixation with locking plate, while the remaining 44 had cerclage wire as additional fixation. The clinical data were compared between the two groups.ResultsAll the patients in the study had surgical procedures performed smoothly. Although the plate group had significantly longer operation times and significantly higher hospitalization expenses than the wire group (P < 0.05), no statistically significant differences in intraoperative blood loss and hospital stay were proved between the groups (P > 0.05). The follow‐up period lasted for 12–24 months with an average of (16.81 ± 2.92) months. The plate group returned to full‐weight bearing significantly earlier than the wire group (P < 0.05). The Harris Hip Score (HHS) significantly increased in both groups over time postoperatively (P < 0.05). The plate group achieved a higher HHS than the wire group, which was statistically significant at 3 months (P < 0.05), whereas it became insignificant at 6 and 12 months postoperatively (P > 0.05). Regarding radiographic assessment, an excellent rate of fracture reduction was proved in 71.79% of the plate group, compared to 45.45% of the wire group, which was statistically significant (P < 0.05). In addition, fracture healing was achieved significantly earlier in the plate group than the wire group (P < 0.05); nevertheless, no statistically significant difference was noted in neck‐shaft angle at the latest follow‐up between the two groups (P > 0.05). At the latest follow‐up, two cases of implant loosening and two cases of coxa varus were found in the plate group, while one case of femoral head necrosis and three cases of coxa varus were revealed by radiographs in the wire group.ConclusionThe cerclage wire has benefits of saving time and operation costs; however, the locking plate has the advantages of improving fracture reduction quality, shortening time to full weight bearing and fracture healing, and improving hip function recovery due to the lateral additional fixations to proximal femoral intramedullary nail for unstable trochanteric fractures.
Rate and Risk Factors of Superior Facet Joint Violation during Cortical Bone Trajectory Screw Placement: A Comparison of Robot‐Assisted Approach with a Conventional Technique
Authors: Le Xiao‐feng , Shi Zhan , Wang Qi‐long , Xu Yun‐feng , Zhao Jing‐wei , Tian Wei 
Published: December 2019

ObjectiveTo compare the incidence and risk factors of superior facet joint violation (FJV) during cortical bone trajectory screw placement in robot‐assisted approach versus conventional technique.MethodsA retrospective study, including 69 patients having cortical bone trajectory (CBT) screw instrumentation for symptomatic degenerated diseases or trauma, was conducted between June 2015 to January 2019. All patients underwent CBT surgery performed by the same team of experienced surgeons. Patients were randomly divided into two groups: a conventional group (CG, 46 cases) and a robot group (RG, 23 cases). The surgical robotic system was used for screw instrumentation in the robot group and the traditional screw instrumentation with fluoroscopic guidance was used in the conventional group. Cortical screws followed a medio‐to‐lateral path in the transverse plane and a caudal‐to‐cephalad path in the sagittal plane. Preoperative and postoperative computed tomography (CT) scans were obtained to determine the degree and incidence of FJV. The violation status of facet joint was evaluated according to the modified classification: grade 0, no violation; grade 1, screw shaft, screw head or rod within 1 mm of or abutting the facet joint, but did not enter the articular facet joint; grade 2, screw shaft, screw head or rod clearly in the facet joint. The following factors that may contribute to the occurrence of FJV were analyzed: age, sex, body mass index (BMI), proximal fusion level, fusion length, the side of screw, preoperative vertebral slip, superior facet angle, and degenerative scoliosis. The chi‐squared test and Student's t‐test were used for analysis of the variables for significance (P < 0.05).ResultsFJV occurred in 41.3% of patients in CG and 17.3% of patients in RG. A chi‐squared analysis revealed a significantly lower rate of FJV for RG compared with CG (P= 0.04). In the CG, 17 of the 109 cephalad screws were grade 1 (15.6%), and five were grade 2 (4.6%). In the RG, three of the 46 cephalad screws were grade 1 (6.5%), and three were grade 2 (6.5%). There was a statistically significant difference in the incidence of FJV between the left and right screw with fluoroscopy‐assisted CBT screw instrumentation (P < 0.05). A significant correlation between scoliosis with the FJV was found in CG (P < 0.05) and in RG (P < 0.05). With regard to superior facet angle, a measurement ≥45° was a significant risk factor of FJV in CG (P < 0.05) and in RG (P < 0.05).ConclusionsA robot‐assisted approach could reduce the incidence of FJV compared with the conventional approach in CBT technique.
Associations between health‐related quality of life and health care costs among children with atopic dermatitis and their caregivers: A cross‐sectional study
Authors: Olsson Maja , Bajpai Ram , Yew Yik Weng , Koh Mark Jean Aan , Thng Steven , Car Josip , Järbrink Krister 
Published: December 2019

AbstractBackground/objectivesAtopic dermatitis is associated with a decreased health‐related quality of life and contributes to substantial health care costs. It is important to understand what accelerates health care costs to inform various stakeholders, so they can effectively meet health care needs. This cross‐sectional study aims to explore associations between health‐related quality of life, health care costs, and cost‐accelerating variables.MethodsInformation on health‐related quality of life (HRQoL) was collected through generic and disease‐specific instruments from caregivers and children <16 years of age with a physician‐confirmed diagnosis of atopic dermatitis. The economic impact of atopic dermatitis was evaluated by analyzing information on health service utilization and other health care costs related to managing the condition.ResultsChildren with high impact on health‐related quality of life presented an annual health care cost of US$ 3787 compared with US$ 2548 for moderately impacted and US$ 2258 among children for which the condition had low impact. The severity of atopic dermatitis, disease duration, and a lower health‐related quality of life was associated with greater health care costs. Analyses of subdomains of health‐related quality of life revealed correlations between “mood” and “personal relationships” on one hand and caregivers’ physical health and health care costs on the other hand.ConclusionsHighly affected HRQoL is associated with increased health care costs and could be a valuable complement to traditional severity assessments. By using HRQoL instruments, burdens and symptoms beyond severity can be identified and addressed with interventions to increase HRQoL and subsequently reduce health care costs.
Characteristics of nonoliguric hyperkalemia in preterm infants: A case‐control study in a single center
Authors: Aoki Kuraaki , Akaba Kazuhiro 
Published: December 2019

AbstractBackgroundPreterm infants often present with hyperkalemia during the first days after birth without showing oliguria. This is known as nonoliguric hyperkalemia (NOHK). As its clinical features have not been completely understood to date, we aimed to elucidate the characteristics of NOHK, including its risk factors, in preterm infants.MethodsFor this case‐control study, we reviewed the files of all infants born before 32 weeks of gestational age in our neonatal intensive care unit between 2011 and 2018. We distinguished the NOHK and non‐NOHK groups and compared their characteristics and blood potassium levels. Nonoliguric hyperkalemia was defined as peak blood potassium concentration of ≥6.0 mmol/L during the first 72 h of life with a urine output of ≥1 mL/kg/h.ResultsOf the 99 infants enrolled, 21 (21%) demonstrated NOHK. Infants with NOHK were more likely to have been exposed to antenatal magnesium sulfate (MgSO4) (P = 0.019) than those in the non‐NOHK group. Acute morbidities and mortality were not statistically different. Multivariate analysis indicated that administration of maternal MgSO4 for longer than 24 h at any point before delivery was a risk factor for NOHK. Its adjusted odds ratio and 95% confidence interval were 4.0 and 1.4–12.3, respectively (P = 0.012).ConclusionsIn this study, maternal MgSO4 administration for longer than 24 h proved to be a risk factor for NOHK in infants born before 32 weeks of gestational age. Infants born to mothers who have received MgSO4 should be regularly monitored for their electrolytes.
Ingenious floral structure drives explosive pollination in Hydrilla verticillata (Hydrocharitaceae)
Authors: Zhang Q. , Fu W.‐L. , Wang X.‐F. , Huang L.‐J. 
Published: December 2019

Abstract

In explosive pollination, many structures and mechanisms have evolved to achieve high‐speed stamen movement. The male flower of the submerged plant Hydrilla verticillata is reported to be able to release pollen explosively some time after leaving the mother plant time, but the mechanism of stamen movement and the related functional structure in this species are unclear.

In this study, we observed the male flower structure and pollen dispersal process of H. verticillata. We analysed the stamen movements during the pollen dispersal process and conducted several controlled experiments to study the process of storage and release of elastic potential energy in explosive pollination.

When the male flower of H. verticillata is bound to the united bracts, the sepals accumulate elastic potential energy through the expansion of basal extensor cells. After the male flower is liberated from the mother plant, the stamens unfold rapidly with the sepals under adhesion and transfer the elastic potential energy to the filament in seconds. Once stamens unfold to a critical angle, at which the elasticity of the filament just exceeds the adhesion between sepals and anthers, the stamens automatically rebound and release pollen in milliseconds.

These results reveal that Catapult‐like stamens, spoon‐shaped sepals and enclosed united bracts in the spathe together constitute the functional structure in rapid stamen movement of H. verticillata. They ensure that the pollen can be released on the water surface, and thus adapt successfully to the pollen‐epihydrophilous pollination.
Immediate response of fish communities and water chemistry to causeway breaching and bridge installation in the Kaouk River estuary, British Columbia, Canada
Authors: Gerwing Travis G. , Plate Elmar , Kidd Jess , Sinclair Jesse , Burns Christopher W. , Johnson Shane , Roias Steven , McCulloch Cameron , Bocking Robert C. 
Published: December 2019

The Kaouk River estuary is located on the northwest coast of Vancouver Island, British Columbia, Canada, in the Treaty Settlement Lands of the Ka:'yu:'k't'h'/Che:k'tles7et'h First Nations. Stretching across the widest point of this estuary is a causeway providing road access to Fair Harbour. This causeway was observed to decrease habitat connectivity throughout the estuary, specifically limiting juvenile salmon access to high‐quality rearing habitat in the tidal marsh. As such, the causeway was breached in 2019 and a bridge was installed. Juvenile salmon were observed using the new connection and were captured both up and downstream of the causeway immediately following breaching. Postbreach water chemistry (dissolved oxygen, pH, salinity, and temperature) near the causeway was recorded within the range of values observed throughout the estuary. Use of the breach by juvenile salmon and homogenized water chemistry indicate the project succeeded in improving habitat connectivity within the Kaouk River estuary and has enhanced juvenile salmon access to 2.7 km2 of wetland rearing habitat.
Role of latitudinal shift and climate change in evolution of red and yellow palaeosols of the Himalayas: Implications for early Oligocene seasonality and Mid‐Miocene enhanced precipitation
Authors: Upreti Neha , Srivastava Pankaj 
Published: December 2019

AbstractCenozoic atmospheric circulation, climatic changes, sedimentation and weathering over the Indian sub‐continent were mainly influenced by the northward drift of the Indian Plate, the shrinking Paratethys, India‐Asia collision and the rise of the Himalayas. This study is aimed at exploring the fluvial sedimentary record of the north‐west part of the Himalayan Foreland Basin to interpret weathering and pedogenesis during early Oligocene to Mid‐Miocene time. Palaeopedological investigation of a 3.1 km thick succession from Kangra sub‐basin of the Himalayan Foreland Basin shows that the lower 2 km part of the succession is characterized by the red (10R hue) and the upper 1.1 km part of the succession by the yellow (2.5Y hue) palaeosols with varying intensity of weathering and pedogenesis. The association of sedimentary rocks and pedogenic expression in palaeosols indicate four (Type‐A to Type‐D) pedofacies in the entire Oligocene–Miocene succession. The pedofacies are defined by a decrease in the intensity of palaeopedogenic development from strongly‐developed palaeopedofeatures in Type‐A, moderately‐developed palaeopedofeatures in Type‐B, weakly‐developed palaeopedofeatures in Type‐C and to the only incipient stage of palaeopedogenesis in Type‐D pedofacies. The palaeolatitudinal shift during the convergence of the Indian Plate played a major role in weathering and palaeopedogenesis with the inception of seasonality during the early Oligocene, which is demonstrated by the formation of the red palaeosols with pedogenic CaCO3 and vertic features in tropical conditions. The transition to yellow palaeosols at about 20 Ma is marked by increased humidity, rapid aggradation, pronounced uplift and enhanced erosion of the hinterland. These yellow palaeosols are characterized by the abundance of weakly‐developed Bw and Bss horizons, pure clay pedofeatures and absence of any pedogenic CaCO3 during short pedogenic intervals in subtropical conditions.
Examining the links between beliefs and institutional emergence
Authors: Dromi Shai M. 
Published: December 2019

AbstractAlthough the study of institutions is one of the longest standing sociological topics, numerous recent studies have revisited questions about the genesis of new institutions and institutional domains. In this review, I argue for increased attention to the role cultural beliefs play in the emergence of new institutions. I highlight three substantive research areas where sociologists have demonstrated a relatively independent causal effect of beliefs on the genesis of new institutions: (a) studies of states and state institutions; (b) studies of emergent markets; and (c) studies of the charitable aid sector. I conclude by highlighting promising avenues for future research on beliefs and institutional emergence.
Students' use of STEM content in design justifications during engineering design‐based STEM integration
Authors: Siverling Emilie A. , Suazo‐Flores Elizabeth , Mathis Corey A. , Moore Tamara J. 
Published: December 2019

AbstractEngineering design‐based STEM integration is one potential model to help students integrate content and practices from all of the STEM disciplines. In this study, we explored the intersection of two aspects of pre‐college STEM education: the integration of the STEM disciplines, and the NGSS practice of engaging in argument from evidence within engineering. Specifically, our research question was: While generating and justifying solutions to engineering design problems in engineering design‐based STEM integration units, what STEM content do elementary and middle school students discuss? We used naturalistic inquiry to analyze student team audio recordings from seven curricular units in order to identify the variety of STEM content present as students justified their design ideas and decisions (i.e., used evidence‐based reasoning). Within the four disciplines, fifteen STEM content categories emerged. Particularly interesting were the science and mathematics categories. All seven student teams used unit‐based science, and five used unit‐based mathematics, to support their design ideas. Five teams also applied science and/or mathematics content that was outside the scope of the units' learning objectives. Our results demonstrate that students integrated content from all four STEM disciplines when justifying engineering design ideas and solutions, thus supporting engineering design‐based STEM integration as a curricular model.
Preservice teachers’ use of mathematics and science learning processes
Authors: Cormas Peter C. , Middlemiss Samantha 
Published: December 2019

AbstractMathematics and science have similar learning processes (SLPs) and it has been proposed that courses focused on these and other similarities promote transfer across disciplines. However, it is not known how the use of these processes in lessons taught to children change throughout a preservice teacher education course or which are most likely to transfer within and between disciplines. Three hundred and ninety lesson plans written by 113 preservice teachers (PSTs) from 10 sections of an elementary mathematics/science methods course were analyzed. PSTs taught an eight‐lesson sequence to children: five science lessons followed by three mathematics lessons. The findings suggested that: (a) PSTs needed to only teach three mathematics lessons, after five science lessons, to reach the same number of SLPs used in the five science lessons; (b) some SLPs are highly correlated processes (HCPs) and are more likely to transfer within and between science and mathematics lessons; and (c) PSTs needed to teach no mathematics lessons, after four science lessons, to reach the same number of HCPs used in the four science lessons. Implications include centering courses on multiple and varied representations of learning processes within problem‐solving, and HCPs may be essential similarities of problem‐solving which promote transfer.
Land suitability evaluation using image processing based on determination of soil texture–structure and soil features
Authors: Mahmoodi‐Eshkaftaki Mahmood , Haghighi Amin , Houshyar Ehsan 
Published: December 2019

AbstractLand evaluation is the process of land performance predictions over time based on land uses and soil features. Traditional methods in determining soil features are proved to be time‐consuming and costly. Therefore, in order to overcome these limitations, a simpler automated method using the image segmentation was developed in this study. The method was designed by integrating dynamic region merging and genetic algorithm. An area index was calculated for each soil profile using the automated method. It was used to present the amount of soil coarse particles and thereupon to determine the rating value of text‐structure. Using the method, the mean intersection over union of above 0.7 was obtained for detecting the coarse particles which confirms its suitability. Data analysis showed that (a) compared to the Storie‐land index (R2 = 0.71), the Square root‐land index was more correlated to the harvest index (R2 = 0.73), and (b) comparing to manual methods, not only the automated text‐structure had a higher correlation with the harvest index (R2 = 0.64) but also it decreased the determination time (>3.75 times). Furthermore, among the models developed by response surface methodology for estimation of soil features, the developed model for estimation of soil lime showed the highest accuracy (R2 = 0.89). In conclusion, since the developed method is more accurate, more economic and faster than the usual manual methods, it can be widely used in land suitability evaluation.
The Academy for Emerging Leaders in Patient Safety: developing a community of practice
Authors: Oates Kim , Burgess Annette , Dalton Sarah , Sammut John , Mayer David 
Published: December 2019

SummaryBackgroundThere is a high incidence of preventable error in health care. Many of these errors are the result of poor teamwork between different health professionals and not listening to the patient voice. We describe changes in attitudes to patient safety from potential future health care leaders who participated in an interactive programme focusing on these attributes.MethodsA total of 87 scholars from medicine, nursing and pharmacy participated in an annual 4‐day intensive programme, repeated over 3 years. Their attitudes about patient safety were measured before and after the programme using the Attitudes to Patients Safety Questionnaire (APSQ3) and qualitative data about their experiences during the course. Data were analysed using descriptive statistics and qualitative measures.ResultsThe majority showed shifts in attitudes, particularly about the value of teamwork, patients being more involved in their own care, the importance of learning about patient safety and the value of self‐care as ways of reducing error. Qualitative data showed that the course was valuable in networking with like‐minded people, having faculty members on site with a flattened hierarchy and being encouraged to promote change in their own workplaces.DiscussionWe showed that an interprofessional immersive course can change the thinking of young clinicians in a way that may be able contribute to improved health care.
‘Know‐Can’ gap: gap between knowledge and skills related to childhood diarrhoea and pneumonia among frontline workers in rural Uttar Pradesh, India
Authors: Ray Saraswati Lopamudra , Baker Margaret , Mishra Ashutosh , Bhandari Prince , Rai Animesh , Mishra Punit , Chandan Ambrish , Crockett Maryanne , Pelly Lorine , Anthony John , Shetye Mrunal , Krotki Karol , Kraemer John 
Published: December 2019

AbstractObjectivesIn India, frontline workers (FLWs) – public accredited social health activists (ASHAs) and private rural medical providers (RMPs) – are important for early detection and treatment of childhood diarrhoea and pneumonia. This cross‐sectional study aims to measure knowledge and skills, and the gap between the two (‘know‐can’ gap), regarding assessment of childhood diarrhoea with dehydration and pneumonia among FLWs, and to explore factors associated with them.MethodsWe surveyed 473 ASHAs and 447 RMPs in six districts of Uttar Pradesh. We assessed knowledge and skills using face‐to‐face interviews and video vignettes, respectively, about key signs of both conditions. The ‘know‐can’ gap corresponds to absent skills among FLWs with correct knowledge. We used logistic regression to identify the correlates of knowledge and skills.ResultsFLWs’ correct knowledge ranged from 23% to 48% for dehydration signs and 27% to 37% for pneumonia signs. Their skills ranged from 3% to 42% for dehydration and 3% to 18% for pneumonia. There was a significant ‘know‐can’ gap in all the signs, except ‘sunken eyes’. Training and supervisory support was associated with better knowledge and skills for diarrhoea with dehydration, but only better knowledge for pneumonia.ConclusionsFLWs are crucial to the Indian health system, and high‐quality FLW services are necessary for continued progress against under‐five deaths. The gap between FLWs’ knowledge and skills warrants immediate attention. In particular, our results suggest that knowledge‐focused trainings are insufficient for FLWs to convert knowledge into appropriate assessment skills.