bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indigenous Preferences for Inpatient Rooms in Australian Hospitals: A Mixed-Methods Study in Cross-Cultural Design
Authors: Nash Daphne , O’Rourke Timothy , Memmott Paul , Haynes Michele 
Published: May 2020

Aim: This mixed-method study aimed to establish preliminary evidence for spatial and design features that can improve the experience and participation of Indigenous inpatients in healthcare. Background: Disadvantaged across a range of health measures, a disproportionately high number of Indigenous people leave hospital without receiving appropriate medical care. Australian government policies to improve cultural safety of Indigenous patients have largely ignored physical settings and their potential to improve health outcomes. Despite increasing evidence on the potential of design to reduce patient stress, there is minimal research on cross-cultural design in health facilities, including for Indigenous Australians. Methods: A cross-sectional, area-based survey elicited design preferences of four healthcare settings from Indigenous participants ( n = 602). On the screen-based survey, participants selected from paired images that indicated their preferences for room layout and features of inpatient rooms. Semistructured in-depth interviews ( n = 55) explored meanings behind preferences. Results: Participants showed majority preferences for the two-bed patient room, for a balcony rather than a window only, Indigenous art, and view of a park over an urban environment. Analysis of qualitative data shifted the focus from Ulrich’s three supportive design components to cultural recognition, the desire for company of family members, and connection to life outdoors. Conclusions: Social and cultural factors were highly significant to patients for sense of control, family support, and positive distraction. In response, inpatient room size and type, views, access to outdoors and Indigenous art need to be considered in hospital design for Indigenous patients and families.
Risk Factors Influencing the Incidence of Ankle Sprain Among Elite Football and Basketball Players: A Prospective Study
Authors: Pourgharib Shahi Mohammad Hosein , Selk Ghaffari Maryam , Mansournia Mohammad Ali , Halabchi Farzin 
Published: May 2020

Introduction. The objective of the present study was to investigate whether certain intrinsic factors (foot hyperpronation, generalized joint laxity) and clinical tests (anterior drawer and talar tilt tests, single-leg balance test and star excursion balance test, ankle and first metatarsophalangeal range of motion) could predict the incidence of lateral ankle sprains among elite football and basketball players during a full year. Method. In a prospective cohort study, 106 elite basketball and football players were recruited. During the preseason period, players underwent baseline measurements. Team physicians in following year reported occurrence of new ankle sprains. Results. Ankle sprain was more frequent among basketball players ( P = .01). The history of recurrent ( P = .001) and acute ankle sprain ( P = .01) and each 5-year increase in age ( P = .039) were predictive factors for ankle sprain. No evidence for relationship between other risk factors and occurrence of ankle sprain were achieved. Conclusion. In our study, the history of recurrent and acute ankle sprain was the strongest predictor for ankle injuries. Considering the limitations of this study, it seems mandatory to conduct more prospective studies with a larger sample size and longer follow-up period. Levels of Evidence: Level II: Prognostic
Teaching Training and Surgical Education in Minimally Invasive Surgery (MIS) of the Spine: What Are the Best Teaching and Learning Strategies for MIS? Do We Have Any Experience and Data?
Authors: Falavigna Asdrubal , Guiroy Alfredo , Taboada Néstor 
Published: May 2020

Study Design: Literature review and transversal study. Objective: Advances in new technologies give the surgeons confidence to manage complex spine conditions with a lower morbidity rate. This has changed the expectations of patients and medical payers and foreshadows the shift now underway: the use of minimally invasive techniques. The ethical considerations of learning directly on patients require a change in the education and training programs. Methods: The education paradigm has changed, and surgical training on minimally invasive surgery of the spine (MISS) techniques should follow a “curriculum.” The assessment of skill proficiency while learning the MISS techniques must be measurable to objectively show the performance gained over time and the changes that should be performed during training. Different strategies include “ex vivo” and “in vivo” training. Results: We have worked on a curriculum in which the participants can perceive the growth in their knowledge through the different educational opportunities. There are 3 levels: basic, advanced, and masters. Conclusions: We developed an educational curriculum for MISS rationale and techniques, that showed to be effective and interesting in our region.
Robotic Spine Surgery: Current State in Minimally Invasive Surgery
Authors: Vo Chau D. , Jiang Bowen , Azad Tej D. , Crawford Neil R. , Bydon Ali , Theodore Nicholas 
Published: May 2020

Study Design: Narrative review. Objectives: Robotic systems in spinal surgery may offer potential benefits for both patients and surgeons. In this article, the authors explore the future prospects and current limitations of robotic systems in minimally invasive spine surgery. Methods: We describe recent developments in robotic spine surgery and minimally invasive spine surgery. Institutional review board approval was not needed. Results: Although robotic application in spine surgery has been gradual, the past decade has seen the arrival of several novel robotic systems for spinal procedures, suggesting the evolution of technology capable of augmenting surgical ability. Conclusion: Spine surgery is well positioned to benefit from robotic assistance and automation. Paired with enhanced navigation technologies, robotic systems have tremendous potential to supplement the skills of spine surgeons, improving patient safety and outcomes while limiting complications and costs.
The Endoscopic Approach to Lumbar Discectomy, Fusion, and Enhanced Recovery: A Review
Authors: Liounakos Jason I. , Wang Michael Y. 
Published: May 2020

Study Design: Review. Objectives: To review the current state of endoscopic spine surgery with regard to discectomy, interbody fusion, and combination with Enhanced Recovery After Surgery programs in order to evaluate its relevance to the future of spine care. Methods: A review of the literature and expert opinion is used to accomplish the objectives. Results: The greatest strength of endoscopic spine surgery lies in its adherence to the basic tenets of minimally invasive surgery and its innate compatibility with Enhanced Recovery After Surgery programs, which aim to improve outcomes and reduce health care costs. The greatest challenge faced is the unique surgical skill set and significant learning curve. Conclusions: Endoscopic spine surgery strives to achieve the core goals of minimally invasive surgery, while reducing cost and enhancing quality. In a healthcare market that is becoming increasingly burdened by cost and regulatory constraints, the utilization of endoscopy may become more widespread in the coming years.
Exports of Spanish manufacturing firms and financial constraints
Authors: Máñez Juan A. , Vicente-Chirivella Óscar 
Published: May 2020

We investigate the role of financial constraints on firms’ exporting behavior, including firms’ export decision, export intensity, firms starting to export decision, and exports persistence. Our financial constraints variable is a synthetic variable that summarizes information on different dimensions such as total assets, profitability, liquidity, solvency, repaying ability, and (new in this type of analyses) the cost of external financing. Using data on Spanish manufacturing for the period 1992–2014, we find evidence supporting that financial health is relevant to explain small and medium-sized enterprises (SMEs) exporting decisions and starting to export decisions but not those of large firms. Financial health does not seem to affect large firms’ export intensity and the results of the impact of financial health on SMEs export intensity are not conclusive. Nevertheless, financial health is a determinant of export persistence of large firms and SMEs. JEL CLASSIFICATION: F14; G32; L60; C35
Prediction of Wind Erosion over a Heritage Site: A Case Study of Yongling Mausoleum, China
Authors: Wang Xiaoyu , Meng Jinzhu , Zhu Tianwei , Zhang Jingyu 
Published: May 2020

AbstractTo protect heritage buildings better, a method exploiting computational fluid dynamics (CFD) was developed for the analysis of wind erosion at a heritage site. Over a two-year period, we collected measurements of hourly weather data at Xinbin County to obtain statistics of wind speeds and directions for the Yongling Mausoleum. Subsequent results from CFD simulations show that before greening, with wind speeds reaching 10 m/s, certain structures (southwest-facing corners, doors and windows on open sides, places where swirling winds develop, and eaves of sloping roofs) of four heritage buildings were eroded more severely. With appropriate greening, plants may exert their unique ecological presence to better protect heritage buildings and their historical environments. After greening, the severity of damage to these vulnerable structures by wind was reduced. With wind speeds reaching 10 m/s, the average pressure on the structures of each building was 0.41–27.85 Pa, representing a reduction of 2.4%–75.6% from pressures before greening. We also constructed a 1:500-scale model to verify in experiments the correctness of CFD simulation qualitatively. The CFD simulations were found to provide an effective method to investigate and predict wind erosion of the heritage site.
Negotiating Contestations for Community-Oriented Heritage Management: A Case Study of Loushang in China
Authors: Zhao Xiaomei 
Published: May 2020

AbstractRural heritage is a living heritage of significant importance; it requires community-oriented management for cultural continuity and local development. Different social relations exist at rural heritage sites, which lead to external contestation among stakeholders and internal contestation within the community. It is essential to identify the impact caused by such contestations and determine an appropriate way to negotiate solutions. This paper examines the case of Loushang in Guizhou Province, identifying the contestations by examining the social relations through questionnaires and semi-structured interviews. Negotiation requires an appropriate person or social group to act as intermediary: they engage the stakeholders and induce them to collaborate; they also empower the community in heritage management. The case of Loushang indicates the tools that are necessary to facilitate community-oriented management for rural heritage; it bridges theoretical research and heritage practice.
Complete chloroplast genomes of four Physalis species (Solanaceae): lights into genome structure, comparative analysis, and phylogenetic relationships
Authors: Feng Shangguo , Zheng Kaixin , Jiao Kaili , Cai Yuchen , Chen Chuanlan , Mao Yanyan , Wang Lingyan , Zhan Xiaori , Ying Qicai , Wang Huizhong 
Published: May 2020

AbstractBackgroundPhysalisL. is a genus of herbaceous plants of the family Solanaceae, which has important medicinal, edible, and ornamental values. The morphological characteristics ofPhysalisspecies are similar, and it is difficult to rapidly and accurately distinguish them based only on morphological characteristics. At present, the species classification and phylogeny ofPhysalisare still controversial. In this study, the complete chloroplast (cp) genomes of fourPhysalisspecies (Physalis angulata,P. alkekengivar.franchetii,P. minimaandP. pubescens) were sequenced, and the first comprehensive cp genome analysis ofPhysaliswas performed, which included the previously published cp genome sequence ofPhysalis peruviana.ResultsThePhysaliscp genomes exhibited typical quadripartite and circular structures, and were relatively conserved in their structure and gene synteny. However, thePhysaliscp genomes showed obvious variations at four regional boundaries, especially those of the inverted repeat and the large single-copy regions. The cp genomes’ lengths ranged from 156,578 bp to 157,007 bp. A total of 114 different genes, 80 protein-coding genes, 30 tRNA genes, and 4 rRNA genes, were observed in four new sequencedPhysaliscp genomes. Differences in repeat sequences and simple sequence repeats were detected among thePhysaliscp genomes. Phylogenetic relationships among 36 species of 11 genera of Solanaceae based on their cp genomes placedPhysalisin the middle and upper part of the phylogenetic tree, with a monophyletic evolution having a 100% bootstrap value.ConclusionOur results enrich the data on the cp genomes of the genusPhysalis. The availability of these cp genomes will provide abundant information for further species identification, increase the taxonomic and phylogenetic resolution ofPhysalis, and assist in the investigation and utilization ofPhysalisplants.
Molecular delimitation of European leafy liverworts of the genus Calypogeia based on plastid super-barcodes
Authors: Ślipiko Monika , Myszczyński Kamil , Buczkowska Katarzyna , Bączkiewicz Alina , Szczecińska Monika , Sawicki Jakub 
Published: May 2020

AbstractBackgroundMolecular research revealed that some of the EuropeanCalypogeiaspecies described on the basis of morphological criteria are genetically heterogeneous and, in fact, are species complexes. DNA barcoding is already commonly used for correct identification of difficult to determine species, to disclose cryptic species, or detecting new taxa. Among liverworts, some DNA fragments, recommend as universal plant DNA barcodes, cause problems in amplification. Super-barcoding based on genomic data, makes new opportunities in a species identification.ResultsOn the basis of 22 individuals, representing 10Calypogeiaspecies, plastid genome was tested as a super-barcode. It is not effective in 100%, nonetheless its success of species discrimination (95.45%) is still conspicuous. It is not excluded that the above outcome may have been upset by cryptic speciation inC. suecica, as our results indicate. Having the sequences of entire plastomes of EuropeanCalypogeiaspecies, we also discovered that thendhBandndhHgenes and thetrnT-trnLspacer identify species in 100%.ConclusionsThis study shows that even if a super-barcoding is not effective in 100%, this method does not close the door to a traditional single- or multi-locus barcoding. Moreover, it avoids many complication resulting from the need to amplify selected DNA fragments. It seems that a good solution for species discrimination is a development of so-called “specific barcodes” for a given taxonomic group, based on plastome data.
Infraclavicular nerve block reduces postoperative pain after distal radial fracture fixation: a randomized controlled trial
Authors: Wong Stanley S. , Chan Wing S. , Fang Christian , Chan Chi W. , Lau Tak W. , Leung Frankie , Cheung Chi W. 
Published: May 2020

Abstract
Background
It is unclear whether regional anesthesia with infraclavicular nerve block or general anesthesia provides better postoperative analgesia after distal radial fracture fixation, especially when combined with regular postoperative analgesic medications. The aim of this study was to compare the postoperative analgesic effects of regional versus general anesthesia.

Methods
In this prospective, observer blinded, randomized controlled trial, 52 patients undergoing distal radial fracture fixation received either general anesthesia (n = 26) or regional anesthesia (infraclavicular nerve block, n = 26). Numerical rating scale pain scores, analgesic consumption, patient satisfaction, adverse effects, upper limb functional scores (Patient-Rated Wrist Evaluation, QuickDASH), health related quality of life (SF12v2), and psychological status were evaluated after surgery.

Result
Regional anesthesia was associated with significantly lower pain scores both at rest and with movement on arrival to the post-anesthetic care unit; and at 1, 2, 24 and 48 h after surgery (p ≤ 0.001 at rest and with movement). Morphine consumption in the post-anesthetic care unit was significantly lower in the regional anesthesia group (p<0.001). There were no differences in oral analgesic consumption. Regional anesthesia was associated with lower incidences of nausea (p = 0.004), and vomiting (p = 0.050). Patient satisfaction was higher in the regional anesthesia group (p = 0.003). There were no long-term differences in pain scores and other patient outcomes.

Conclusion
Regional anesthesia with ultrasound guided infraclavicular nerve block was associated with better acute pain relief after distal radial fracture fixation, and may be preferred over general anesthesia.

Trial registration
Before subject enrollment, the study was registered at ClinicalTrials.gov (NCT03048214) on 9th February 2017.
End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit
Authors: Bobillo-Perez Sara , Segura Susana , Girona-Alarcon Monica , Felipe Aida , Balaguer Monica , Hernandez-Platero Lluisa , Sole-Ribalta Anna , Guitart Carmina , Jordan Iolanda , Cambra Francisco Jose 
Published: May 2020

AbstractBackgroundThe purpose of this paper is to describe how end-of-life care is managed when life-support limitation is decided in a Pediatric Intensive Care Unit and to analyze the influence of the further development of the Palliative Care Unit.MethodsA 15-year retrospective study of children who died after life-support limitation was initiated in a pediatric intensive care unit. Patients were divided into two groups, pre- and post-palliative care unit development. Epidemiological and clinical data, the decision-making process, and the approach were analyzed. Data was obtained from patient medical records.ResultsOne hundred seventy-five patients were included. The main reason for admission was respiratory failure (86/175). A previous pathology was present in 152 patients (61/152 were neurological issues). The medical team and family participated together in the decision-making in 145 cases (82.8%). The family made the request in 10 cases (9 vs. 1,p = 0.019). Withdrawal was the main life-support limitation (113/175), followed by withholding life-sustaining treatments (37/175). Withdrawal was more frequent in the post-palliative group (57.4% vs. 74.3%,p = 0.031). In absolute numbers, respiratory support was the main type of support withdrawn.ConclusionsThe main cause of life-support limitation was the unfavourable evolution of the underlying pathology. Families were involved in the decision-making process in a high percentage of the cases. The development of the Palliative Care Unit changed life-support limitation in our unit, with differences detected in the type of patient and in the strategy used. Increased confidence among intensivists when providing end-of-life care, and the availability of a Palliative Care Unit may contribute to improvements in the quality of end-of-life care.
Efficacy of tubing technique with biomaterials compared to direct coaptation technique after peripheral neurotmesis in nerve healing and return to functionality in young adult rats: a systematic review protocol
Authors: Brito Ana Camila Nobre de Lacerda , Santos Sara Emanuely Veríssimo , Martins Wilayane Alves , Queiroz Paulo César da Silva , Sougey Wenddy Wyllie Damascena , Alves Paula Ketilly Nascimento , Ribeiro Kalline Lourenço , de Oliveira Maria Danielly Lima , de Moraes Sílvia Regina Arruda 
Published: May 2020

Abstract
Background
Peripheral nerves are constant targets of traumatic injury which may result in neurotmesis and which invariably requires surgical treatment. In view of this, tissue engineering studies developed biomaterials which were first tested in animal models and used as a guide for nerve stumps in the procedure in order to speed up the healing process. Therefore, the aim of this study is to evaluate the efficacy of biomaterials used in tubing technique on healing and histological and functional recovery after peripheral nerve neurotmesis in rats.

Methods
We will search PubMed/MEDLINE, Embase, Web of Science, LILACS, and CENTRAL (from inception onwards). Grey literature will be identified through searching dissertation databases, guidelines, policy documents, and reports. We will include randomized and non-randomized trials conducted in young adult rats with peripheral neurometsis undergoing surgical repair through tubing technique with biomaterials. Primary outcomes will be histomorphometry, immunohistochemistry of the nerve tissue, and sciatic functional index. Secondary outcome will be nerve macroscopic evaluation. Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The methodological quality (or risk of bias) of individual studies will be appraised using an appropriate tool. If feasible, we will conduct random effects meta-analysis.

Discussion
This systematic review of animal studies will identify, evaluate, and synthetize the evidence on the the efficacy of tubing technique with biomaterials compared to direct coaptation technique after peripheral neurotmesis in nerve healing and return to functionality.

Systematic review registration
PROSPERO CRD42018106042.