bluuebunny/crossref_metadata_2025_split huggingface dataset:
Descriptive study of outcome of antibiotic cement-impregnated intramedullary nail in treatment of infected non-union of weight bearing long bones
Authors: Sen Abhijit , Kulkarni Chandan , Meena Ashok 
Published: October 2019

<p class="abstract"><strong>Background: </strong>Infected non-union of tibia and femur is a debilitating disorder for patient as well as challenging task for treating surgeon. Conventionally treatment of infected non-union is a two staged procedure. But antibiotic cement-impregnated intramedullary nailing (ACIINs) is a single staged and cost-effective procedure. Hence we intended to study the outcome of ACIIN use in infected non-union of tibia and femur.</p><p class="abstract"><strong>Methods:</strong> This is a hospital based prospective case series type of descriptive study conducted in Department of Orthopedics, SMS Medical College and Hospital, Jaipur. We studied 35 cases of infected non-union of femur and tibia fracture with interlock nail in situ. All patients were treated with interlock nail removal, debridement and freshening of sclerosed bony ends and fixation with ACIIN. All were followed for at least 6 months for infection control and bony union and final results were evaluated by Paley’s bony criteria and functional criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Infection was controlled in 94.28% cases. Bony union was achieved in 88.57% cases (19 femur and 12 tibia). Average duration for bony union was 7.3 months for femur and 8 months for tibia. According to Paley’s criteria for bony outcome and functional outcome 65.71% and 51.43% had shown excellent outcome respectively.</p><p class="abstract"><strong>Conclusions:</strong> ACIIN is a good modality for treatment of infected non union of tibia and femur in terms of infection control and bony union and has a good functional outcome when bone gap is less.</p>
Locking plate for displaced proximal humerus fractures-outcomes and complications: a prospective study
Authors: Rathod Avinash , Balaji Gopisankar , Patro Dilip 
Published: October 2019

<p class="abstract"><strong>Background:</strong> The management of unstable proximal humerus fractures is controversial as many fixation techniques have evolved over the years claiming to be a better fixation device compared to the other.</p><p class="abstract"><strong>Methods:</strong> 23 patients with closed displaced proximal humerus fractures were included in this study. All patients underwent open reduction and internal fixation with proximal humerus locking plate through either delto-pectoral or deltoid splitting approach. Standard shoulder rehabilitation program was used in all cases. Functional and radiological outcome were assessed at follow-up.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean constant-Murley score achieved at 6 months was 66. Complications were reported in a total of 7 patients including 3 varus malunion, 1 valgus malunion, 2 screw penetration into the joint and 1 nonunion with implant breakage.</p><p class="abstract"><strong>Conclusions:</strong> The proximal humeral locking plate seems to be an adequate device for the fixation of displaced proximal humerus fractures as 83% of our study population had good/moderate functional outcomes.</p><p class="abstract"> </p>
Inhaler Refill Adherence among Patients with COPD/Asthma at a General Hospital in Northern Peninsular Malaysia
Authors: Chern Ang Wei , Mahdzan Mahirah , Mohmad Rashila 
Published: October 2019

Background: Most adherence studies are based on self-report measures. There are limited studies on medication refill adherence (MRA) conducted in Malaysia, especially on bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). The study aimed to investigate the MRA for inhalers with fixed dosing indicated for BA or COPD, prescribed from paediatric and medical clinics in Hospital Tuanku Fauziah and the factors that may affect MRA of COPD/BA inhalers.
Methods: A cross-sectional study was conducted on repeat prescriptions (fixed-dose inhalers dispensed as the units of analysis) collected from 1st January 2015 to 31st December 2015 from the specialist clinic pharmacy. Descriptive analysis was conducted based on satisfactory MRA which was set as the dispensed refill of inhalers covering 80-120% of the prescribed treatment time. Logistic regression analysis was used to explore each variable (diagnosis, gender, ethnicity and age) in relation to MRA: overall satisfactory MRA (≥80% MRA) with undersupply (<80% MRA) as the reference group.
Results: Out of the repeat prescriptions analysed (N=199), the majorities were COPD (N=118; 64.3%), male (N=122; 61.4%), Malay (N=175; 88.0%), and aged 60-69 years old (N=56; 28.3%). 44.5% of repeat prescriptions (N=57) for COPD showed satisfactory MRA, compared to only 25.4% (N=18) in BA. Repeat prescriptions for fluticasone/salmeterol accuhalers showed the highest satisfactory MRA at 18.1% (N=36). Diagnosis, gender and ethnicity did not significantly influence the overall MRA while age marginally influenced the overall MRA.
Conclusion: More than half of the repeat prescriptions for BA and COPD inhalers showed undersupply and oversupply: patients may not be compliant nor using the inhaler correctly.
The role of intra- and interpersonal relations in the process of diagnosis and treatment
Authors: Stanisławska-Kubiak Maia , Warchoł-Biedermann Katarzyna , Skommer Maria , Mojs Ewa , Wójciak Rafał W. 
Published: October 2019

There is an increasing tendency to adopt biopsychosocial approach to teaching how to care for patients. Participation in Balint’s groups is used to train students in communication and building relations with patients. Aim: To identify positive and negative aspects of participation in Balint’s groups, which are a part of compulsory training for students.Methods: 70 medical students, who took part in the study, filled in a questionnaire specifically developed for students participating in Balint’s group. The questionnaire consisted of three open questions. The answers were collected and then analyzed by way of qualitative analysis of text and factorial analysis Results: The results suggest that Balint’s method can be difficult for medical students because they have not practiced building therapeutic relations with patients. Nevertheless, most students benefit from training in terms of personal development, awareness of mechanisms influencing patients – doctor communication and satisfaction with participation in classes. Conclusion: Balint’s Workshops is a useful method of teaching which influences medical student’s self – reflection because they become aware of the necessity of personality development.
Precision in Biostratigraphy: Evidence For a Temporary Flow Reversal in the Central American Seaway During Or After the Oligocene-miocene Transition
Authors: Fraass Andrew J. , Leckie R. Mark , Lowery Christopher M. , DeConto Robert 
Published: October 2019

AbstractThe Oligocene-Miocene Transition (OMT) was a time of significant oceanic, climatic, and biotic change, but there is still a great deal we do not understand about its effects, particularly in terms of ocean circulation. The Central American Seaway (CAS) was an important ocean gateway at this time; recent fully coupled modeling results have suggested a possible temporary reversal of surface flow, from westward to eastward, during the OMT. Such a flow reversal would have altered numerous oceanographic properties and the dispersal of marine taxa. Here, we find a mismatch in the timing of the Atlantic vs. Pacific first appearances of the tropical mixed layer planktic foraminifer Paragloborotalia kugleri, a key zonal marker for the OMT. The first appearance ages for P. kugleri from fourteen ocean drilling sites vary from ∼23.2–23.05 Ma in the Pacific to ∼23.05–22.7 Ma in the Atlantic. Key requirements for including a site in this compilation are: 1) sampling resolution; 2) independent non-biostratigraphic chronology, such as magnetostratigraphy or orbital tuning; and 3) a preference for shore-based biostratigraphic analyses rather than shipboard estimates. Although we explore alternative explanations, we conclude that, given the restricted nature of the CAS gateway, timing of dispersal, and results from previous modeling efforts, CAS flow reversal is the most parsimonious explanation for the delayed first appearance of P. kugleri in the Atlantic relative to the Pacific. We suggest that after originating in the tropical Pacific, P. kugleri was initially blocked from dispersal into the Atlantic by westward surface circulation through the CAS during the latest Oligocene. During the OMT, circulation reversed and Pacific surface water flowed through the CAS into the Atlantic, allowing P. kugleri to disperse into the Atlantic. Previously published ocean-climate simulations suggest that the cause of this reversed flow may be related to the progressive constriction of Tethys and opening of the Drake Passage at the time of the OMT, compounded by a short-lived glaciation event in Antarctica and possible change in meridional temperature gradient and prevailing wind patterns in the tropics.
Zooglider-Based Measurements of Planktonic Foraminifera in the California Current System
Authors: Gaskell Daniel E. , Ohman Mark D. , Hull Pincelli M. 
Published: October 2019

AbstractSpines and rhizopodia play an important role in the feeding behavior, symbiont ecology, shell geochemistry, and density and drag of planktonic foraminifera. However, there are few empirical data on planktonic foraminifera in situ, and these delicate structures are disturbed on capture. Here, we report spine and rhizopod measurements from underwater images obtained in the California Current System near La Jolla, California by Zooglider, a new autonomous zooplankton-sensing glider. Across all observed species, we find that spine length and flexibility correlate with test size and that spines increase the effective prey encounter volume of spinose foraminifera by two to three orders of magnitude. Our data also yielded several novel observations regarding hastigerinid foraminifera (Hastigerinella digitata and Hastigerina pelagica), a group of unusually large planktonic foraminifera that are abundant in our dataset below 250 m. First, the effective encounter volume of hastigerinid foraminifera can be very large: our largest specimen occupies almost 40 cm3 (about the size of a golf ball), while the median specimen occupies 5.3 cm3 (about the size of a cherry). Second, the majority of hastigerinid foraminifera in our dataset have asymmetric bubble capsules, which are most frequently oriented with their bubbles on the upward side of the test, consistent with the hypothesis that the bubble capsule is positively buoyant. Third, 16% of hastigerinid foraminifera in our dataset have dispersed bubble capsules with detached bubbles distributed along the spines and rhizopodia, consistent with a regular source of natural disturbance. Taken together, our observations suggest that hastigerinid foraminifera play a larger role as mesopelagic predators in the California Current System than previously recognized.
Nasopharyngeal carriage, spa types and antibiotic susceptibility profiles of Staphylococcus aureus from healthy children less than 5 years in Eastern Uganda
Authors: Kateete David , Asiimwe Benon B , Mayanja Raymond , Mujuni Brian , Bwanga Freddie , Najjuka Christine F , Källander Karin , Rutebemberwa Elizeus 
Published: October 2019

Abstract
Background:
Staphylococcus aureus carriage is a known risk factor for staphylococcal disease. However, the carriage rates vary by country, demographic group and profession. This study aimed to determine the S. aureus carriage rate in children in Eastern Uganda, and identify S. aureus lineages that cause infection in Uganda.

Methods:
Nasopharyngeal samples from 742 healthy children less than 5 years residing in the Iganga/Mayuge Health & Demographic Surveillance Site in Eastern Uganda were processed for isolation of S. aureus. Antibiotic susceptibility testing based on minimum inhibitory concentrations (MICs) was determined by the BD PhoenixTM system. Genotyping was performed by spa typing.

Results:
The processed samples yielded 144 S. aureus isolates (one per child) therefore, the S. aureus carriage rate in children was 19.4% (144/742). Thirty one percent (45/144) of the isolates were methicillin resistant (MRSA) yielding a carriage rate of 6.1% (45/742). All isolates were susceptible to rifampicin, vancomycin and linezolid. Moreover, all MRSA were susceptible to vancomycin, linezolid and clindamycin. Compared to methicillin susceptible S. aureus (MSSA) isolates (68.8%, 99/144), MRSA isolates were more resistant to non-beta-lactam antimicrobials –trimethoprim/sulfamethoxazole 73.3% (33/45) vs. 27.3% (27/99) [P<0.0001]; erythromycin 75.6% (34/45) vs. 24.2% (24/99) [P<0.0001]; chloramphenicol 60% (27/45) vs. 19.2% (19/99) [P<0.0001]; gentamicin 55.6% (25/45) vs. 25.3% (25/99) [P=0.0004]; and ciprofloxacin 35.6% (16/45) vs. 2% (2/99) [P<0.0001]. Furthermore, 42 MRSA (93.3%) were multidrug resistant (MDR) and one exhibited high-level resistance to mupirocin. Overall, 61 MSSA (61.6%) were MDR, including three mupirocin and clindamycin resistant isolates. Seven spa types were detected in MRSA, of which t037 & t064 were predominant and associated with SCCmec types I & IV, respectively. Fourteen spa types were detected in MSSA, of which t645 & t4353 were predominant.

Conclusions:
S. aureus carriage rate in healthy children in Eastern Uganda is high and comparable to rates for hospitalized patients in Kampala. The detection of mupirocin resistance is worrying as it could rapidly increase if mupirocin is administered in a low-income setting. S. aureus strains of spa types t064, t037 (MRSA) and t645, t4353 (MSSA) are prevalent and could be responsible for majority of staphylococcal infections in Uganda.
Effectiveness of an online self-management tool, OPERAS (an On-demand Program to EmpoweR Active Self-management), for people with rheumatoid arthritis: a research protocol
Authors: Tam Johnathan , Lacaille Diane , Liu-Ambrose Teresa , Shaw Chris D , Xie Hui , Backman Catherine L , Esdaile John M , Miller Kimberly , Petrella Robert , Li Linda C 
Published: October 2019

Abstract
Background. Active self-management is a process where patients are fully engaged in managing their health in daily life by having access to contextualized health data and tailored guidance to support a healthy lifestyle. The current study aims to determine whether an e-health intervention which incorporates symptom/disease activity monitoring and physical activity counselling can improve self-management ability in patients with rheumatoid arthritis (RA). Methods. The Empowering active self-management of arthritis: Raising the bar with OPERAS (an On-demand Program to EmpoweR Active Self-management) project is a randomized controlled trial which uses a delayed control design. 134 participants with RA will be randomized to either start the intervention immediately (Immediate Group) or start 6 months later (Delayed Group). The intervention involves: 1) use of a Fitbit-compatible web app to record and monitor their RA disease activity, symptoms and time spent on physical activity and a Fitbit; 2) group education and individual counselling by a physiotherapist (PT), and 3) 6 phone calls with a PT. The primary outcome measure is self-management ability measured by the Patient Activation Measure. Secondary outcome measures include disease status, fatigue, pain, depressive symptoms, and characteristics of habitual behavior. In addition, time spent in physical activity and sedentary activity with a wearable multi-sensor device (SenseWear Mini). Following the 6-month intervention, we will interview a sample of participants to examine their experiences with the intervention. Discussion. The results of this study will help to determine whether this technology-enhanced self-management intervention improves self-management ability and their health outcomes for people living with RA. A limitation of this study is that participants will need to self-report their symptoms, disease status, and treatment use through questionnaires on the OPERAS web app. The user-friendly interface, reminder emails from the research staff, and tailored guidance from PTs will encourage participants to actively engage with the app. Trial Registration. Date of last update in ClinicalTrials.gov: January 2, 2019 ClinicalTrials.gov Identifier: NCT03404245
Simulation-based education improves student self-efficacy in physiotherapy assessment and management of paediatric patients
Authors: Hough Judith , Levan Daniel , Steele Michael , Kelly Kristine , Dalton Megan 
Published: October 2019

Abstract
Physiotherapy students have limited opportunities to develop competency in paediatric physiotherapy due to the lack of paediatric clinical placements. To address this risk, simulation-based education (SBE) has been proposed as an educational strategy to address the placement shortfall. Despite encouraging evidence for its use in physiotherapy education, there is limited evidence supporting its use specifically in paediatric populations. The aims of this research were to investigate the effect of SBE on student self-efficacy in the physiotherapy assessment and management of paediatric clients, and to determine student satisfaction with SBE as a learning strategy. Three interactive SBE sessions were run during the undergraduate paediatric physiotherapy unit at the campus of one Australian university. Self-efficacy was surveyed before and after each session, to determine confidence in clinical skills, clinical decision-making, treatment preparation and planning, communication skills; evaluating and modifying interventions, and interprofessional practice. Student satisfaction with SBE as a learning strategy was surveyed after the final SBE session. For the 164 participants included in this study, self-efficacy survey response rate varied from 77-96% for each session. Significant increases in mean student self-efficacy were recorded for all questions (p<0.001). A total of 139 (85%) responded to the learning reactionnaire with 78.6% indicating they were very satisfied with SBE as a learning strategy. Written comments from 41 participants identified ‘experience’ as the primary theme.
Conclusion: SBE had a significant positive effect on student self-efficacy in the physiotherapy assessment and management of paediatric patients. Students also perceived SBE to be a valuable learning experience. Future research is needed to investigate whether the improvement in self-efficacy achieved through SBE translates into improved student performance during workplace-based clinical placements.
A longitudinal study assessing differences in causes of death among housed and homeless people diagnosed with HIV in San Francisco
Authors: Hessol Nancy Ann , Eng Monica , Vu Annie , Pipkin Sharon , Hsu Ling C. , Scheer Susan 
Published: October 2019

Abstract
Background: San Francisco has implemented several programs addressing the needs of two large vulnerable populations: people living with HIV and those who are homeless. Assessment of these programs on health outcomes is paramount for reducing preventable deaths.
Methods: Individuals diagnosed with HIV/AIDS and reported to the San Francisco Department of Public Health HIV surveillance registry, ages 13 years or older, who resided in San Francisco at the time of diagnosis, and who died between January 1, 2002, and December 31, 2016 were included in this longitudinal study. The primary independent variable was housing status, dichotomized as ever homeless since diagnosed with HIV, and the dependent variables were disease-specific causes of death, as noted on the death certificate. The Cochran-Armitage test measured changes in the mortality rates over time and unadjusted and adjusted Poisson regression models measured prevalence ratios (PR) and 95% confidence intervals (CI) for causes of death.
Results: A total of 4158 deceased individuals were included in the analyses: the majority were male (87%), ages 40-59 years old at the time of death (64%), non-Hispanic White (60%), men who have sex with men (54%), had an AIDS diagnosis prior to death (87%), and San Francisco residents at the time of death (63%). Compared to those who were housed, those who were homeless were more likely to be younger at time of death, African American, have a history of injecting drugs, female or transgender, and were living below the poverty level (all p values < 0.0001). Among decedents who were SF residents at the time of death, there were declines in the proportion of deaths due to AIDS-defining conditions (p<0.05) and increases in accidents, cardiomyopathy, heart disease, ischemic disease, non-AIDS cancers, and drug overdoses (p<0.05). After adjustment, deaths due to mental disorders (aPR=1.63, 95% CI 1.24, 2.14) were more likely and deaths due to non-AIDS cancers (aPR=0.63, 95% CI 0.44, 0.89) were less likely among those experiencing homelessness.
Conclusions: Additional efforts are needed to improve mental health services to homeless people with HIV and prevent mental-health related mortality.
Levetiracetam induction of theta frequency oscillations in rodent hippocampus in vitro
Authors: Xing Hang , Xu Sihan , Xie Xin'e , Wang Yuan , Lu Cheng Biao , Han Xiong 
Published: October 2019

Abstract
Background Levetiracetam (LEV), an antiepileptic drug, has been recently demonstrated to improve the cognitive function. Hippocampal theta rhythm (4–12 Hz) is associated with a variety of cognitively related behaviors, such as exploration, locomotion and spatial memory in both humans and animal models. We investigated the effects of LEV on the theta rhythm in the rat hippocampal CA3 area. Results We found that LEV increased the power of theta oscillation in a dose-dependent manner. The increase in theta power can be blocked by GABAA receptor or NMDA receptor antagonists but not by AMPA receptor antagonist, indicating the involvement of GABAA receptor and NMDA receptor in the induction of theta activity. Interestingly, LEV enhancement of theta power can be also blocked by taurine or THIP, indicating that LEV induction of theta may be related to the indirect boosting of GABA action via reduction of extrasynaptic GABAA receptor activation. Furthermore, the increased theta power can be partially reduced by mACh receptor antagonist atropine but not by nACh receptor antagonists, suggesting that mACh receptor activation provides excitatory input into local network responsible for LEV induction of theta. Conclusions Our study demonstrated that induction of a synchronized network oscillation, a novel role of LEV may especially benefit for the treatment of the neuronal disorders with impaired theta oscillation and cognitive function.