bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correction of Posttraumatic Medial Growth Arrest of the Distal Tibia in Adolescents
Authors: Kotlarsky Pavel , Abu Dalu Khaled , Eidelman Mark 
Published: December 2021

Background Partial growth arrest of the medial part of the distal tibial physis following fractures that penetrated the epiphysis is relatively common. We present the results of treatment, based on a protocol of supramalleolar tibial and fibular osteotomy for ankle alignment correction, and contralateral epiphysiodesis of distal tibia and fibula to balance leg length discrepancy (LLD). Methods This case series study describes the results of 7 patients with a median age of 14 years (range = 10-15 years) who were operated in our institution. All were treated by closed or open reduction and internal fixation after Salter-Harris (SH) types 3 and 4 fractures of the distal tibia. All patients had a partial medial growth arrest, distal tibial varus, relative overlengthening of the distal fibula, and slight leg shortening. Treatment Protocol Contralateral distal tibial and fibular epiphysiodesis to prevent significant LLD, completion of closure of the ipsilateral epiphysis, supramalleolar osteotomy of the distal tibia and fibula, and insertion of a triangular wedge cortical allograft into the tibial osteotomy creating a normal ankle joint orientation. The osteotomy was supported by a medial anatomically contoured locking plate. The fibula was fixed with an intramedullary wire. Results All patients had uneventful healing of the osteotomy after 6 weeks. At the latest follow-up (mean 3 years, range 1.5-5 years), 6 out of 7 patients reached maturity, and the lateral distal tibial angle was within normal limits. The LLD in all patients was less than 8 mm. Conclusions Our protocol provides anatomic correction with the restoration of the ankle joint and prevents the progression of LLD. Levels of Evidence: Level IV
The ‘Maxillary Pull-through’ Technique: A Minimally Invasive Endoscopic-Assisted Approach to Nasal Septum Neoformations with Maxillary Bone Infiltration
Authors: Priore Paolo , Giovannetti Filippo , Battisti Andrea , Di Giorgio Danilo , Della Monaca Marco , Raponi Ingrid , Cassoni Andrea , Valentini Valentino 
Published: December 2021

Study Design Description and validation of a surgical technique. Objective En-bloc maxillectomy with removal of the nasal septum is a rare procedure; preservation of the nasal bones and integrity of the alveolar ridge is even rarer. These procedures traditionally required a combined transfacial-transoral approach based on lateral rhinotomy. We describe a combined endoscopic transnasal-transoral approach for treatment of nasal septal malignancies that involve the hard palate. Methods Excision of malignant tumours arising from the nasal septum was achieved in 4 patients using a transnasal-transoral endoscopic approach. Using 4-mm optics angled at 0° and 30°, the septum was freed from the ethmoid and removed en-bloc with the hard palate, by pulling the septum down through the hard palate. Results Of the 4 patients, 2 underwent complete removal of septal chondrosarcomas, one removal of a sinonasal undifferentiated carcinoma and one removal of a mucoepidermoid carcinoma. In two cases, the palatal mucosa was spared and repositioned to restore separation between the nose and oral cavity. The remaining two cases underwent complete resection of the hard palate; one palate was reconstructed using a pedicled temporalis muscle flap and the other by employing an obturator. No infection was encountered. Partial ethmoidectomy was performed in all four cases. The mean hospital stay was 5 days. All patients are free of disease after a mean follow-up of 4 years (range: 2–7 years). Conclusions Our new approach allows for minimally invasive resection of nasal septal malignancies that extend to the palate. Our maxillary pull-through technique is a valuable new surgical procedure for malignant pathologies of the nasal septum; the only drawback is that endoscopic surgery has a steep learning curve.
Association between health insurance enrolment and maternal health care service utilization among women in Ethiopia
Authors: Seid Abdu , Ahmed Mohammed 
Published: December 2021

Abstract
Background
Health insurance was considered as the third global health transition which can increase access to health care services by eliminating monetary obstacles to maternal health care use, particularly in emerging nations. Hence, this study aimed to assess the association between health insurance enrolment and maternal health care service utilization among women in Ethiopia.

Methods
A cross-sectional study was conducted using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set. About 4278 mothers who had delivered at least one child in the last five years of the survey were selected in the study. Multivariate logistic regression analysis was performed to measure the relationship between health insurance enrolment and maternal health care service utilization by controlling confounders An adjusted odds ratio with a 95% confidence interval and p-values < 0.05 were well-thought-out to state the imperative association.

Results
The overall health insurance coverage among the women was 4.7%. About, 18.1% of women from households in the poorest wealth quantile had no health insurance coverage for maternal health care services. Moreover, 84% of women lived in a rural area did not enclose by health insurance. According to multivariate logistic regression, the likelihoods of ANC utilization were 1.54 times (AOR: 1.54; 95% CI: 1.06–2.25) higher among mothers who were enrolled in health insurance compared to their counterparts. In the same vein, the likelihoods of been attended by a skilled birth attendant were 1.84 times (AOR: 1.84; 95% CI: 1.1–3.08) higher among mothers who were enrolled in health insurance.

Conclusions
This study has shown that women enrolled in health insurance were associated with skilled delivery and recommended ANC utilization than women who did not enroll in health insurance. Health insurance enrolment enterprises must be available to all pregnant women, particularly those of poorer socioeconomic rank.
Anterior intrapelvic approach and suprapectineal quadrilateral surface plate for acetabular fractures with anterior involvement: a retrospective study of 34 patients
Authors: Ciolli Gianluca , De Mauro Domenico , Rovere Giuseppe , Smakaj Amarildo , Marino Silvia , Are Lorenzo , El Ezzo Omar , Liuzza Francesco 
Published: December 2021

Abstract
Background
The purpose of the study is to evaluate the use of the suprapectineal quadrilateral surface (QLS) plates associated with the anterior intrapelvic approach (AIP) to the acetabulum in the surgical treatment of acetabular fractures with anterior involvement.

Methods
We did a retrospective study of patients surgically treated with QLS plates and AIP for acetabular fractures with the involvement of the anterior column, between February 2018 and February 2020, in our Hospital. The following data were recorded: mechanism of injury, the pattern of fracture, presence of other associated injuries, the time before performing the surgery, surgical approach, position on operating table, time of surgery, intraoperative bleeding, hospitalization time, intraoperative and postoperative complications. Follow-ups were performed at 1, 3, 6, 12 months, then annually. The clinical-functional outcome was assessed with the Merle d’Aubigne Postel score (MAP) modified by Matta; while the radiological outcome with the Matta Radiological Scoring System (MRSS). A Chi-square test was utilized to examine associations between parametric variables.

Results
We included 34 patients, mean age 62.1, with an average follow-up of 20.7 months. The most frequent traumatic mechanism was road trauma. There were 15 isolated anterior columns and 19 associated patterns. There were 5 cases of associated visceral injuries, and 10 cases of other associated skeletal fractures. All patients were in the supine position. The surgical approach used was the AIP in all cases, with the addition of the first window of the ilioinguinal approach in 16 cases and of the Kocher-Langenbeck approach in 2 cases. The average time before performing the surgery was 8.5 days. The mean time of the surgery and the mean length of stay after surgery were 227.9 min and 8.2 days, respectively. There weren’t cases of intra-operative complications, while there were postoperative complications in 5 patients. The MRSS was judged anatomical in 26 cases, imperfect in 7 cases and poor in 1 case. The average MAP value was 15.2. We observed a significant relationship between the radiological outcome and the clinical outcome (p < 0.05).

Conclusions
The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement.
Designing a resilience model for pharmaceutical supply chain during crises: a grounded theory approach
Authors: Bastani Peivand , Sadeghkhani Omid , Ravangard Ramin , Rezaei Rita , Bikine Parisa , Mehralian Gholamhossein 
Published: December 2021

Abstract
Background
During disasters or crises, the traditional models of supply chain encounter failure and skewedness under the inevitable and unknown pressures. The procurement and transformation of required equipment to the involved areas is considered as one of the main triggers of decreasing damages and losses during crisis. In this regard, a breakdown in pharmaceutical supply chain can lead to intensive, undesired consequences.

Methods
This was a qualitative study applying a grounded theory approach. The study was conducted with attending of 32 informant participants who were qualified in supply chain during natural disasters and crisis. In order to collect the data, deep semi-structured interviews were applied along with investigating the documents, observation, field notes and theoretical memos. For data analysis, a continuous comparison was used according to Corbin and Strauss method.

Results
Results of the study were categorized in 8 main categories as the main themes. “Wasting” appeared as the main factor of the resilience of pharmaceutical and consumable medical equipment supply chain. Wasting included two subthemes of loss of resources and wasting time.

Conclusion
In order to make resilience in pharmaceutical and consumable medical equipment during disasters, it is necessary to reinforce the various dimensions of the resilience model to increase the rate of supply chain responsiveness. This study particularly contributes to broadening and deepening our understanding of how to mitigate the risk of undesirable outcomes of pharmaceutical supply chain during the disasters or crises.
Leptomeningeal metastasis from melanoma emulating chronic subdural hematoma: a case report
Authors: Yadav Pawan , Mangal Govind , Bhaumik Uday , Agarwal Sanjeev , Thakor Poojan , Lakhanpal Vaibhav 
Published: December 2021

Abstract
Background
Melanoma is a disease in which the patient doesn’t know about the primary lesion, and it has a propensity to metastases to any organ in the human body. Amongst melanoma, leptomeningeal metastasis has the least incidence.

Case presentation
In this case, we report a 56-year-old lady presenting with headache, recurrent vomiting and slurring of speech which on imaging was suggestive of chronic subdural hematoma which had led to surgical preparation but upon further examination, and radioimaging was found to be leptomeningeal metastasis from melanoma for which systemic therapy was started.

Conclusions
The concern is vigilance that is much needed in any case presenting in emergency. When the diagnosis is chronic subdural hematoma, it is followed by surgical treatment which is not done for leptomeningeal metastasis.
Earthen architecture in the Iberian Peninsula: a portrait of vulnerability, sustainability and conservation
Authors: Mileto Camilla , López-Manzanares Fernando Vegas , Cristini Valentina , Soriano Lidía García 
Published: December 2021

AbstractFor more than a decade, a wide range of Spanish case studies, relating especially to rural inner or abandoned sites and areas, have been analysed by the authors as part of different research projects linked with traditional and monumental architecture, conservation strategies and earthen buildings. On one hand the studies have been undertaken in the framework of a project concerning the conservation of rammed earth in the Iberian Peninsula, including criteria, techniques, results and perspectives and, on the other, by a project about the conservation and rehabilitation of traditional earthen architecture in the Iberian Peninsula, providing guidelines and tools for its sustainable intervention. In all cases the researchers’ efforts focused on enhancing new perspectives and opportunities for rural earthen buildings, analysing landscapes, contexts, constructive features, decay and problems. The final common aim of this research is to stress these crucial topics to improve tangible or intangible opportunities for conservation strategies.
GCM2Variants in Familial and Multiglandular Primary Hyperparathyroidism
Authors: Vincze Sarah , Peters Nicholas V , Kuo Chia-Ling , Brown Taylor C , Korah Reju , Murtha Timothy D , Bellizzi Justin , Riccardi Aaliyah , Parham Kourosh , Carling Tobias , Costa-Guda Jessica , Arnold Andrew 
Published: December 2021

AbstractContextMultiglandular and familial parathyroid disease constitute important fractions of primary hyperparathyroidism (PHPT). Germline missense variants of GCM2, a regulator of parathyroid development, were observed in familial isolated hyperparathyroidism and sporadic PHPT. However, as these previously reported GCM2 variants occur at relatively high frequencies in the population, understanding their potential clinical utility will require both additional penetrance data and functional evidence relevant to tumorigenicity.ObjectiveDetermine the frequency of GCM2 variants of interest among patients with sporadic multigland or familial parathyroid disease and assess their penetrance.Design and PatientsDNA-encoding PHPT-associated GCM2 germline variants were polymerase chain reaction–amplified and sequenced from 107 patients with either sporadic multigland or suspected/confirmed familial parathyroid tumors.ResultsGCM2 variants were observed in 9 of 107 cases (8.4%): Y282D in 4 patients (6.3%) with sporadic multigland disease; Y394S in 2 patients (11.1%) with familial PHPT and 3 (4.8%) with sporadic multigland disease. Compared with the general population, Y282D was enriched 5.9-fold in multigland disease, but its penetrance was very low (0.02%). Y394S was enriched 79-fold in sporadic multigland disease and 93-fold in familial PHPT, but its penetrance was low (1.33% and 1.04%, respectively).ConclusionsObserved in vitro–activating GCM2 variant alleles are significantly overrepresented in PHPT patients with multiglandular or familial disease compared to the general population, yet penetrance values are very low; that is, most individuals with these variants in the population have a very low risk of developing PHPT. The potential clinical utility of detecting these GCM2 variants requires further investigation, including assessing their possible role as pathogenic/low-penetrance alleles.
Self-Selection of Peers and Performance
Authors: Kiessling Lukas , Radbruch Jonas , Schaube Sebastian 
Published: December 2021

This paper studies how the presence of peers and different peer assignment rules—self-selection versus random assignment—affect individual performance. Using a framed field experiment, we find that the presence of a randomly assigned peer improves performance by 28% of a standard deviation (SD), whereas self-selecting peers induces an additional 15%–18% SD improvement in performance. Our results document peer effects in multiple characteristics and show that self-selection changes these characteristics. However, a decomposition reveals that variations in the peer composition contribute only little to the performance differences across peer assignment rules. Rather, we find that self-selection has a direct effect on performance. This paper was accepted by Yan Chen, decision analysis. Funding: Funding by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) through CRC TR 224 (projects A01 and A02) is gratefully acknowledged. Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2021.4267 .
Burnout in frontline ambulance staff
Authors: Beldon Rachel , Garside Joanne 
Published: December 2021

Background: Staff retention is a significant issue for ambulance services across the globe. Exploratory research, although minimal, indicates that stress and burnout, in particular, influence attrition within the paramedic profession. These need to be understood if their impact on retention is to be addressed. Aims: To determine the presence of and contributory factors for burnout in the ambulance service to inform recommendations for positive change. Methods: A two-phased survey approach was adopted using an adapted Maslach Burnout Inventory and Copenhagen self-assessment burnout questionnaire, to measure levels of burnout, depersonalisation (cynicism) and personal achievement. Open-ended questions explored factors that influenced these. Demographic and comparative analysis identified trends and thematic analysis was carried out on the qualitative data. Results: Ninety-four per cent of ambulance staff in this study (n=382) reported a sense of personal achievement within their professional role; however, more than 50% were experiencing varying levels of burnout with 87% displaying moderate or high levels of depersonalisation towards their work. Causes of stress were complex: themes attributed were a perceived lack of management support, the public's misuse of the ambulance service, involuntary overtime and a poor work-life balance. Conclusions: Burnout poses a genuine threat to retention in the ambulance service and needs addressing. Proactive screening, better communication between practice staff and management and access to counselling services are recommended. This problem of burnout is beginning to be acknowledged but further evidence is needed to understand it in more depth in order for effective solutions to be developed.
Prescribing errors in general practice
Authors: McCutcheon Jennifer 
Published: December 2021

Prescribing errors are relatively common in general practice. Jennifer McCutcheon provides an overview of common prescribing errors and how they can be prevented Nurses, pharmacists and allied health professionals are increasingly becoming prescribers and many of them work autonomously in general practice. Prescribing professionals have a duty to understand what a prescribing error is, common examples of errors in practice, how they are prevented and how they can be investigated and reported should they occur.
Quality and flexural strength of laser-cut glass: classical top-down ablation versus water-assisted and bottom-up machining
Authors: Dudutis Juozas , Zubauskas Laimis , Daknys Eimantas , Markauskas Edgaras , Gvozdaitė Rasa , Račiukaitis Gediminas , Gečys Paulius 
Published: December 2021

The growing applicability of glass materials drives the development of novel processing methods, which usually lack comprehensive comparison to conventional or state-of-art ones. That is especially delicate for assessing the flexural strength of glass, which is highly dependent on many factors. This paper compares the traditional top-down laser ablation methods in the air to those assisted with a flowing water film using picosecond pulses. Furthermore, the bottom-up cutting method using picosecond and nanosecond pulses is investigated as well. The cutting quality, sidewall roughness, subsurface damage and the four-point bending strength of 1 mm-thick soda-lime glass are evaluated. The flexural strength of top-down cut samples is highly reduced due to heat accumulation-induced cracks, strictly orientated along the sidewall. The subsurface crack propagation can be reduced using water-assisted processing, leading to the highest flexural strength among investigated techniques. Although bottom-up cut samples have lower flexural strength than water-assisted, bottom-up technology allows us to achieve higher cutting speed, taper-less sidewalls, and better quality on the rear side surface and is preferable for thick glass processing.
High genome plasticity and frequent genetic exchange in Leishmania tropica isolates from Afghanistan, Iran and Syria
Authors: Glans Hedvig , Lind Karlberg Maria , Advani Reza , Bradley Maria , Alm Erik , Andersson Björn , Downing Tim 
Published: December 2021

BackgroundThe kinetoplastid protozoanLeishmania tropicamainly causes cutaneous leishmaniasis in humans in the Middle East, and relapse or treatment failure after treatment are common in this area.L.tropica’s digenic life cycle includes distinct stages in the vector sandfly and the mammalian host. Sexual reproduction and genetic exchange appear to occur more frequently than in otherLeishmania species. Understanding these processes is complicated by chromosome instability during cell division that yields aneuploidy, recombination and heterozygosity. This combination of rare recombination and aneuploid permits may reveal signs of hypothetical parasexual mating, where diploid cells fuse to form a transient tetraploid that undergoes chromosomal recombination and gradual chromosomal loss.Methodology/principal findingsThe genome-wide SNP diversity from 22L.tropicaisolates showed chromosome-specific runs of patchy heterozygosity and extensive chromosome copy number variation. All these isolates were collected during 2007–2017 in Sweden from patients infected in the Middle East and included isolates from a patient possessing two genetically distinct leishmaniasis infections three years apart with no evidence of re-infection. We found differing ancestries on the same chromosome (chr36) across multiple samples: matching the reference genome with few derived alleles, followed by blocks of heterozygous SNPs, and then by clusters of homozygous SNPs with specific recombination breakpoints at an inferred origin of replication. Other chromosomes had similar marked changes in heterozygosity at strand-switch regions separating polycistronic transcriptional units.Conclusion/significanceThese large-scale intra- and inter-chromosomal changes in diversity driven by recombination and aneuploidy suggest multiple mechanisms of cell reproduction and diversification inL.tropica, including mitotic, meiotic and parasexual processes. It underpins the need for more genomic surveillance ofLeishmania, to detect emerging hybrids that could spread more widely and to better understand the association between genetic variation and treatment outcome. Furthering our understanding ofLeishmaniagenome evolution and ancestry will aid better diagnostics and treatment for cutaneous leishmaniasis caused byL.tropicain the Middle East.