bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Screw Insertion Method for Anterior Surgical Treatment of Unstable Thoracolumbar Fracture: Quadrant Positioning Method
Authors: Wang Song , Duan Chun‐yan , Yang Han , Kang Jian‐ping , Wang Qing 
Published: August 2019

ObjectiveTo develop a novel screw positioning method to improve the treatment of unstable thoracolumbar fractures.MethodsA total of 72 patients with unstable thoracolumbar fractures who were treated with anterior screw–rod interfixation from January 2011 to October 2015 were included in this clinical study. Those patients included 48 male and 24 female patients with an average age of 45.10 years (range, 26–63 years). Patients were randomly divided into two groups: an observation group (n = 36) and a control group (n = 36). The quadrant positioning method was used for screw insertion in the observation group during the operation, while the traditional screw positioning method was used in the control group. The quadrant positioning method targeted four quadrants, including the superior anterior (SA), superior posterior (SP), inferior anterior (IA) and inferior posterior (IP) quadrants, while for the traditional screw positioning, four screws were inserted into the vertebral bodies above and below the excision. Patients were followed up for approximately 40 months to record recovery. Clinical and radiological records, local angle and fractured vertebra body height, clinical outcomes, complications, neurological improvement, and fusion rate were recorded and compared between the two groups.ResultsThe quadrant positioning method was successfully used for anterior screw insertion. The quadrant center in the lateral view of the vertebral body was well marked, and screws were easily located on the scheduled quadrant. Blood loss (BL), hospital stay (HS), and operation time (OP) in the observation group were 749.40 ± 379.90 mL, 17.10 ± 4.10 days, and 167.40 ± 44.70 min, respectively. While those parameters in the control group were 1198.40 ± 339.27 mL, 23.22 ± 3.77 days, and 221.47 ± 32.15 min, respectively. The average operation time and hospital stay time were significantly shorter, and blood loss was significantly less in the observation group than in the control group (P < 0.05). Local angle and vertebral body height were markedly improved and 1–2 grade improvement was achieved in patients with neurological deficits in both groups. Both groups of patients achieved bony fusion during follow‐up. No incision infection or internal fixation failure was observed in the two groups, and complications including cerebrospinal fluid and chylous leakage and hemothorax were resolved.ConclusionsThe quadrant positioning method can shorten operation time, reduce blood loss, and accelerate postoperative recovery. The technique provides an effective method for screw insertion for double screw–rod instrumentation fixation in the treatment of thoracolumbar fracture via the anterior approach.
Effect of Cross‐Linked Hyaluronate Scaffold on Cartilage Repair: An In Vivo Study
Authors: Xiao Shi‐peng , Tang Lian‐sheng , Chen Jian‐ying , Li Zhong‐tao , Cheng Guang‐hui , Chen Qian‐qian , Liu Sheng‐hou , Liu Wen‐guang 
Published: August 2019

ObjectiveTo determine the safety and effectiveness of a cross‐linked sodium hyaluronate (CHA) scaffold in cartilage repair.MethodsPhysicochemical properties of the scaffold were determined. The safety and effectiveness of the scaffold for cartilage repair were evaluated in a minipig model of a full‐thickness cartilage defect with microfracture surgery. Postoperative observation and hematological examination were used to evaluate the safety of the CHA scaffold implantation. Pathological examination as well as biomechanical testing, including Young's modulus, stress relaxation time, and creep time, were conducted at 6 and 12 months postsurgery to assess the effectiveness of the scaffold for cartilage repair. Furthermore, type II collagen and glycosaminoglycan content were determined to confirm the influence of the scaffold in the damaged cartilage tissue.ResultsThe results showed that the routine hematological indexes of the experimental animals were within the normal physiological ranges, which confirmed the safety of CHA scaffold implantation. Based on macroscopic observation, it was evident that repair of the defective cartilage in the animal knee joint began during the 6 months postoperation and was gradually enhanced from the central to the surrounding region. The repair smoothness and color of the 12‐month cartilage samples from the operation area were better than those of the 6‐month samples, and the results for the CHA scaffold implantation group were better than the control group. Greater cell degeneration and degeneration of the adjacent cartilage was found in the implantation group compared with the control group at both 6 and 12 months postoperation, evaluated by O'Driscoll Articular Cartilage Histology Scoring. Implantation with the CHA scaffold matrix promoted cartilage repair and improved its compression capacity. The type II collagen level in the CHA scaffold implantation group tended to be higher than that in the control group at 6 months (2.33 ± 1.50 vs 1.68 ± 0.56) and 12 months postsurgery (3.37 ± 1.70 vs 2.06 ± 0.63). The GAG content in the cartilage of the control group was significantly lower than that of the experimental group (2.17 ± 0.43 vs 3.64 ± 1.17, P = 0.002 at 6 months and 2.27 ± 0.38 vs 4.12 ± 1.02, P = 0.002 at 12 months). Type II collagen and glycosaminoglycan content also demonstrated that CHA was beneficial for the accumulation of both these vital substances in the cartilage tissue.ConclusionsThe CHA scaffold displayed the ability to promote cartilage repair when applied in microfracture surgery, which makes it a promising material for application in the area of cartilage tissue engineering.
On Choosing Mixture Components via Non-Local Priors
Authors: Fúquene Jairo , Steel Mark , Rossell David 
Published: August 2019

SummaryChoosing the number of mixture components remains an elusive challenge. Model selection criteria can be either overly liberal or conservative and return poorly separated components of limited practical use. We formalize non-local priors (NLPs) for mixtures and show how they lead to well-separated components with non-negligible weight, interpretable as distinct subpopulations. We also propose an estimator for posterior model probabilities under local priors and NLPs, showing that Bayes factors are ratios of posterior-to-prior empty cluster probabilities. The estimator is widely applicable and helps to set thresholds to drop unoccupied components in overfitted mixtures. We suggest default prior parameters based on multimodality for normal–T-mixtures and minimal informativeness for categorical outcomes. We characterize theoretically the NLP-induced sparsity, derive tractable expressions and algorithms. We fully develop normal, binomial and product binomial mixtures but the theory, computation and principles hold more generally. We observed a serious lack of sensitivity of the Bayesian information criterion, insufficient parsimony of the Akaike information criterion and a local prior, and a mixed behaviour of the singular Bayesian information criterion. We also considered overfitted mixtures; their performance was competitive but depended on tuning parameters. Under our default prior elicitation NLPs offered a good compromise between sparsity and power to detect meaningfully separated components.
Should we video OSCEs for student appeals?
Authors: Hogley Rhianna , Thampy Harish , Fisher Pip 
Published: August 2019

BackgroundThose setting objective structured clinical exams (OSCEs) are likely to encounter candidates who dispute the examiners’ scores and feedback. At our own institution, candidates have requested video recording to aid in later academic appeals. Before ceding to such requests, we wished to be certain that the marking of recorded OSCEs would give comparable results to live marking, and that technical challenges could be met within reasonable cost.MethodsWe adopted a mixed‐methods approach to explore the use of video recording OSCEs. Following an initial literature review, we surveyed and interviewed the assessment leads of UK medical schools and postgraduate institutions setting high stakes OSCEs to explore their views and experience in using recordings as part of summative OSCE assessments.ResultsResults from our literature review reveal inconsistent findings about the comparability of marks awarded from video marking and those awarded by examiner in‐station marking, with suggestions that video marking generates lower scores. The majority of UK medical education institutions were neither videoing OSCEs nor considering doing so. Many logistical and assessor‐related drawbacks to video review were identified, with significant concerns raised about how such a process could be feasibly managed.DiscussionAlthough the videoing of OSCEs may superficially appear an easy solution to provide defensibility of the process, the potential use is beset with challenge, going beyond purely logistical and technical difficulties. The use of videoing for the purpose of OSCE appeals is not currently supported by the literature, nor by the majority of UK undergraduate and postgraduate medical education institutions delivering high‐stakes summative OSCEs.
Perceptions and experience of veterinary surgery residents with minimally invasive surgery simulation training
Authors: Balsa Ingrid M. , Giuffrida Michelle A. , Culp William T. N. , Mayhew Philipp D. 
Published: August 2019

AbstractObjectiveTo determine access to and use of minimally invasive surgery (MIS) simulators among American College of Veterinary Surgeons (ACVS) small animal residents and to identify barriers to simulator use and perceptions of simulator training.Study designVoluntary online survey.Sample populationOne hundred forty‐one ACVS small animal residents.MethodsAmerican College of Veterinary Surgeons residents were identified by contacting ACVS residency program directors. An emailed online survey was sent to residents along with a reminder email 2 weeks later. All surveys were collected within 1 month. Participation was voluntary but incentivized.ResultsResponse rate to the survey was 79 of 141 (56%) residents. Twenty‐eight of 77 (36%) residents have access to a simulator, with box simulators being most common. Lack of time was the most frequent reason for not using the simulator more. Sixty‐eight of 77 (88%) and 65 of 77 (65%) residents agreed or strongly agreed that simulator‐based training improves laparoscopic skills and that simulator skills are transferable to the operating room, respectively. Residents with access to a simulator were more comfortable with basic laparoscopic surgeries at the end of their residency than those without such access (P = .04).ConclusionThere is substantial room for improved access to and use of MIS simulator training in ACVS residency programs. Despite lack of simulator access, residents believed that simulator training improved their skill and comfort level with basic laparoscopic procedures.Clinical significanceThe results of this study inform us about access to and perceptions of MIS simulator training among residents. This information is important to surgeons responsible for training residents and may help guide the creation of a surgical skills curriculum.
A reappraisal of the phylogeny of Mylodontidae (Mammalia, Xenarthra) and the divergence of mylodontine and lestodontine sloths
Authors: Boscaini Alberto , Pujos François , Gaudin Timothy J. 
Published: August 2019

AbstractThe phylogeny of mylodontid sloths has recently been the subject of multiple studies. Contrasting hypotheses have been proposed, especially for the relationships among late Miocene–Pleistocene mylodontines and lestodontines. In this paper, a new and detailed phylogenetic analysis is conducted, after adding new characters and taxa previously unexplored from a phylogenetic point of view. New features derived from postcranial skeletal anatomy are added to previous studies based on craniodental evidence. In this way, the current reappraisal represents the first exhaustive phylogenetic study on the Mylodontidae that incorporates features coded for the entire skeleton. When available, multiple specimens of each bony element are observed for each operational taxonomic unit, in order to take into account intraspecific variation. The taxonomic sample of this study considers Mylodontinae at the specific level. However, many other Mylodontidae are considered, and their phylogenetic relationships tested. The taxonomic sample of this study is enriched with new taxa from central and northern South America, with the aim of compensating for the knowledge bias in favour of austral mylodontids, which have historically been more extensively studied than those from tropical latitudes. Special emphasis is given to the phylogenetic relationships of Mylodontinae, and particularly to the mylodontine and lestodontine sloths, that are recovered in the present study as monophyletic clades, and together form a larger monophyletic group. According to the present results, the Mylodontini–Lestodontini split occurred at the middle–late Miocene transition, giving rise to independent adaptive radiations across South and North America.
Research priorities for young people with cancer: a UK priority setting partnership with the James Lind Alliance
Authors: Aldiss Susie , Fern Lorna A , Phillips Robert S , Callaghan Amy , Dyker Karen , Gravestock Helen , Groszmann Michael , Hamrang Leila , Hough Rachael , McGeachy Demi , Morgan Sue , Smith Sam , Upadhyaya Sheela , Veitch Helen , Veitch Lara , Williamson Max , Whelan Jeremy S , Gibson Faith 
Published: August 2019

ObjectivesTo conduct a UK-wide survey of young people who have experienced cancer, carers and professionals, to identify and prioritise research questions to inform decisions of research funders and support the case for research with this unique cancer population.DesignJames Lind Alliance Priority Setting Partnership.SettingUK health service and community.MethodsA steering group oversaw the initiative and partner organisations were recruited. Unanswered questions were collected in an online survey. Evidence searching verified uncertainties. An interim survey was used to rank questions prior to a final prioritisation workshop.ParticipantsYoung people aged 13–24 years with a current or previous cancer diagnosis, their families, friends, partners and professionals who work with this population.ResultsTwo hundred and ninety-two respondents submitted 855 potential questions. Following a refining process and removal of ‘out of scope’ questions, 208 unique questions remained. Systematic evidence checking identified seven answered questions and 16 were the subject of ongoing studies. The interim survey was completed by 174 participants. The top 30 questions were prioritised at a workshop attended by 25 young people, parents and multidisciplinary professionals. The top three priorities are: (1) What psychological support package improves psychological well-being, social functioning and mental health during and after treatment? (2) What interventions, including self-care, can reduce or reverse adverse short-term and long-term effects of cancer treatment? (3) What are the best strategies to improve access to clinical trials? The remaining questions reflect the complete cancer pathway: new therapies, life after cancer, support, education/employment, relapse and end-of-life care.ConclusionsWe have identified shared research priorities for young people with cancer using a rigorous, person-centred approach involving stakeholders typically not involved in setting the research agenda. The breadth of priorities suggest future research should focus on holistic and psychosocial care delivery as well as traditional drug/biology research.
LncRNA CCAT1 Promotes Prostate Cancer Cell Proliferation by Interacting with DDX5 and MIR-28-5P
Authors: You Zonghao , Liu Chunhui , Wang Can , Ling Zhixin , Wang Yiduo , Wang Yali , Zhang Minghao , Chen Shuqiu , Xu Bin , Guan Han , Chen Ming 
Published: August 2019

Abstract
Accumulated evidence indicates that CCAT1 functions as an oncogene in the progression of a variety of tumors. However, little is known as to how CCAT1 impacts tumorigenesis in human prostate cancer. In this study, we found from The Cancer Genome Atlas and Memorial Sloan Kettering Cancer Center database that CCAT1 is highly upregulated in castration-resistant prostate cancer (CRPC) compared with androgen-dependent prostate cancer (ADPC). Higher level of CCAT1 leads to increased mortality in patients with CRPC. In vitro and in vivo studies show that CCAT1 promotes prostate cancer cell proliferation as well as the tumor growth of prostate cancer xenografts. Mechanistically, in cytoplasm, CCAT1 sponges MIR-28-5P to prevent the anticancer effect. In nucleus, CCAT1 acts as a scaffold for DDX5 (P68) and AR transcriptional complex to facilitate the expression of AR-regulated genes, thus stimulating CRPC progression. Our findings suggest that CCAT1 is an oncogenic factor in the progression of CRPC with different regulatory mechanisms in the nucleus and cytoplasm of cells.
Educating Paramedics on the Finger-to-Nose Test Improves Recognition of Posterior Stroke
Authors: Oostema J. Adam , Chassee Todd , Baer William , Edberg Allison , Reeves Mathew J. 
Published: August 2019

Background and Purpose—
Emergency medical services (EMS) stroke recognition facilitates rapid care, however, prehospital stroke screening tools rely on signs that are often absent in posterior circulation strokes. We hypothesized that addition of the finger-to-nose (FTN) test to the Cincinnati Prehospital Stroke Scale would improve EMS posterior stroke recognition.

Methods—
In this controlled before and after study of consecutive EMS transported posterior ischemic strokes, paramedics in a single EMS agency received in-person training in the use of the FTN test. Paramedics at 2 other local EMS agencies served as controls. We compared the change in posterior stroke recognition, door-to-CT times, and alteplase delivery between the FTN (intervention) and control agencies.

Results—

Over 21 months, 51 posterior circulation strokes were transported by the FTN agency and 88 in the control agencies. Following training, posterior stroke recognition improved from 46% to 74% (
P
=0.039) in the FTN agency, whereas there was no change in the control agencies (32% before versus 39% after,
P
=0.467). Mean door-to-CT time in the FTN agency also improved following training (62–41 minutes,
P
=0.037) but not in the control agencies (58–61 minutes,
P
=0.771). There was no difference in alteplase delivery.

Conclusions—
Paramedics trained in the FTN test were more likely to identify posterior stroke. If future studies confirm these findings, such training may expedite the care of posterior stroke patients transported by EMS.
Experience of implementing new mental health indicators within information systems in six low- and middle-income countries
Authors: Ahuja Shalini , Hanlon Charlotte , Chisholm Dan , Semrau Maya , Gurung Dristy , Abdulmalik Jibril , Mugisha James , Mntambo Ntokozo , Kigozi Fred , Petersen Inge , Shidhaye Rahul , Upadhaya Nawaraj , Lund Crick , Evans-Lacko Sara , Thornicroft Graham , Gureje Oye , Jordans Mark 
Published: August 2019

BackgroundSuccessful scale-up of integrated primary mental healthcare requires routine monitoring of key programme performance indicators. A consensus set of mental health indicators has been proposed but evidence on their use in routine settings is lacking.AimsTo assess the acceptability, feasibility, perceived costs and sustainability of implementing indicators relating to integrated mental health service coverage in six South Asian (India, Nepal) and sub-Saharan African countries (Ethiopia, Nigeria, South Africa, Uganda).MethodA qualitative study using semi-structured key informant interviews (n= 128) was conducted. The ‘Performance of Routine Information Systems’ framework served as the basis for a coding framework covering three main categories related to the performance of new tools introduced to collect data on mental health indicators: (1) technical; (2) organisation; and (3) behavioural determinants.ResultsMost mental health indicators were deemed relevant and potentially useful for improving care, and therefore acceptable to end users. Exceptions were indicators on functionality, cost and severity. The simplicity of the data-capturing formats contributed to the feasibility of using forms to generate data on mental health indicators. Health workers reported increasing confidence in their capacity to record the mental health data and minimal additional cost to initiate mental health reporting. However, overstretched primary care staff and the time-consuming reporting process affected perceived sustainability.ConclusionsUse of the newly developed, contextually appropriate mental health indicators in health facilities providing primary care services was seen largely to be feasible in the six Emerald countries, mainly because of the simplicity of the forms and continued support in the design and implementation stage. However, approaches to implementation of new forms generating data on mental health indicators need to be customised to the specific health system context of different countries. Further work is needed to identify ways to utilise mental health data to monitor and improve the quality of mental health services.Declaration of interestNone.
Effective methods for knowledge transfer to strengthen mental health systems in low- and middle-income countries
Authors: Ayuso-Mateos Jose L. , Miret Maria , Lopez-Garcia Pilar , Alem Atalay , Chisholm Dan , Gureje Oye , Hanlon Charlotte , Jordans Mark , Kigozi Fred , Lund Crick , Petersen Inge , Semrau Maya , Shidhaye Rahul , Thornicroft Graham 
Published: August 2019

Background
The Emerald project's focus is on how to strengthen mental health systems in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda). This was done by generating evidence and capacity to enhance health system performance in delivering mental healthcare.
A common problem in scaling-up interventions and strengthening mental health programmes in LMICs is how to transfer research evidence, such as the data collected in the Emerald project, into practice.

Aims
To describe how core elements of Emerald were implemented and aligned with the ultimate goal of strengthening mental health systems, as well as their short-term impact on practices, policies and programmes in the six partner countries.

Method
We focused on the involvement of policy planners, managers, patients and carers.

Results
Over 5 years of collaboration, the Emerald consortium has provided evidence and tools for the improvement of mental healthcare in the six LMICs involved in the project. We found that the knowledge transfer efforts had an impact on mental health service delivery and policy planning at the sites and countries involved in the project.

Conclusions
This approach may be valid beyond the mental health context, and may be effective for any initiative that aims at implementing evidence-based health policies for health system strengthening.