bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fracturas de tobillo en ancianos y personas de edad muy avanzada. [Ankle fractures in elderly and old people]
Authors: Arzac Ulla Ricardo Ignacio 
Published: May 2019

Introducción: La Organización Mundial de la Salud define como persona anciana a toda aquella de entre 75 y 90 años y los que sobrepasan esta edad se denominan personas de edad muy avanzada. El objetivo de este estudio fue analizar los resultados posoperatorios de las fracturas de tobillo tratadas con técnicas MIPO, y de reducción abierta y fijación interna (RAFI), en las que se logró una reducción funcional y biológica en pacientes >75 años.Materiales y Métodos: Entre 2013 y 2017, se evaluó a 13 pacientes >75 años con fractura inestable de tobillo. Seis fueron operados con técnica MIPO y siete, con RAFI. Todos fueronevaluados a los 90 días y a los 18 meses de la cirugía mediante el puntaje de la AOFAS.Resultados: La edad promedio era de 79.7 años (rango 75-95). El puntaje global de la AOFAS fue 97 a los 90 días y 96 a los 18 meses. No se observaron pérdidas de reducción ni vicios de ejes.Conclusión: Nuestro estudio indica que la reducción biológica y funcional en pacientes >75 años es el tratamiento ideal para las fracturas de tobillo. AbstractIntroduction: The World Health Organization defines elderly person as anyone who is between 75 and 90 years of age and those who surpass this age are called old people. The objective of this study was to analyze postoperative results of ankle fractures treated with MIPO and ORIF techniques, achieving a functional and biological reduction in patients older than 75 years.Methods: Between 2013 and 2017, 13 patients beyond the age of 75 with unstable ankle fractures were evaluated. Six were treated with MIPO technique and 7 with ORIF. All patients were evaluated at 90 days and at 18 month postoperatively using the AOFAS score.Results: Mean age was 79.7 years (range 75-95). Overall postoperative AOFAS score was 97 at day 90 and 96 at 18 months. No losses of reduction or shaft defects were observed.Conclusion: Our study indicates that biological and functional reduction in patients older than 75 years is the ideal treatment for ankle fractures.
Instrucción Ortopédica de Posgrado - Imágenes. Presentación del caso.
Authors: Ghisi Juan Pablo , Schneebeli Guillermo , Lamanna Agostina 
Published: May 2019

Se presenta caso de un paciente de 18 años que había se había desgarrado su LCA y tratado quirúrgicamente con HTH.Presentó nuevo episodio traumático con mecanismo en valgo practicando fútbol en césped sintético con botines de césped natural.Al examen físico se constató inestabilidad mediante las maniobras de Lachman y pívot shift por lo que se solicitó un control por RM.
Preparing for Discharge From the Neonatal Intensive Care Unit
Authors: Gupta Munish , Pursley DeWayne M. , Smith Vincent C. 
Published: May 2019

BACKGROUND:
Discharge readiness is a key determinant of outcomes for families in the NICU. Since 2003, using a broad set of outcome and process measures, we have conducted an ongoing quality improvement initiative to improve the discharge preparation process in our NICU and readiness of families being discharged from the NICU.

METHODS:
Iterative improvements to the discharge preparation process were made by a multidisciplinary committee. Discharge readiness was measured by using a parental and nurse survey for all families discharged from our NICU. Primary outcome measures included parental self-assessment of discharge readiness and nurse assessment of the family’s emotional and technical discharge readiness. Secondary outcome measures included assessment of specific technical skills and emotional factors. Process measures included nursing familiarity with family at discharge. Improvement over time was analyzed by using statistical process control charts.

RESULTS:
Significant improvement was seen in all primary outcome measures. Family self-assessment of discharge readiness increased from 85.1% to 89.1%; nurse assessment of the family’s emotional discharge readiness increased from 81.2% to 90.5%, and technical discharge readiness increased from 81.4% to 87.7%. Several secondary outcome measures revealed significant improvement, whereas most remained stable. Nurse familiarity with the family at discharge increased over time.

CONCLUSIONS:
Quality improvement methodology can be used to measure and improve discharge readiness of families with an infant in the NICU. This model can provide the necessary framework for a structured approach to systematically evaluating and improving the discharge preparation process in a NICU.
Evaluación de un modelo urbano nuevo. Santiago el Pinar, México, 1999-2013
Authors: Vázquez-Honorato Luis Arturo , Salazar-Martinez Bertha Lilia , García-Medina Karla María 
Published: May 2019

El programa Ciudad Rural Sustentable (CRS) que implementó el Gobierno del estado de Chiapas en localidades como Santiago el Pinar hasta el año 2013 surgió como resultado de dos problemáticas: una de naturaleza social y otra territorial. La primera, debido a la necesidad de los grupos indígenas con una ubicación dispersa que, por consideraciones geográficas, climatológicas, funcionales y en deplorables condiciones de habitabilidad, no contaban con una vivienda adecuada. La segunda, a causa de los asentamientos que se encontraban ubicados en zonas de alto riesgo, con antecedentes de pérdidas de bienes materiales y vidas humanas. En este marco, el documento reflexiona sobre el resultado de dicha política pública, en busca de un nuevo modelo urbano, considerando el bienestar de la población a partir del hábitat y de sus hábitos para propiciar mejores condiciones de equilibrio social, económico y ambiental como pauta para su crecimiento.
La producción de conocimiento urbano-arquitectónico. ¿Una colonización cultural?
Authors: Alcantara-Ceballos Yuzzel 
Published: May 2019

El artículo presenta cuatro categorías analíticas relacionadas con el ámbito económico y cultural como globalización, sociedad del riesgo, marginalidad y racionalismo, categorías con las cuales se enseña a pensar el espacio urbano arquitectónico en un contexto universitario mexicano. Esta reflexión es parte del trabajo realizado en el seminario Análisis crítico de la arquitectura y el urbanismo: las opciones contemporáneas, y corresponde a una autocrítica que intenta dar cuenta de la necesidad de descolonizar el saber científico con el que se enseña a pensar la arquitectura y las ciudades latinoamericanas.
Renal Perfusion during Hemodialysis: Intradialytic Blood Flow Decline and Effects of Dialysate Cooling
Authors: Marants Raanan , Qirjazi Elena , Grant Claire J. , Lee Ting-Yim , McIntyre Christopher W. 
Published: May 2019

Significance Statement
Residual renal function (RRF) characteristically declines after patients with ESRD initiate dialysis. Although RRF preservation correlates with improved outcomes, poor understanding of the pathophysiology underlying RRF decline limits protection strategies. Previous research found that dialysate cooling reduces hemodialysis-induced circulatory stress and protects the brain and heart from ischemic injury. To examine renal perfusion decline during hemodialysis and the effects of cooling, the authors used computed tomography perfusion imaging to scan patients undergoing continuous dialysis with or without dialysate cooling. They found an acute decrease in renal perfusion during hemodialysis, a first step toward characterizing hemodialysis-mediated RRF loss. Dialysate cooling ameliorated this decline but this effect did not reach statistical significance. Further study is needed to explore the potential of dialysis-based interventions to slow RRF decline.

Background
Residual renal function (RRF) confers survival in patients with ESRD but declines after initiating hemodialysis. Previous research shows that dialysate cooling reduces hemodialysis-induced circulatory stress and protects the brain and heart from ischemic injury. Whether hemodialysis-induced circulatory stress affects renal perfusion, and if it can be ameliorated with dialysate cooling to potentially reduce RRF loss, is unknown.

Methods
We used renal computed tomography perfusion imaging to scan 29 patients undergoing continuous dialysis under standard (36.5°C dialysate temperature) conditions; we also scanned another 15 patients under both standard and cooled (35.0°C) conditions. Imaging was performed immediately before, 3 hours into, and 15 minutes after hemodialysis sessions. We used perfusion maps to quantify renal perfusion. To provide a reference to another organ vulnerable to hemodialysis-induced ischemic injury, we also used echocardiography to assess intradialytic myocardial stunning.

Results
During standard hemodialysis, renal perfusion decreased 18.4% (P<0.005) and correlated with myocardial injury (r=−0.33; P<0.05). During sessions with dialysis cooling, patients experienced a 10.6% decrease in perfusion (not significantly different from the decline with standard hemodialysis), and ten of the 15 patients showed improved or no effect on myocardial stunning.

Conclusions
This study shows an acute decrease in renal perfusion during hemodialysis, a first step toward pathophysiologic characterization of hemodialysis-mediated RRF decline. Dialysate cooling ameliorated this decline but this effect did not reach statistical significance. Further study is needed to explore the potential of dialysate cooling as a therapeutic approach to slow RRF decline.
Pretreatment Neutrophil-to-Lymphocyte Ratio Predicts Prognosis in Patients with Diabetic Macular Edema Treated with Ranibizumab
Authors: Hu Yuxiang , Cheng Yi , Xu Xiaoxuan , Yang Bo , Mei Feng , Zhou Qiong , Yan Li , Wang Jun , Wu Xiaorong 
Published: May 2019

Abstract
Background: To investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in patients with diabetic macular edema (DME) treated monthly with ranibizumab.
Methods: We retrospectively analyzed the medical records of all patients who received intravitreal ranibizumab (IVR) treatment for DME at the First Affiliated Hospital of Nanchang University between December 2015 and December 2017. Clinicopathological parameters, including NLR, were evaluated to identify predictors of better outcomes of IVR monotherapy.
Results: Ninety-one treatment-naïve eyes treated with IVR for DME were retrospectively analyzed in this study. Baseline best-corrected visual acuity (BCVA), neutrophils, NLR, monocyte-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were negatively correlated with the changes in BCVA at 24 weeks compared with the baseline, while baseline central retinal thickness and lymphocytes were positively correlated with the changes in BCVA at 24 weeks compared with the baseline. Multiple linear regression analysis revealed that NLR was independently associated with the mean change of BCVA between baseline and week 24. In addition, patients with NLR < 2.27 showed a better improvement in letter score than those with NLR > 2.27.
Conclusion: Pretreatment NLR is independently associated with the BCVA in DME patients treated with IVR, and higher pretreatment NLR may contribute to inferior BCVA outcomes.
The effect of Spinal Manipulative Therapy on Heart Rate Variability and pain in patients with chronic neck pain: A Randomized Controlled trial
Authors: Bakken Anders Galaasen , Axén Iben , Eklund Andreas , O'neill Sören 
Published: May 2019

Abstract
Background

Recent experimental research has suggested that Spinal Manipulative Therapy (SMT) may reduce pain through modulation of the ascending pain signals and/or the central pain regulating mechanisms. People with persistent neck pain (NP) have also been found to have disturbances in Autonomic Nervous System (ANS) regulation. A common way to study ANS is to measure heart rate variability (HRV). It is not known if deviations in HRV are related to changes in pain perception or to the treatment response to SMT.

Commonly, an individual in pain will experience pain reduction when exposed to a second pain stimulus, a mechanism known as Conditioning Pain Modulation (CPM). Patients with persistent pain have been found to have a reduced CPM reaction. It is not known if this is predictive of treatment response to SMT.

The aim of the study is to examine the effects of SMT on HRV and pain and to test if a CPM test can be used to predict treatment response, in a population of patients with recurrent and persistent NP.

Method/Design

A multicentre randomized controlled clinical trial will be carried out in multidisciplinary primary care clinics. This setting is chosen to minimize bias resulting from patient preference to treatment modality and provider.

The subjects are either self-referred or referred from other health care practitioners locally. The treatment modalities are two well-known interventions for NP; SMT and stretching exercises compared to stretching exercises alone.

The subjective pain experience will be investigated by assessing pain intensity and the affective quality of pain. HRV will be measured using a portable heart monitor and CPM will be measured with a standardized cold-pressor-test. Measurements will be performed at baseline, prior to the third treatment and after the fourth treatment.

Discussion

The study will utilize normal clinical procedures, which should aid transferability and external validity of the results. The study will provide knowledge regarding the underlying mechanisms of the effects of SMT. Furthermore, the study will examine if a CPM test is predictive of treatment outcome in a population of patients with recurrent and persistent NP.
CYP3A4 and CYP11A1 Variants are Risk Factors for Ischemic Stroke: a Case Control Study
Authors: Gao Ning , Tang Hong , Gao Ling , Tu Guolong , Luo Han , Xia Ying 
Published: May 2019

Abstract
Background

This study aimed to investigate the roles of CYP3A4 and CYP11A1 variants in ischemic stroke (IS) susceptibility among the Han Chinese population.

Methods

477 patients with IS and 493 healthy controls were enrolled. Seven single-nucleotide polymorphisms (SNPs) of CYP3A4 and CYP11A1 were genotyped by Agena MassARRAY. Odds ratio (OR) and 95% confidence intervals (CI) were calculated by logistic regression adjusted for age and gender.

Results

We found that CYP3A4 rs3735451 (OR = 0.81, p = 0.039) and rs4646440 (OR = 0.72, p = 0.021) polymorphisms decreased the risk of IS. CYP3A4 rs4646440 (OR = 0.74, p = 0.038) and CYP11A1 rs12912592 (OR = 1.58, p = 0.034) polymorphisms were correlated with IS risk in males. CYP3A4 rs3735451 (OR = 0.63, p = 0.031) and rs4646440 (OR = 0.57, p = 0.012) possibly weaken the IS susceptibility at age > 61 years. Besides, CYP3A4 rs4646437 (OR = 0.59, p = 0.029), CYP11A1 rs12912592 (OR = 1.84, p = 0.017) and rs28681535 (OR = 0.66, p = 0.038) were associated with IS risk at age ≤ 61 years. Haplotype analysis showed that CYP3A4 GT haplotype (rs4646440 and rs35564277) increased the susceptibility to IS (OR = 1.29, p = 0.033). CYP11A1 rs28681535 TT genotype was higher high-density lipoprotein cholesterol level than the GT and GG genotype (p = 0.027).

Conclusions

Our findings indicated that rs3735451, rs4646440, rs4646437 in CYP3A4 and rs28681535 in CYP11A1 might be protective factors for IS, while CYP11A1 rs12912592 polymorphism be a risk factor for IS in Chinese Han population.
Impacts of Nitrogen Rate and Landscape Position on Soils and Switchgrass Root Growth Parameters
Authors: Kumar Sandeep , Lai Liming , Kumar Pardeep , Valentín Feliciano Yashira Marie , Battaglia Martín Leonardo , Hong Chang Oh , Owens Vance N. , Fike John , Farris Rodney , Galbraith John 
Published: May 2019

Core Ideas
Nitrogen rate did not affect soil properties for Oklahoma, South Dakota, and Virginia.
Landscape position affected soil properties under higher slope.
Nitrogen rate affected root N, surface area, and weight for the total profile.
Landscape position affected the root C and N.
Switchgrass roots can increase C accumulation and reduce risk of N loss in soils.
ABSTRACTSwitchgrass (Panicum virgatum L.) has been recognized as a potential bioenergy feedstock, and can positively impact soils and the environment. The experimental sites were established in 2008 at three locations with each in Oklahoma (OK), South Dakota (SD), and Virginia (VA) to assess the impacts of N fertilization rate (N rate; low, 0 kg ha−1; high, 112 kg ha−1) and landscape position (shoulder, backslope, and footslope) on select soil properties and root growth parameters. Data indicate that N rate did not affect soil bulk density (BD), pH, electrical conductivity (EC), soil organic carbon (SOC), and total nitrogen (TN) for any of five depths. Landscape position impacted some of these properties by depth, depending on location. The N rate influenced root weight (RW), root surface area (RSA), and root total nitrogen (RTN) for the total profile (0–100‐cm depth) depending on local site conditions. The landscape position impacted RW, root total carbon (RTC), and RTN for total profile according to different site conditions. The interactions of landscape position by N rate on switchgrass root parameters were significant. The findings in this study indicate that the root system of switchgrass could improve soils and increase C accumulation and reduce the risk of N loss to benefit the environment.
Increased Maize Plant Population Induced Leaf Senescence, Suppressed Root Growth, Nitrogen Uptake, and Grain Yield
Authors: Li Rongfa , Liu Peng , Dong Shuting , Zhang Jiwang , Zhao Bin 
Published: May 2019

Core IdeasIncreased maize plant population induced leaf senescence, especially lower leaf.Senescence of lower leaves could significantly decrease the distribution of C to the root system, root activity weakened, reducing the uptake of nitrogen.Senescence of lower leaves decreased the accumulation of biomass, resulting in lower yield.To date, little attention has been paid to the effects of lower position leaves on root function and N uptake in maize. This study was conducted to analysis the relationship between lower leaf senescence and root function in different plant population (67,500 plants ha−1, 90,000 plants ha−1). We used the maize varieties DengHai661 (DH661) and ZhengDan958 (ZD958) in field and soil column experiments to unravel this physiological puzzle. The field experiment evaluated their effects on N accumulation and grain yield. Relative to the low plant population, the high plant population reduced leaf area (52.6–69.2%), and the root biomass (25.5–31.8%) per plant. Grain weight and the number of grains per ear were also negatively affected. Biomass and grain yield generally increased (P< 0.05) with increasing plant population. The grain yield of DH661 and ZD958 increased by 8.1% and 10.1% in 2015, and 7.5% and 13.0% in 2016, respectively. The N accumulation of two varieties post‐silking decreased. In the soil column experiments, we found that lower leaf senescence suppressed root growth, N uptake, and altered N partition, thereby decreasing green leaf area and ultimately affecting grain yield. Grain yield in DH661 and ZD958 decreased by 5.8 and 8.6%, respectively. Our results suggest that delaying lower leaf senescence in high plant population would be conducive to maintaining the N‐uptake ability of roots, higher canopy photosynthetic capacity, and the building of grain sink to obtain higher yields.
Mulching Affects Seed Set, Provisioning, and Offspring Performance of Vicia unijuga (Fabaceae)
Authors: Tang Wei , Li Rui , Zhang Zhixin , Baskin Carol C. , Nan Zhibiao 
Published: May 2019

Core Ideas
Seed set of V. unijuga plants can be maximized by mulching in subalpine conditions.
Plastic mulching increased seed provisioning, thus improving V. unijuga seed quality.
Increased seed provisioning (mass) of V. unijuga improved germination success.
Large seeds/seedlings have higher competitive ability relative to small seeds.
ABSTRACTOur aim was to identify the soil and environmental modifications needed to improve seed set and seed quality of the perennial forage legume perennial vetch (Vicia unijuga A. Br.) in harsh subalpine conditions. A 3‐yr field experiment was conducted in a subalpine zone of China to evaluate the effects of modified soil temperature and moisture conditions generated by no mulching (control), plastic film mulching (FM), removal of plastic film mulching at the 30% flowering stage (RM), and threshed barley straw mulching (SM) on seed set, mass, reserves, germination, and seedling growth. The FM and SM treatments were efficient in increasing seed maturation and decreasing ovule abortion at the base of the pods. There were higher 100‐seed weight (HSW) and seed nutrient reserves in the FM and RM treatments, accompanied by higher final germination percentage (FGP) and lower time to 50% germination (T50) and greater initial seedling growth than in the control, whereas the reverse was true for the SM treatment. Modified soil temperature and moisture generated by mulching improved offspring performance traits of V. unijuga through an increase in HSW. The HSW was positively correlated with FGP and seedling growth traits and was negatively associated with T50. In conclusion, the FM treatment provided adequate soil temperature and water resources to maximize seed set by V. unijuga plants. The well‐provisioned seeds from this treatment conferred the advantages of good offspring performance on high germination and seedling growth traits.
Dung Beetles Increase Greenhouse Gas Fluxes from Dung Pats in a North Temperate Grassland
Authors: Evans Kenneth S. , Mamo Martha , Wingeyer Ana , Schacht Walter H. , Eskridge Kent M. , Bradshaw Jeff , Ginting Daniel 
Published: May 2019

Soil fauna plays a critical role in various ecosystem processes, but empirical data measuring its impact on greenhouse gas (GHG) emissions from rangelands are limited. We quantified the effects of dung beetles on in situ CO2, CH4, and N2O emissions from simulated cattle dung deposits. Soil in meadows of the semiarid Nebraska Sandhills was treated with three treatments (dung pats with exposure and without exposure to dung beetles, and a no dung control). A closed‐chamber method was used to measure GHG fluxes at 0, 1, 2, 3, 7, 10, 14, 21, 28, and 56 d after dung placement in the early season (June–August) and late season (July–September) in 2014 and 2015. The greatest dung beetle abundance was 6 ± 2 beetles per quarter pat on Day 7; the abundance decreased to <2 ± 0.6 on Day 14 and 28 and zero on Day 56. Dung beetles increased fluxes of CO2 by 0.2 g C d−1 m−2, N2O by 0.4 mg N d−1 m−2 (only in late season 2015), and CH4 by 0.2 mg C d−1 m−2. These increases were due to beetle‐made macropores that facilitated gas transport in wet dung (initial moisture = 4.6 g g−1 on a dry‐weight basis) within 7 d after dung placement. Seasonal environmental differences resulted in greater CO2, N2O, and CH4 fluxes in the early season than in the late season. This study concluded that dung beetles increased GHG fluxes from early‐ and late‐season dung deposits on meadows of the semiarid Nebraska Sandhills.Core Ideas
Dung beetle activities on dung pat enhanced CO2–C emission.
The effect of dung beetle activities on N2O emission from dung pat was inconsistent.
Soil moisture and temperature had a significant effect on GHG emission.