bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Modern Intramedullary Nailing in Distal Fibula Fracture Fixation
Authors: Tracey Joseph , Vovos Tyler J. , Arora Danny , Adams Samuel , Parekh Selene G. 
Published: October 2018

Background. Lateral malleolus (LM) fixation is necessary for unstable ankle fractures. Traditional fixation relies on the use of plates through a lateral incision, wound healing can be an issue for such incisions. A novel intramedullary (IM) fixation device has been developed that can be placed through a minimal incision. The purpose of this study was to demonstrate the clinical efficacy of this device. Methods. A retrospective analysis was performed on patients who received IM fixation for isolated fibula, bimalleolar (BM), and trimalleolar (TM) fractures. Pertinent demographic information, operative factors, complications, and clinical outcomes were recorded. Results. Sixteen patients were included in the study with an average age of 59 years (range 35-86 years). Six patients presented with isolated LM fractures, four patients had a BM fracture with a syndesmotic injury, 2 patients sustained a LM fracture with an associated syndesmotic injury, 2 patients had a BM fracture, and 2 patients had a TM fracture with a syndesmotic injury. There was a 100% healing rate of the lateral malleolus without any cases of malunion or shortening. There were no cases of sural nerve or peroneal tendon injuries, nor any wound complications found. Conclusion. These findings demonstrate the safe and efficacious use of a novel intramedullary fixation device for fibula fractures with lower wound complications compared with published outcomes found with lateral fibular plating. The features of this device allow for reliable fixation of the fibula, maintaining length and minimizing wound issues. Levels of Evidence: Level IV: Case series
Pediatric Meningoencephaloceles Endoscopic Endonasal Repair: Our Experience
Authors: Marfatia Hetal K. , Parelkar Kartik A. , Chakraborty Adhara , Mishra Shampa 
Published: October 2018

Background Pediatric patients presenting with a nasal mass is uncommon and a high index of suspicion for it to be a meningoencephalocele is essential. Majority of these are congenital and require early intervention owing to the risk of meningitis. Surgery in these cases is very challenging because of the risk of anesthesia and limited space. Objective This study aimed to describe our technique and experience in managing pediatric meningoencephaloceles. Methods A retrospective study of 19 pediatric patients (age ranging from 40-day-old infants to 11.5-year-old children) was conducted at our tertiary care center from January 2012 to February 2017. Patients presenting with an intranasal meningoencephalocele were treated by endoscopic approach, using otological microinstruments. After detailed imaging and clinical evaluation, a tailored repair, using fat/fascia/cartilage, a multilayer closure, was carried out in all cases. Results All patients had a successful repair and recovery, except for one death following an episode of convulsion. There was a minor circumferential narrowing of the nasal vestibule and synechia formation in 2 of our cases. Conclusion Transnasal endoscopic repair of meningoencephalocele is minimally invasive. It avoids permanent anosmia and is cosmetic. A combination of miniaturized instruments and a 4-mm 0° nasal endoscope gives excellent visual field and an adequate working space. Owing to the larger defects in congenital meningoencephaloceles, a multilayer repair provides excellent outcomes.
Comparing biomechanical strength of unicortical locking plate versus bicortical compression plate for transverse midshaft metacarpal fracture
Authors: Shanmugam Rukmanikanthan , Jian Chong Yin Chyi@ Chong Shyh , Haseeb Amber , Aik Saw 
Published: October 2018

Purpose: Metacarpal bone fractures constitute 10% of all fractures. Unstable metacarpal fractures require surgical intervention, which poses danger to flexor tendon either due to bicortical drilling or construct of the implant. Unicortical locking plate fixation may be the solution to preventing flexor tendon injury. Studies have compared locking and compression plates. However, in these studies, the biomechanical properties were tested using the static loading method. This study looks into cyclical loading that is more representative of in vivo conditions, particularly for early rehabilitation. We compared the biomechanical strength of the unicortical locking plate and bicortical compression plate system in a transverse metacarpal fracture, tested with cyclical loading and torsion. Method: Twenty pieces of fourth-generation, biomechanical testing grade, left third metacarpal composite bones were used. Resin was used to create the holding block at both ends of the bone. An oscillating saw with 0.8 mm thick saw blade was used to osteotomize the metacarpal sawbones to create a midshaft transverse metacarpal fracture model. Ten pieces were fixed with a 2.0 mm titanium locking plate via unicortical screw purchase and 10 were fixed with a 2.0 mm, four holes, titanium dynamic compression plate, bicortical purchase of screws. They were subjected to cyclic load to failure testing three-point bending and torsion. Results: There were no significant difference in stiffness and cyclic three-point bending to failure between the unicortical locking plate group and the bicortical compression plate group. The bicortical compression plate group is stiffer and has a higher cyclic bending load to failure as compared to the unicortical locking plate group. Conclusion: Unicortical locking plate fixation of metacarpal fracture can be reliably applied clinically to produce a strong and stable construct that allows early mobilization of the joints. This will not only reduce the complication rate of metacarpal plating, but also improve the functional outcome of the hand.
Manipulation under anaesthetic following total knee arthroplasty: Predicting stiffness and outcome
Authors: Cartwright-Terry Matthew , Cohen Daniel R , Polydoros Fotis , Davidson John S , Santini Alasdair JA 
Published: October 2018

Purpose: A stiff total knee replacement can severely limit a patient’s post-operative function, but there remain few prospective trials identifying those patients at risk, nor the efficacy of manipulation. We analysed our prospectively collected database to assess predictors of stiffness and outcomes following manipulation. Methods: Using prospectively collected knee arthroplasty data, including preoperative and post-operative range of knee movement, SF-12 (physical and mental) and The Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, patients requiring manipulation were compared to a matched group of patients not requiring manipulation, with a detailed statistical analysis undertaken to assess potential risk factors and the post-manipulation outcome. Results: Of the 1313 arthroplasty patients, 69 required manipulation. Patients with less than 80° of flexion at discharge, diabetes or on warfarin were more likely to require manipulation, but flexion at discharge was the overwhelming predictive factor for stiffness. Forty per cent of the range of movement gained during manipulation was maintained at 1 year, with earlier manipulation deriving greater improvements. While the WOMAC scores improved post-manipulation, there was no significant difference in either of the SF12 scores. Conclusion: Flexion at discharge is the overwhelming predictive factor for the requirement for manipulation.
Point-of-Care Ultrasound Abnormalities in Late-Onset Severe Preeclampsia: Prevalence and Association With Serum Albumin and Brain Natriuretic Peptide
Authors: Ortner Clemens M. , Krishnamoorthy Vijay , Neethling Elmari , Flint Margot , Swanevelder Justiaan L. , Lombard Carl , Fawcus Susan , Dyer Robert A. 
Published: September 2018

BACKGROUND:
Pilot studies applying point-of-care ultrasound (POCUS) in preeclampsia indicate the presence of pulmonary interstitial edema, cerebral edema, and cardiac dysfunction. Laboratory markers of oncotic pressure (albumin) and cardiac dysfunction (brain natriuretic peptide [BNP]) may be abnormal, but the clinical application remains unclear. We investigated the prevalence of pulmonary interstitial syndrome (PIS), cardiac dysfunction, and increased optic nerve sheath diameter (ONSD) in late-onset preeclampsia with severe features. The primary aim was to examine the association between PIS or ONSD and maternal serum albumin level. The secondary aims were to explore the association between cardiac dysfunction and PIS, ONSD, BNP, and serum albumin level and between POCUS-derived parameters and a suspicious or pathological cardiotocograph.

METHODS:
Ninety-five women were enrolled in this prospective observational cohort study. A POCUS examination of lungs, heart, and ONSD was performed. PIS was defined as a bilateral B-line pattern on lung ultrasound and diastolic dysfunction according to an algorithm of the American Society of Echocardiography. ONSD >5.8 mm was interpreted as compatible with raised intracranial pressure (>20 mm Hg). Serum BNP and albumin levels were also measured.

RESULTS:
PIS, diastolic dysfunction, systolic dysfunction, and raised left ventricular end-diastolic pressure (LVEDP) were present in 23 (24%), 31 (33%), 9 (10%), and 20 (25%) women, respectively. ONSD was increased in 27 (28%) women. Concerning the primary outcome, there was no association between albumin level and PIS (P = .4) or ONSD (P = .63). With respect to secondary outcomes, there was no association between albumin level and systolic dysfunction (P = .21) or raised LVEDP (P = .44). PIS was associated with diastolic dysfunction (P = .02) and raised LVEDP (P = .009; negative predictive value, 85%). BNP level was associated with systolic (P < .001) and diastolic dysfunction (P = .003) and LVEDP (P = .007). No association was found between POCUS abnormalities and a suspicious/pathological cardiotocograph (P = .07).

CONCLUSIONS:
PIS, diastolic dysfunction, and increased ONSD were common in preeclampsia with severe features. Cardiac ultrasound abnormalities may be more useful than albumin levels in predicting PIS. The absence of PIS may exclude raised LVEDP. The further clinical relevance of PIS and raised ONSD remains to be established. BNP level was associated with cardiac ultrasound abnormalities. Although this study was not designed to directly influence clinical management, the findings suggest that POCUS may serve as a useful adjunct to clinical examination for the obstetric anesthesiologist managing these complex patients.
Persistent Nociception Facilitates the Extinction of Morphine-Induced Conditioned Place Preference
Authors: You Zerong , Ding Weihua , Doheny Jason T. , Yang Jinsheng , Yang Liuyue , Lim Grewo , Miao Jiamin , Chen Lucy , Shen Shiqian , Mao Jianren 
Published: September 2018

BACKGROUND:
As opioid abuse and addiction have developed into a major national health crisis, prescription of opioids for pain management has become more controversial. However, opioids do help some patients by providing pain relief and improving the quality of life. To better understand the addictive properties of opioids under chronic pain conditions, we used a conditioned place preference (CPP) paradigm to examine the rewarding properties of morphine in rats with persistent nociception.

METHODS:
Spared nerve injury (SNI) model was used to induce persistent nociception in rats. Nociceptive behavior was assessed by von Frey test. CPP test was used to examine the rewarding properties of morphine.

RESULTS:
Our findings are as follows: (1) SNI rats did not show a difference compared with sham rats in magnitude of morphine-induced CPP 1 day after last morphine injection (2-way analysis of variance; for SNI versus sham, F[1,42] = 0.014, P = .91; and 95% confidence intervals for difference of means, −5.9 [−58 to 46], 0.76 [−51 to 53], and 0.90 [−51 to 53] for 2.5, 5, and 10 mg/kg, respectively); (2) increasing morphine dosage (2.5, 5, and 10 mg/kg) did not further increase the magnitude of CPP in both sham and SNI rats (for dosage: F[2,42] = 0.94, P = .40); and (3) morphine-induced CPP persisted in sham rats but extinguished in SNI rats when tested at 8 days after last morphine injection (for sham versus SNI: Bonferroni correction, P < .006 for both 5 and 10 mg/kg doses; and 95% confidence intervals for difference of means, 80.3 [19.7–141] and 87.0 [26.3–148] for 5 and 10 mg/kg, respectively).

CONCLUSIONS:
Our data provide new evidence supporting the notion that the brain’s reward circuitry changes in the context of persistent pain. This observational study suggests that future investigation into the neurobiology of opioid reward requires consideration of the circumstances in which opioid analgesics are administered.
Desempenho dos serviços de saúde na atenção à tuberculose na estratégia de saúde da família [Health service performance in tuberculosis care in the Family Health Strategy] [Rendimiento de los servicios de salud en la atención a la tuberculosis en la estrategia de salud de la familia]
Authors: Benetti Keidi Vianna , Medeiros Celia Regina Da Silva , Parreira Pedro Miguel Diniz , Mauro Maria yvone Chaves , Souza Maria Helena Do Nascimento , Farias Sheila Nascimento Pereira de 
Published: October 2018

Objetivo: avaliar o desempenho dos serviços de saúde na atenção à tuberculose, na percepção das equipes da estratégia saúde da família. Método: estudo transversal de abordagem quantitativa, realizado com 210 profissionais das equipes da estratégia de saúde da família de uma área de planejamento do Rio de Janeiro. Foi aplicado o questionário PCATool – tuberculose, no período de agosto a novembro de 2015. Os dados foram tratados e analisados, no programa epi info versão 7.1.5. Projeto aprovado no comitê de ética em pesquisa da Escola de Enfermagem Anna Nery e da Secretaria Municipal de Saúde. Resultados: observou-se que para o diagnóstico de tuberculose o desempenho das unidades foi razoável e para o tratamento o resultado foi satisfatório. Conclusão: o desempenho dos serviços de saúde apresenta fragilidades e atende parcialmente a clientela.ABSTRACT Objective: to evaluate health service performance in tuberculosis care as perceived by family health strategy teams. Methods: in this quantitative, cross-sectional study, the PCATool-tuberculosis was applied between August and November 2015, to 210 professionals from family health strategy teams in a planning area in Rio de Janeiro. Data were processed and analyzed using Epi Info software, version 7.1.5. The project was approved by the research ethics committees of the Anna Nery School of Nursing and Municipal Health Secretariat. Results: the units’ performance was observed to be reasonable in tuberculosis diagnosis, and satisfactory in treatment. Conclusion: health service performance displays weaknesses and meets client needs partially.RESUMENObjetivo: evaluar el rendimiento de los servicios de salud en la atención a la tuberculosis, bajo la percepción de los equipos de la estrategia de salud de la familia. Método: estudio transversal de abordaje cuantitativo, realizado junto a 210 profesionales de los equipos de la estrategia de salud de la familia de un área de planificación de Río de Janeiro. Fue aplicado el cuestionario PCATool –tuberculosis, en el periodo de agosto a noviembre de 2015. Los dados fueron tratados y analizados en el programa epi info versión 7.1.5. Proyecto aprobado en el comité de ética en investigación de la Escuela de Enfermaría Anna Nery y de la Secretaría Municipal de Salud. Resultados: se verificó que, para el diagnóstico de tuberculosis, el rendimiento de las unidades fue adecuado y, para el tratamiento de los resultados, fue satisfactorio. Conclusión: el rendimiento de los servicios de salud presenta fragilidades y atiende parcialmente la clientela.
Grandparents of Children With Intellectual and Developmental Disabilities: Navigating Roles and Relationships
Authors: Yang Xueyan , Artman-Meeker Kathleen , Roberts Carly A. 
Published: October 2018

AbstractGrandparents can play critical roles in the lives of children with intellectual and developmental disabilities and their families. However, current research and understanding around grandparent roles and experiences is limited. The purpose of this qualitative study was to examine the roles and experiences of grandparents supporting children with disabilities. In this article, the voices of grandparents with diverse experiences are presented. Key themes that emerged were the role of the grandparent, boundaries in roles and space, navigating family dynamics, and the general experiences of grandparenting. These findings have implications for the types of supports provided to grandparents and for practitioners working with families who have actively involved grandparents.
Denaturation-Enhanced Droplet Digital PCR for Liquid Biopsies
Authors: Fitarelli-Kiehl Mariana , Yu Fangyan , Ashtaputre Ravina , Leong Ka Wai , Ladas Ioannis , Supplee Julianna , Paweletz Cloud , Mitra Devarati , Schoenfeld Jonathan D , Parangi Sareh , Makrigiorgos G Mike 
Published: October 2018

Abstract

BACKGROUND
Although interest in droplet-digital PCR technology (ddPCR) for cell-free circulating DNA (cfDNA) analysis is burgeoning, the technology is compromised by subsampling errors and the few clinical targets that can be analyzed from limited input DNA. The paucity of starting material acts as a “glass ceiling” in liquid biopsies because, irrespective how analytically sensitive ddPCR techniques are, detection limits cannot be improved past DNA input limitations.

METHODS
We applied denaturation-enhanced ddPCR (dddPCR) using fragmented genomic DNA (gDNA) with defined mutations. We then tested dddPCR on cfDNA from volunteers and patients with cancer for commonly-used mutations. gDNA and cfDNA were tested with and without end repair before denaturation and digital PCR.

RESULTS
By applying complete denaturation of double-stranded DNA before ddPCR droplet formation the number of positive droplets increased. dddPCR using gDNA resulted in a 1.9–2.0-fold increase in data-positive droplets, whereas dddPCR applied on highly-fragmented cfDNA resulted in a 1.6–1.7-fold increase. End repair of cfDNA before denaturation enabled cfDNA to display a 1.9–2.0-fold increase in data-positive signals, similar to gDNA. Doubling of data-positive droplets doubled the number of potential ddPCR assays that could be conducted from a given DNA input and improved ddPCR precision for cfDNA mutation detection.

CONCLUSIONS
dddPCR is a simple and useful modification in ddPCR that enables extraction of more information from low-input clinical samples with minor change in protocols. It should be applicable to all ddPCR platforms for mutation detection and, potentially, for gene copy-number analysis in cancer and prenatal screening.
Analisis Dampak Tax Morale Terhadap Kepatuhan Pajak UMKM: Studi Kasus Kota Semarang
Authors: Mahmudah Muslimah , Iskandar Deden Dinar 
Published: September 2018

This study aims to analyze the impact of tax morale on Micro, Small, and Medium Enterprises (MSMEs) tax complianceSemarang City as the case study. This study uses primary data generated from 117 samples of MSMEs in Semarang. Data analysis is performed using binary logistic regression analysis. The results showed that environmental, institutional, ethical, business, and business size variables significantly influence MSMEs tax compliance. On the other hand, variables whose effect on tax compliance is not statistically significant include happiness, religiosity, gender, age, education, and marital status.
Association of serum sphingomyelin profile with clinical outcomes in patients with lower respiratory tract infections: results of an observational, prospective 6-year follow-up study
Authors: Baumgartner Thomas , Zurauskaite Giedre , Steuer Christian , Bernasconi Luca , Huber Andreas , Mueller Beat , Schuetz Philipp 
Published: September 2018

AbstractBackgroundSphingolipids – the structural cell membrane components – and their metabolites are involved in signal transduction and participate in the regulation of immunity. We investigated the prognostic implications of sphingolipid metabolic profiling on mortality in a large cohort of patients with lower respiratory tract infections (LRTIs).MethodsWe measured 15 different sphingomyelin (SM) types in patients with LRTIs from a previous Swiss multicenter trial that examined the impact of procalcitonin-guided antibiotic therapy on total antibiotic use and rates and duration of hospitalization. Primary and secondary end points were adverse outcomes – defined as death or intensive care unit admission within 30 days – and 6-year mortality.ResultsOf 360 patients, 8.9% experienced an adverse outcome within 30 days and 46% died within 6 years. Levels of all SM types were significantly lower in pneumonia patients vs. those with chronic obstructive pulmonary disease (COPD) exacerbation (p<0.0001 for all comparisons). Sphingomyelin subspecies SM (OH) C22:1 and SM (OH) C22:2 were associated with lower risk for short-term adverse outcomes (sex-, gender- and comorbidity-adjusted odds ratios [OR]: 0.036; 95% confidence interval [CI], 0.002–0.600; p=0.021 and 0.037; 95% CI, 0.001–0.848; p=0.039, respectively). We found no significant associations with 6-year mortality for any SM.ConclusionsCirculating sphingolipid levels are lower in inflammatory conditions such as pneumonia and correlate with adverse short-term outcomes. Further characterization of the physiological, pathophysiological and metabolic roles of sphingolipids under inflammatory conditions may facilitate understanding of their roles in infectious disease.
Über einige Aspekte der Arbeit von Peter Scholze
Authors: Wedhorn Torsten 
Published: September 2018

Zusammenfassung
Im August 2018 erhielt Peter Scholze die Fieldsmedaille for transforming arithmetic algebraic geometry over p-adic fields through his introduction of perfectoid spaces, with application to Galois representations, and for the development of new cohomology theories.
Es ist wahrscheinlich nicht möglich, auf wenigen Seiten eine präzise Version oder auch nur einen
einigermaßen vollständigen Eindruck der Vielzahl von bahnbrechenden Resultaten von Scholze
zu geben. Selbst eine genaue Erklärung der obigen Kurzlaudatio der internationalen
Mathematikunion würde sicherlich einen sehr viel längeren Text erfordern. Aber vielleicht ist es
möglich, eine vage Idee des Begriffs eines perfektoiden Raumes zu geben und einen Eindruck zu
vermitteln, warum diese Räume einen großen Teil der arithmetischen algebraischen Geometrie
revolutioniert haben. Dies ist ein Versuch.
Indiskrete Logarithmen?
Authors: Zumbrägel Jens 
Published: September 2018

Zusammenfassung
Die moderne Public-Key-Kryptographie, begründet durch die bahnbrechende Arbeit von Diffie und Hellman, ist seit jeher mit der Schwierigkeit des diskreten Logarithmusproblems verbunden. Allerdings ist in Körpern kleiner Charakteristik die Hartnäckigkeit dieses Problems nicht so hoch, wie
lange Zeit angenommen. Daraus resultieren beträchtliche Rekordberechnungen, sowie Konsequenzen für die Sicherheit einiger Kryptosysteme.
Fußball-WM-Design
Authors: Bjelde Antje 
Published: September 2018

Zusammenfassung
Der Gewinn eines großen Turniers, wie zum Beispiel der Fußballweltmeisterschaft, hängt nicht nur von
dem eigenen Können, sondern auch von der Reihenfolge der Spiele und Gegner ab. Wie diese
Reihenfolge „gut“ gewählt werden kann, kann mit Mechanismusdesign, einem Teilgebiet der
Spieltheorie, modelliert werden. Die Fußballweltmeisterschaft berührt also nicht nur kombinatorische
Fragen – „Wie viele mögliche Gruppenaufteilungen gibt es?“ –, sondern liefert uns auch den Einstieg in
diesen Artikel. Neben einem Einblick in das junge und spannende Gebiet des Mechanismusdesign
betrachten wir einige Auswahlmechanismen näher, wie sie beispielsweise bei Klassensprecherwahlen
Anwendung finden. Ein Artikel für die Kaffeepause mit Fußball, Pizza und Diktatoren.