bluuebunny/crossref_metadata_2025_split huggingface dataset:
Competence for older people nursing in care and nursing homes: An integrative review
Authors: Kiljunen Outi , Välimäki Tarja , Kankkunen Päivi , Partanen Pirjo 
Published: December 2016

BackgroundPeople living in care and nursing homes are vulnerable individuals with complex needs; therefore, a wide array of nursing competence is needed to ensure their well‐being. When developing the quality of care in these units, it is essential to know what type of competence is required for older people nursing.Aims and objectivesThe aim of this integrative review was to identify the competence needed for older people nursing in licensed practical nurses' and registered nurses' work in care and nursing homes.DesignIntegrative literature review.MethodsWe performed an integrative review using Whittemore and Knafl's method. The CINAHL, MEDLINE, PsycINFO, SocINDEX and Scopus databases were searched for studies published from 2006 to April 2016. We assessed the quality of the studies using Joanna Briggs Institute critical appraisal tools and analysed the data by applying qualitative content analysis.ResultsTen articles were included in the review. Most of the studies focused on registered nurses' work. We identified five competence areas that are needed for older people nursing in registered nurses' work in care and nursing homes: attitudinal and ethical, interactional, evidence‐based care, pedagogical, and leadership and development competence. Empirical evidence of competence requirements related to licensed practical nurses' work in these facilities was scarce.ConclusionsThe competence required for registered nurses and licensed practical nurses should be clearly identified to support competence management in the care and nursing home context.Implications for practiceWell‐educated nursing staff are needed in care and nursing homes to provide high‐quality care because comprehensive and advanced nurse competence is required to meet the needs of older people.
Intra‐ and inter‐ examiner repeatability of cycloplegic retinoscopy among young children
Authors: McCullough Sara J. , Doyle Lesley , Saunders Kathryn J. 
Published: December 2016

AbstractPurposeTo evaluate the intra‐ and inter‐examiner repeatability of cycloplegic retinoscopy in young children aged 4–5 years old.MethodsExaminer 1 refracted all children in the first sample (n = 108); firstly with masked loose lenses, then using unmasked loose lenses (intra‐examiner repeatability). Examiners 1 and 2 refracted all children in the second sample (n = 97) using unmasked loose lenses, blind to the child's refractive error, presence/magnitude of habitual spectacle correction and to each other's findings (inter‐examiner repeatability). Refractions were performed on one eye chosen at random. Mean differences, 95% limits of agreement (LOAs) and confidence intervals were calculated for intra‐ and inter‐examiner repeatability of sphere, cylinder and spherical equivalent refraction (SER).ResultsParticipants had a wide range of refractive errors (−1.50DS to +7.25DS; ≥4.50DC). Mean differences (95% LOAs) were small for both intra‐ and inter‐examiner repeatability [Intra: Sphere 0.00D (−0.85, +0.85D), Cylinder −0.03D (−0.68, +0.62D), SER −0.06D (−0.90, +0.78D); Inter: Sphere −0.08D (−0.92, +0.76D), Cylinder −0.08D (−0.75, +0.59D), SER −0.13D (−0.95, +0.69D). A statistically significant proportional bias was present for intra‐examiner repeatability of cylinder (ρ = 0.20, p = 0.04) and SER measurement (ρ = 0.19, p = 0.049). Proportional bias was not present for any other measure (p > 0.12). Examiners agreed on cylinder axis within ±20° in 71% of refractions where astigmatism of −0.75D or higher was present. 80% of intra‐ and inter‐examiner measures fell within ±0.50D for spherical and cylindrical components.ConclusionsDifferences of ±1.00D and ±0.75D or more for spherical and cylindrical measures respectively can be considered significant when performing cycloplegic retinoscopy on young children.
Correlations of Japanese Orthopaedic Association Scoring Systems with Gait Parameters in Patients with Degenerative Spinal Diseases
Authors: Zheng Chen‐fan , Liu Yan‐cheng , Hu Yong‐cheng , Xia Qun , Miao Jun , Zhang Ji‐dong , Zhang Kuan 
Published: December 2016

ObjectiveJapanese Orthopaedic Association (JOA) scoring systems were developed to evaluate the neurological function of patients with cervical or lumbar degeneration. As patient‐based and multi‐dimensional clinical evaluation tools, these systems should be capable of reflecting the walking disability of patients. The association between JOA scores and gait parameters, however, are not well characterized. The purpose of this study was to determine the correlations between JOA scores and gait parameters of patients with cervical spondylotic myelopathy (CSM) and lumbar intervertebral disc herniation (LDH).MethodsA total of 32 CSM and 30 LDH patients with gait dysfunction were recruited for the present study. All patients were diagnosed by two senior orthopaedic doctors and evaluated with JOA scoring systems. A body‐mounted motion analyzer, the Intelligent Device for Energy Expenditure and Activity (IDEEA), was applied to measure gait parameters of patients across 30 m of flat floor in an orthopaedic ward. A linear regression model was used to determine the correlations between JOA scores and gait parameters. Multiple linear regressions were used to identify the relationships between subsections of the JOA systems and gait parameters.ResultsJapanese Orthopaedic Association scores of LDH patients from the JOA lumbar scoring system are significantly correlated with gait speed (R
2 = 0.557, P < 0.001) and stride length (R
2 = 0.544, P < 0.001). JOA scores are also correlated with double support duration, step duration, cycle duration and cadence, and weakly correlated with single support duration. For the four subsections of the JOA lumbar scoring system, “restriction of activities of daily living” is the significant predictor of all gait parameters, especially gait speed (R
2 = 0.573, P < 0.001) and stride length (R
2 = 0.553, P < 0.001). However, JOA scores of CSM patients from the JOA cervical scoring system are only weakly correlated with these measures (all R
2 < 0.3). For the four subsections of the JOA cervical scoring system, “motor function of the lower extremity” is a weak predictor of gait parameters (all R
2 < 0.3).ConclusionsThere is a significant correlation between gait parameters and functional disability as measured by the JOA lumbar scoring system, which indicates that the JOA lumbar scoring system can reflect gait impairment. The JOA cervical scoring system, however, may need to be improved for efficiently evaluating the walking ability of CSM patients in the assessment of motor function of the lower extremity.
What Role Does Low Bone Mineral Density Play in the “Killer Turn” Effect after Transtibial Posterior Cruciate Ligament Reconstruction?
Authors: Li Yue , Chen Xing‐zuo , Zhang Jin , Song Guan‐yang , Li Xu , Feng Hua 
Published: December 2016

ObjectiveTo explore the mechanism of the “killer turn”, which is reported to be a reason for postoperative residual laxity after transtibial posterior cruciate ligament (PCL) reconstruction, in a low bone mineral density (BMD) condition.MethodsA total of 80 skeletally mature female New Zealand white rabbits were included for biomechanical evaluation after transtibial PCL reconstructions. The subjects were equally divided into low BMD (n = 40) and control groups (n = 40). Rabbits in the low BMD group were treated with surgery and drug injection to establish an osteoporotic model. Rabbits in the control group received sham surgeries and no injection. All assignments were conducted randomly according to random numbers generated by a computer. All grafts were then subjected to biomechanical testing with an MTS model‐858 Mini Bionix servohydraulic materials testing machine (MTS Systems, Minneapolis, Minnesota, USA). The experimental outcomes were the increment of total graft displacement, tunnel inlet enlargement, graft elongation, stiffness and failure load of the two groups, and the comparison between them.ResultsAmong the 80 subjects, 1 subject of the low BMD group failed at the 30th cycle by proximal tibial fracture and 1 subject of the control group failed at the 20th cycle for the same reason. As a result, 39 subjects of the low BMD group and 39 subjects of the control group survived the cyclic loading test. Compared with the control group, the low BMD group demonstrated significantly larger total graft displacement (
P
= 0.006) and tunnel inlet enlargement (
P
= 0.041) than the control group. The number of subjects with less than 10% enlargement was significantly greater (57.1%) in the control group than in the low BMD group (
P
= 0.004). In the load‐to‐failure test, 26 (66.7%) subjects in the low BMD group failed by proximal tibial fracture (around the tunnel), 6 (15.4%) at the mounting site, 5 (12.8%) at the fixation site, and only 2 (5.1%) failed at the “killer turn.” In the control group, 20 (51.3%) failed at the “killer turn,” 9 (23.1%) at the proximal tibia (around the tunnel), 5 (12.8%) at the mounting site, and 5 (12.8%) at the fixation site. There were significantly fewer failures (10.0%) at the “killer turn” (
P
= 0.000) and 155.6% more for the para‐tunnel fracture (
P
= 0.000) in the low BMD group compared with the control group.ConclusionsThe low BMD group demonstrated an inferior biomechanical outcome to the control group with the transtibial technique. With low BMD, the “killer turn” effect compromises the posterior tibial cortex by enlarging the tunnel inlet.
Relationship between the Patellar Ridge and the Femoral Trochlea in the Patellar Tracking
Authors: Wang Xiao‐meng , Liu Hui‐xin , Niu Jing‐hui , Duan Gu‐man , Wang Fei 
Published: December 2016

ObjectiveTo investigate the anatomic morphology of the patellar ridge and how it matches the femoral trochlea in patellar tracking.MethodWe selected 40 volunteers, 20 males (age, 28 ± 5 years) and 20 female (age, 27 ± 6 years), who were completely asymptomatic with normal knee structures. We measured the right or left legs of volunteers, and the region from the distal femur to the tibial tuberosity was scanned by computed tomography (CT) with flexion at 0°, 30°, 60°, and 90°. CT data was reconstructed using image analysis software (Mimics). Variables such as the angle between the patellar ridge and patellar long axis, the tibial external rotation angle, as well as the best matching position between the patellar ridge and femoral trochlea at different knee flexion angles were measured. A single experienced orthopedic surgeon performed all the measurements, and the surgeon was blinded to the subject identifying information. We analyzed the differences between the various angles using a one‐way analysis of variance. The differences between genders were analyzed using the t test.ResultsThe intraclass correlation coefficient (ICC) values were greater than 0.81 for all measurements, and the ICC value is almost in perfect agreement. The angle between the patellar ridge and the patellar long axis was 11.13° ± 4.1°. The angle in male participants was 10.87° ± 4.5° and it was 12.09° ± 3.7° in female participants. There were significant differences between each angle (0°, 30°, 60°, and 90°). The angles between the patellar ridge and femoral trochlear groove did not greatly increase with the knee flexion. The tibial internal rotation angle also showed a gradually increase at knee flexion of 0°–60°, and a gradually decrease at 60°–90°. The best‐fit point between the patellar ridge and femoral trochlear groove gradually increased along with the knee flexion. There were no significant differences between male and female participants at all angles (
P
< 0.05).ConclusionThe anatomic morphology of the patellar ridge allows better matching between the patellar ridge and femoral trochlea during knee flexion, which is an important mechanism for the regulation of patellar tracking.
Relationship between Patellar Tracking and the “Screw‐home” Mechanism of Tibiofemoral Joint
Authors: Zhang Li‐kang , Wang Xiao‐meng , Niu Ying‐zhen , Liu Hui‐xin , Wang Fei 
Published: December 2016

ObjectiveTo demonstrate the effect of the screw‐home motion on the stability of the patellofemoral joint, and investigate its mechanism of regulation of patellar tracking.MethodsTwenty volunteers who met the criteria were examined. All subjects had axial computed tomography (CT) scanning performed on bilateral knees at 0° and 30° of flexion. Scanning began above the femorotibial articulation and femoral trochlear groove, and moved sequentially down to the level of the anterior tibial tubercle. The following measurements were obtained: tibial rotation relative to the femur (TRRF), tibial tuberosity–trochlear groove (TT–TG) distance, lateral patellar displacement (LPD), patellar tilt angle (PTA), and congruence angle (CA). We assessed the change (Δ) in each variable at both flexion angles, and analyzed this to investigate the corresponding relationship between the patella, the femur, and the screw‐home mechanism. The differences between the values measured at 0° and those measured at 30° flexion were analyzed using the paired sample t‐test. The differences between men and women were analyzed using the t‐test. Pearson’s correlations were performed to determine the relationship between ΔTT–TG distance and ΔLPD, ΔPTA and ΔTRRF, and ΔCA and ΔTRRF.ResultsThere were 10 women and 10 men enrolled in the present study, with an average age of 25 years and an average body mass index of 21.8 kg/m2, and all volunteers had no history of knee injuries. Compared with measurements taken at 0° flexion, TRRF at 30° flexion was significantly increased, and the PTA, CA, LPD, and TT–TG distance were significantly decreased (all P < 0.01). There was no difference between men and women at 0° and 30° flexion, respectively (P < 0.01). In this respect, there was no sex difference, but the change was greater for men than for women. Both ΔPTA and ΔCA demonstrated significant correlation with the ΔTRRF (both P < 0.01); a significant correlation between ΔLPD and ΔTT–TG distance was also demonstrated (P < 0.01).ConclusionsAs the tibiofemoral joint rotated, the patellofemoral joint became more stable and aligned, which indicates that the screw‐home mechanism plays an important role in regulating patellofemoral joint alignment.
Treatment and Management of Osteoporotic Fractures: A Nation‐wide Survey of 484 Senior Orthopaedists in China
Authors: Man Yi , Pan Wei , Lu Jin , Li Sen‐yuan , Zhang Pian , Guo Jun‐zhe , Yu Shu‐fang , Zhang Bei , Xiao En , Zhang Chao , Zuo Wei , Jin He‐juan , Chen Yi , Wu Bin , Shi Xiao‐en , Hong Di , Liu Xun , Gao Ying‐xu , Li Jing , Yin Lu , Xue Qing‐yun 
Published: December 2016

ObjectiveTo investigate the treatment given to osteoporotic fracture patients by orthopaedists at major hospitals in China.MethodsA 25‐item quantitative questionnaire survey, categorized into five domains, including primary purpose of osteoporosis treatment, anti‐osteoporosis therapy, calcium and vitamin D supplement, monitoring of osteoporosis, and knowledge of osteoporosis treatment, was designed to elicit information on orthopaedists’ views on the treatment of osteoporotic fracture. A pre‐survey test was conducted with a sample of 40 orthopaedic specialists to confirm the reliability and validity of the questionnaire. Each interview of the survey took approximately 15 min and did not directly involve any patients. The survey was conducted through face‐to‐face interviews at 119 tier 3 hospitals in 28 cities across Mainland China.ResultsA total of 484 valid responses were received. Seven in ten respondents have ≥10 years of professional practice. While two‐thirds believed that osteoporosis treatment was to prevent fractures or re‐fractures, 95.0% agreed that anti‐osteoporosis medication should be administered to patients with a history of fragility fractures. Three in four would prescribe anti‐osteoporosis medication perioperatively. Of these, 79.0% regarded bisphosphonates as the first‐line drug. Approximately 86.0% of the 21–30 years cohort chose bisphosphonates compared to 71.4% for those with ≤10 years. More of the younger (≤10 years) cohort chose calcitonin compared to their older (21–30 years) colleagues (25.7% vs 11.6%). The most commonly prescribed daily dose is 800 IU for vitamin D supplements and 600 mg/day for calcium.ConclusionsOur respondents generally adhered to guidelines for the treatment and management of osteoporosis. A significant number had recommended lower dosages of vitamin D and calcium. Some differences exist between the younger cohort and their older colleagues in the prescription of pharmacological therapies. The criteria for initiating therapy should be more holistic and include other factors besides bone mineral density (BMD). Our results demonstrated that more comprehensive guidelines for osteoporosis management and a greater awareness of these guidelines by orthopaedists are needed to enable them to better manage their patients.
N‐acetylcysteine Attenuates Cobalt Nanoparticle‐Induced Cytotoxic Effects through Inhibition of Cell Death, Reactive Oxygen Species‐related Signaling and Cytokines Expression
Authors: Liu Ya‐ke , Yang Hong‐wei , Wang Meng‐hong , Wang Wei , Liu Fan , Yang Hui‐lin 
Published: December 2016

ObjectiveComplex cobalt‐chromium alloys, bearing surfaces of the second‐generation metal‐on‐metal (MoM) hip prostheses, are subject to wear and generate cobalt nanoparticles (CoNPs). CoNPs could reduce cellular viability, activate the mitogen‐activated protein kinase (MAPK) pathway and increase cell apoptosis via reactive oxygen species (ROS). However, the detailed mechanisms of ROS functioning on CoNP‐mediated signaling molecules and cytotoxicity has not yet been fully demonstrated. The present study investigated the functional role of N‐acetylcysteine (NAC) in reversing the activation of ROS signaling pathways triggered by CoNPs in normal mice kidney cells (TCMK‐1 cells).MethodsAfter being pretreated with NAC, TCMK‐1 cells were treated with 300–700 μmol/L CoNPs, then, CCK‐8 assay was used to verify the survival of TCMK‐1 cells. Annexin V/PI staining was performed to investigate the apoptosis of TCMK‐1 cells after NAC and different concentrations of CoNP treatments. In addition, western blot was performed to identify the cytokine (p‐ERK, p‐p38, and p‐JNK) expression of the ROS‐related MAPK signaling pathway.ResultsApoptosis rate of TCMK‐1 cells was increased obviously after different concentrations of CoNP treatment. However, TCMK‐1 cells, pretreated with NAC, exhibited a significantly decreased apoptosis rate. In addition, p‐ERK, p‐p38, and p‐JNK expressions were increased with CoNP treatment, which indicated that CoNPs could activate the MAPK pathway. Interestingly, this entire stimulated phenomenon by CoNPs was reversed with NAC treatment.ConclusionsThese findings indicated that NAC could reverse CoNP‐induced cytotoxicity by inhibiting ROS‐induced cell death and cytokine expression. To our knowledge, this is the first report that describes how CoNP‐induced cytotoxicity in TCMK‐1 cells could be attenuated by anti‐oxidative agents (NAC), which may function through inhibition of cell death and ROS.
The Distinctive Significance of Systemic Risk
Authors: James Aaron 
Published: December 2016

AbstractThis paper suggests that “systemic risk” (e.g., of financial market collapse, or of ecological calamity) has a distinctive kind of moral significance. Two intuitive data points need to be explained. The first is that the systematic imposition of risk can be wrongful or unjust in and of itself, even if harm never ensues. The second is that, even so, there may be no one in particular to blame. We can explain both ideas in terms of what I call responsibilities of “Collective Due Care.” Collective Due Care arguably precludes purely aggregative cost‐benefit decision‐making and requires one kind of “precautionary” attitude in public choice.
Climate Change Mitigation Techniques and International Law: Assessing the Externalities of Reforestation and Geoengineering
Authors: Ryngaert Cedric 
Published: December 2016

AbstractAs a subspecies of the climate justice debate, a compelling moral case can be made that actors should receive their fair share of benefits and burdens, and more specifically, that those who benefit from the provision of public goods ought, under some circumstances, to share in the costs of their provision. The climate justice debate has paid relatively scant attention, however, to the possible adverse side‐effects of climate mitigation mechanisms. The article reviews such global public goods‐protecting techniques as compensation payments for keeping rainforests intact, and climate engineering, for their adverse impact on human rights and biodiversity. Espousing a consequentialist ethical perspective, it calls for increased vigilance in institutionally designing and implementing climate change mitigation mechanisms, however well‐intentioned these may be.
The introduction of Hurrian religion into the Hittite empire
Authors: Campbell Dennis R.M. 
Published: December 2016

AbstractThe early Hittite New Kingdom was a period of great change. It was during this period that both a remarkable amount of Hurrian textual material entered into the Hittite capital and Hittite kings began having both Hittite and Hurrian names. In this paper I argue that the importation of Hurrian cultural material accompanied the dynastic marriage between the Hittite king and the king of Kizzuwatna. The reception of the material and its lasting effects within the ruling family are to be attributed to the education of the princes within a royal household headed by Hurrian queens.
Geochronology and Genesis of the Tiegelongnan Porphyry Cu(Au) Deposit in Tibet: Evidence from U–Pb, Re–Os Dating and Hf, S, and H–O Isotopes
Authors: Lin Bin , Tang Ju‐Xing , Chen Yu‐Chuan , Song Yang , Hall Greg , Wang Qin , Yang Chao , Fang Xiang , Duan Ji‐lin , Yang Huan‐Huan , Liu Zhi‐Bo , Wang Yi‐Yun , Feng Jun 
Published: December 2016

AbstractThe Tiegelongnan Cu (Au) deposit is the largest copper deposit newly discovered in the Bangong–Nujiang metallogenic belt. The deposit has a clear alteration zoning consisting of, from core to margin, potassic to propylitic, superimposed by phyllic and advanced argillic alteration. The shallow part of the deposit consists of a high sulphidation‐state overprint, mainly comprising disseminated pyrite and Cu–S minerals such as bornite, covellite, digenite, and enargite. At depth porphyry‐type mineralization mainly comprises disseminated chalcopyrite, bornite, pyrite, and a minor vein molybdenite. Mineralization is disseminated and associated with veins contained within the porphyry intrusions and their surrounding rocks. The zircon U–Pb ages of the mineralized diorite porphyry and granodiorite porphyry are 123.1 ± 1.7 Ma (2σ) and 121.5 ± 1.5 Ma (2σ), respectively. The molybdenite Re–Os age is 121.2 ± 1.2 Ma, suggesting that mineralization was closely associated with magmatism. Andesite lava (zircon U–Pb age of 111.7 ± 1.6 Ma, 2σ) overlies the ore‐bodies and is the product of post‐mineralization volcanic activity that played a critical role in preserving the ore‐bodies. Values of −4.6 ‰ to + 0.8 ‰ δ34S for the metal sulfides (mean − 1.55 ‰) suggest that S mainly has a deep magmatic source. The H and O isotopic composition is (δD = −87 ‰ to −64 ‰; δ18OH2O = 5.5 ‰ to 9.0 ‰), indicating that the ore‐forming fluids are mostly magmatic‐hydrothermal, possibly mixed with a small amount of meteoric water. The zircon εHf(t) of the diorite porphyry is 3.7 to 8.3, and the granodiorite porphyry is 1.8 to 7.5. Molybdenite has a high Re from 382.2 × 10−6 to 1600 × 10−6. Re and Hf isotope composition show that Tiegelongnan has some mantle source, maybe the juvenile lower crust from crust–mantle mixed source. Metallogenesis of the Tiegelongnan giant porphyry system was associated with intermediate to acidic magma in the Early Cretaceous (~120 Ma). The magma provenance of the Tiegelongnan deposit has some mantle‐derived composition, possibly mixed with the crust‐derived materials.