bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Myth about Universal Higher Education: Russia in the International Context
Authors: Bessudnov Alexey , Kurakin Dmitry , Malik Valeriya 
Published: October 2017

It is widely believed that higher education in Russia has become almost universal and more people go to universities compared to most European countries. In this paper we explore this issue empirically with the Russian and European census data and data from the Trajectories in Education and Careers (TREC), a longitudinal cohort study. According to the 2010 census, only 34% of people aged between 25 and 34 in Russia have university degrees, which is nearly the same as in most Eastern European countries and slightly fewer than in Western Europe. The TREC data show that only about 50% of 2012 ninthgrade graduates were university students in 2015. The expansion of higher education in Russia has been in line with the overall European trends. Similar to other countries, there have been changes to the gender composition of university students in Russia over the last two decades, with girls being more likely to attend university than boys. The analysis of social backgrounds of students with different educational trajectories reveals a onsiderable social inequality within the Russian education system. Eighty-four percent of school graduates with university-educated parents are admitted to university, as compared to only 32% of children from less-educated families. Graduation from ninth grade represents an educational fork that is crucial for inequality, as children from less socially advantaged families tend to opt for vocational education at this stage. Graduation from eleventh grade is a less important educational transition: at least 80% of high school students get admitted to university after graduating from 11th grade.
Clinical radiological and pathological assessment of benign breast lumps: our institutional experience
Authors: Bangaru Himabindu , Chandra Alluru Sarath , Gaiki Varun Vijay 
Published: October 2017

Background: With increased awareness about breast cancer, many women with breast lumps are attending clinics. Though benign breast lumps are most common, they may be associated with morbidity and have become cause for concern to patients. Triple assessment by clinical, radiological and pathological examination is a standard approach in the evaluation of breast lumps. Even in cases of benign breast diseases, multimodality tests are being preferred to give reassurance to patients. This study was aimed to study distribution of various benign breast lumps in relation to age at presentation, to identify sensitivity and specificity of clinical breast examination, Ultrasonography (USG) and Fine needle aspiration cytology (FNAC) methods in the evaluation of benign breast lumps and to compare with final histopathological diagnosis.Methods: A retrospective study was conducted in department of general surgery at Malla Reddy institute of medical sciences, Hyderabad from August 2013 to July 2017. 202 females with benign breast lumps were evaluated by clinical breast examination, ultrasonography (USG) and Fine needle aspiration cytology (FNAC) methods. All patients underwent excision biopsy of lump. Final histopathological report was taken as reference standard.Results: Fibroadenoma was most common in 2nd decade. Clinical breast examination and USG showed good sensitivity but less specificity than FNAC. FNAC showed both good sensitivity and specificity. There was very good degree of agreement between FNAC and histopathological diagnosis (Kappa=0.911).Conclusions: Good clinical examination can give accurate preoperative diagnosis of benign breast lumps. Triple assessment by clinical breast examination, USG and FNAC can be useful in the evaluation of benign breast lumps.
Standardized Note Templates Improve Electronic Medical Record Documentation of Neurovascular Examinations for Pediatric Supracondylar Humeral Fractures
Authors: Cao Jue , Farmer Ryan , Carry Patrick M. , Goodfellow Maria , Gerhardt David C. , Scott Frank , Heare Travis , Miller Nancy H. 
Published: October 2017

Update
This article was updated on May 11, 2018, because of a previous error. In the Appendix, the figure that had been missing is now present.
An erratum has been published: JBJS Open Access. 2018 June 7;3(2):e0027ER.

Background:
Optimization of the electronic medical record (EMR) is essential to support the clinician and to improve the quality and efficiency of patient care. The present report describes the development and implementation of a standardized template that is embedded in the EMR and is focused on a comprehensive physical examination during the evaluation of pediatric supracondylar humeral fractures. We compared the completeness of physical examinations as well as the timing of detection and documentation of neurovascular injuries before and after implementation of the template. We hypothesized that the use of a template would increase the completeness of examinations and would lead to earlier documentation of neurovascular injuries.

Methods:
A multidisciplinary quality-improvement task force was created to address neurovascular documentation practices for patients who underwent operative treatment of supracondylar humeral fractures. Following a series of formative and process evaluations, a standardized EMR template was implemented. Neurovascular examination documentation practices that were in use before (pre-template group, n = 224) and after (template group, n = 300) the implementation of the template were compared. Logistic regression analyses of the 2 groups were used to compare the likelihood of a complete neurovascular examination and the timing of neurovascular injury identification.

Results:
There was significant improvement in the documentation of the vascular (odds ratio [OR], 70.7; 95% confidence interval [CI], 39.5 to 126.6; p < 0.0001), motor (OR, 17.6; 95% CI, 9.5 to 32.7; p < 0.0001), and sensory (OR, 23.9; 95% CI, 12.9 to 44.4; p < 0.0001) examinations in the template group. Neurological injuries were more likely to be identified preoperatively in the template group compared with the pre-template group (OR, 6.8; 95% CI, 1.7 to 27.1; p = 0.0067).

Conclusions:
The incorporation of a standardized template in the EMR improved the completeness and timing of documentation of neurological injury. Standardized EMR templates developed by a clinically driven multidisciplinary task force have the potential to improve the quality of clinical documentation and to ease communication among providers.

Level of Evidence:

Level III. See Instructions for Authors for a complete description of levels of evidence.
Effect of Pod Removal, Foliar Fungicides, and Cultivar on Green Stem Disorder of Soybean
Authors: Phillips Xavier A. , Singh Asheesh K. , Kandel Yuba R. , Mueller Daren S. 
Published: October 2017

Core Ideas
Removing 25 to 75% of pods increases green stem disorder.
Some QoI fungicides combined with pod removal further increases green stem disorder.
Cultivars differ in response to changes in source‐sink balance.
Green stem disorder (GSD) is a type of delayed maturity of soybean [Glycine max (L.) Merr.] when stems remain green and fleshy after pods reach physiological maturity and are ready to harvest. Although GSD has not been shown to directly impact yield, the immature green stems may lead to harvest issues. The objectives were to determine how GSD is affected by (i) cultivars and levels of pod removal, (ii) foliar fungicide applications, and (iii) a combination of pod removal and foliar fungicides. A source‐sink imbalance caused by abiotic and biotic sources (e.g., drought or pathogen infection) may be a contributing factor to the development of GSD. To simulate a sink‐limiting stress and induce GSD, pods were removed from soybean plants, at magnitudes typically not seen in normal field conditions. Experiments were completed during 2014 and 2015 in Iowa. Higher levels of GSD were observed in 2015 across most locations. Cultivars varied in their response to pod removal within specific levels. Combining pod removal and fungicide application indicated that certain quinone outside inhibitors (QoI)‐containing fungicides may result in more GSD with and without pod removal under specific conditions. However, this result was inconsistent, especially with no soybean pods removed. Soybean farmers should be aware that prophylactic applications of foliar fungicides might increase GSD incidence, especially in cases that plants experience a sink‐limiting stress.
Effect of Preparation and Freezing Methods on the Concentration of Resistant Starch, Antinutritional Factors and FODMAPs in Beans
Authors: Ávila Bianca P. , Bragança Guilherme C.M. , Pereira Aline , Gularte Márcia A. , Elias Moacir C. 
Published: October 2017

Background:
During frozen storage, the properties of vegetables are greatly influenced by
storage conditions, especially temperature and time, even at low temperatures, suffering important
quality attributes modification as a result of the action of biochemical activity, chemical and physical
phenomena. The effect of freezing on common bean (Phaseolus vulgaris L.) and cowpea bean (Vigna
unguiculata L. Walp.) processed under domestic processing conditions was evaluated to investigate
the contents of resistant starch, oligosaccharides (raffinose and stachyose), phytate levels, protein digestibility
and the inhibitory trypsin activity.

Methods:
The beans were cooked after different pre-soaking treatments and frozen (-20°C) for one,
two and three weeks respectively.

Results:
A reduction was observed in the content of resistant starch by the use of the pre-soaking
treatments; however, it increased significantly after freezing the samples from the treatments in which
the soaking water was maintained and in which the cooked beans were frozen for 7 days. In the case
of oligosaccharide content (raffinose and stachyose), cowpea beans had higher levels than the common
beans, with changes in their values after 7 days of freezing. In the treatments in which the soaking
water was discarded before cooking, raffinose and stachyose showed variable levels. In cowpea,
the treatment in which the soaking water was not used in cooking showed a reduction in the content of
phytate at 14 days of freezing, with inhibition of trypsin at 21 days compared with the initial time. Digestibility
in all treatments was improved after freezing.

Conclusion:
The increase in resistant starch content, removal of phytate and trypsin inhibitors, and
bean flatulence factors were significant in cooked beans after freezing between 14 and 21 days.
Contribution of Bamboo for Vibratory Comfort in Biomechanics of Cycling
Authors: Chiementin Xavier , Crequy Samuel , Feron Robin , Munera Marcela , Abdi Ellie , Provot Thomas , Taiar Redha 
Published: October 2017

Background:Vibrations in cycling produced by road irregularities could cause health problems and affect the cyclist’s comfort and performance. Therefore researchers and manufacturers focus their efforts to reduce the vibrations.Objective:The agro materials appear to consume important properties which help in reducing the values of vibrations. This study offers a perspective on the agro materials’ contribution in the bicycle design.Methods:Three bicycle frames were compared in two situations: (i) real locomotion conditions at three speeds 15, 25, and 35 km/h on slightly grainy road with paved sector and bumps, and (ii) laboratory conditions on a vibrating platform with frequencies ranging between 20 and 80 Hz. The used frames’ materials were carbon, aluminum and agro materials (bamboo and flax).The first protocol measured the effective values in four points of the bicycle (fork, stay, stem, and saddle) in real locomotion condition. The transmissibility was calculated between the input points of vibration and the output points in contact with the rider. The second protocol defined dynamic behavior of the three frames on a vibrating platform at the range of 20-80 Hz.Results:It was noted that the Root Mean Square values (RMS) were significantly higher with the agro materials in 44.4% of the cases and the values were significantly lower in 1 case (Road with 15km/h). The agro materials absorbed a significant part of vibrations in comparison to other materials (19.1%, 14.7%, and 17.2% for agro materials, aluminum, and carbon, respectively).Conclusion:Vibration comfort for cyclists is related to the choice of the frame. The contribution of relevant biomaterials can be relevant. Indeed, agro materials have remarkable properties for the absorption of vibrations.
Validation of the EuroSCORE II in a Greek Cardiac Surgical Population: A Prospective Study
Authors: Stavridis G. , Panaretos D. , Kadda O. , Panagiotakos D. B. 
Published: October 2017

Objective:
The objective of this study was to examine the validity of EuroSCORE II in the Greek population.

Methods:
A prospective single-center study was performed during November 1, 2013 and November 5, 2016; 621 patients undergoing cardiac surgery were enrolled. The EuroSCORE II values and the actual mortality of the patients were recorded in a special database. Calibration of the model was evaluated with the Hosmer-Lemeshow goodness-of-fit test, and discrimination with the areas under the receiver operating characteristic (ROC) curve.

Results:
The observed in-hospital mortality rate was 3% (i.e. 18/621 patients). The median EuroSCORE II value was 1.3% (1st quartile: 0.86%, 3rd quartile: 2.46%), which indicates a low in-hospital mortality. Area under the ROC curve for EuroSCORE II was 0.85 (95% CI: 0.75-0.94), suggesting very good correct classification of the patients.

Conclusion:
The findings of the present work suggest that EuroSCORE II is a very good predictor of in-hospital mortality after cardiac surgery, in our population and, therefore can safely be used for quality assurance and risk assessment.
Human Induced Pluripotent Stem Cells and the Modelling of Alzheimer’s Disease: The Human Brain Outside the Dish
Authors: Tong Godwin , Izquierdo Pablo , Raashid Rana Arham 
Published: October 2017

Background:Neurodegenerative diseases like Alzheimer’s Disease (AD) are a global health issue primarily in the elderly. Although AD has been investigated using primary cultures, animal models and post-mortem human brain tissues, there are currently no effective treatments.Summary:With the advent of induced pluripotent stem cells (iPSCs) reprogrammed from fully differentiated adult cells such as skin fibroblasts, newer opportunities have arisen to study the pathophysiology of many diseases in more depth. It is envisioned that iPSCs could be used as a powerful tool for neurodegenerative disease modelling and eventually be an unlimited source for cell replacement therapy. This paper provides an overview of; the contribution of iPSCs towards modeling and understanding AD pathogenesis, the novel human/mouse chimeric models in elucidating current AD pathogenesis hypotheses, the possible use of iPSCs in drug screening, and perspectives on possible future directions.Key messages:Human/mouse chimeric models using iPSCs to study AD offer much promise in better replicating AD pathology and can be further exploited to elucidate disease pathogenesis with regards to the neuroinflammation hypothesis of AD.
Ethics in Quality Improvement with in Health Care - Focusing on the Improvement
Authors: Sandman Lars 
Published: October 2017

Background:
Health-care is permeated with ethical values and norms and so there are ethical implications to all interventions which changes practice, and this includes quality improvement (QI). The interest for ethics in QI so far has not had an explicit focus on the ethics of the actual improvement. Contrasting this with health technology assessment (HTA), we there find an almost exclusive interest in the ethics of the developed technology, and less regard for the other ethical aspects related to development, evaluation and implementation of the technology.

Method:
We identify how a research ethics perspective on QI differs from the ethics of the actual improvement or change. It will be argued that the field of ethics in QI can benefit from the development of ethics within HTA by raising awareness of the need to ethically assess the actual improvement or change, and by using models for this found within HTA. For an ethical analysis of quality improvement, elderly care in the Swedish context will be given as a tentative example.

Conclusion:
The existing frameworks for ethical assessment within HTA need further development for use within QI. In essence, the introduction of new technologies within health-care could be viewed as a quality improvement, where considerations generally acknowledged within QI are relevant to consider in relation to all potential technologies to be used within health-care.
Language-Games and Quality Improvement in Healthcare in England
Authors: Newman Stephen 
Published: October 2017

Background:
Quality in healthcare is high on the political agenda in England. This paper examines the model of inspection used by the Care Quality Commission to inspect healthcare provison in England.

Methods:
The paper comprises a critical review of the literature to examine the model of judgement used by the Care Quality Commission in their inspection framework.

Results:
It is argued that the model of judgement used makes various assumptions which throw into doubt the notion that such inspections provide an objective picture of quality in healthcare. However, the contrary view, that such inspections are highly subjective, is rejected in favour of developing a perspective informed by the later philosophy of Wittgenstein; one which recognises the importance of social agreement and understanding in developing meaning.

Conclusion:
This perspective highlights the importance of the different social groups that work in healthcare, and those who are treated in the healthcare system, for developing shared understandings and meanings of terms such as ‘quality’.
Mid-Term Outcomes After Open Reduction Internal Fixation of Proximal Interphalangeal Joint Dorsal Fracture-Dislocations Through a Volar, Shotgun Approach and a Review of the Literature
Authors: Giugale Juan Marcelo , Wang Juntian , Kaufmann Robert A. , Fowler John R. 
Published: October 2017

Background:
Proximal interphalangeal (PIP) fracture dislocations remain a complex injury pattern to treat. There are several treatment methods available aimed to restore stability, preserve range of motion, and reconstitute the articular surface. This study looked at the mid-term clinical and radiographic results of open reduction internal fixation through a shotgun approach of comminuted PIP fracture dislocations.

Methods:
A retrospective review was conducted of all PIP fracture dislocations treated through a volar, shotgun approach at a single institution over a 15-year period. Patients identified were contacted and asked to return to the office for clinical and radiographic evaluation. Patient reported outcomes were assessed with the Michigan hand questionnaire (MHQ) and visual analog scale (VAS) for pain.

Results:
5 patients returned to the office for further evaluation with average follow-up of 69 months (range, 33-133 months). 3 patients were found to have post traumatic arthritis on radiographs. 1 case had recurrent instability and one case had a deep infection, both necessitating further surgical intervention. Average PIP arc of motion was found to be 79°. Average VAS score of 0 and MHQ result of 95 (out of a possible score of 100) indicating no residual pain and excellent functionality of the affected hand.

Conclusion:
Open reduction internal fixation of comminuted PIP fracture dislocations utilizing the volar, shotgun approach provides excellent mid-term functional results despite the high incidence of post traumatic arthritis.
Presumed Chemotherapy-Induced Optic Neuropathy and Maculopathy: A Case Report
Authors: Mathew David J. , Arthur Anupriya , John Sheeja Susan 
Published: October 2017

Purpose:
With the advent of more aggressive cytotoxic chemotherapy regimens, the incidence of ocular toxicity due to these drugs is also on the rise. We report a case of Presumed Chemotherapy-Induced optic neuropathy and maculopathy secondary to treatment with cytarabine and daunorubicin for Acute Myeloid Leukaemia (AML).

Case report:
A 50-year-old man with AML developed sudden decrease in vision in his left eye after three cycles of chemotherapy with cytarabine and daunorubicin. He presented to us six weeks later with bilateral optic atrophy and foveal atrophic changes with early bull’s eye maculopathy. A diagnosis of presumed chemotherapy-induced optic neuropathy with maculopathy was made, and the patient was put on an alternative chemotherapeutic regimen. There was no further decrease in vision on follow up.

Conclusion:
To the best of our knowledge, this is the first report of clinically demonstrable macular toxicity in the form of macular atrophic changes and bull’s eye maculopathy associated with the use of cytarabine and daunorubicin. Early diagnosis and appropriate management of such cases is imperative to prevent further visual deterioration.
3D PRINTING TECHNIQUE FOR PATIENT-SPECIFIC INSTRUMENTATION IN TOTAL KNEE ARTHROPLASTY
Authors: Karyakin N. N. , Malyshev E. E. , Gorbatov R. O. , Rotich G K. 
Published: October 2017

The aim of the study was to evaluate clinical and radiological outcomes of knee arthroplasty using patient specific guides produced using physical prototypes and 3D printing that are applied for positioning of resection blocks. Materials and methods. The authors analyzed the treatment outcomes of 4 patients during the period from 2015 to 2016 who underwent total knee arthroplasty for posttraumatic gonarthrosis of III-IV stage with the use of patient specific guides for resection blocks positioning. The mean age of patients was 59±12 years. Initially, all patients reported marked limitation of movement in the knee joint. The average flexion prior to surgery was 53.3±35.1°. According to FLFS roentgenography all patients had a varus deformity of the lower limb with an average value of 15.0±12.3°.Results. In all cases the axis of the lower limb was normalized postoperatively. The average KOOS score for “pain” was 85.2±14.0, for “daily physical activity” — 74.5±14.8, for “symptoms and stiffness” — 69.0±11.0, for “quality of life” — 62.5±12.5 points. Average knee ROM after arthroplasty: flexion 113.3±5.787° and full extension. Such outcomes can be considered as excellent considering preoperative marked knee movement limitations in all patients.Conclusion. Preoperative planning using the technology of producing patient specific guides and prototyping on physical tibia and femur models allowed to restore normal axis of the lower limb. The authors observed a significant improvement in joint function and a pain syndrome reduction in all patients. In authors’ opinion patient specific precision guides can be used in the following cases: inflammatory process or deformation of the femur in patient’s history; when the use of intramedullary guides is difficult and does not allow positioning of the prosthesis components with sufficient accuracy or is associated with an increased risk of a purulent-inflammatory process; ipsilateral hip joint prosthesis when it is desirable to avoid opening the medullary canal; substantial bone defects or massive osteophytes of the posterior portion of femoral condyles that impede correct rotation of the femoral component; severe movement limitations in the knee joint, when it is technically impossible to perform TKA using computer navigation and the use of a standard set of instruments poses significant technical difficulties.