bluuebunny/crossref_metadata_2025_split huggingface dataset:
The outcome of the Mobility total ankle replacement at a mean of four years
Authors: Muir D. , Aoina J. , Hong T. , Mason R. 
Published: September 2013

We performed a retrospective review of a consecutive series of 178 Mobility total ankle replacements (TARs) performed by three surgeons between January 2004 and June 2009, and analysed radiological parameters and clinical outcomes in a subgroup of 129 patients. The mean follow-up was 4 years (2 to 6.3). A total of ten revision procedures (5.6%) were undertaken. The mean Ankle Osteoarthritis Scale (AOS) pain score was 17 (0 to 88) and 86% of patients were clinically improved at follow-up. However, 18 patients (18 TARs, 14%) had a poor outcome with an AOS pain score of > 30. A worse outcome was associated with a pre-operative diagnosis of post-traumatic degenerative arthritis. However, no pre- or post-operative radiological parameters were significantly associated with a poor outcome. Of the patients with persistent pain, eight had predominantly medial-sided pain. Thirty TARs (29%) had a radiolucency in at least one zone. The outcome of the Mobility TAR at a mean of four years is satisfactory in > 85% of patients. However, there is a significant incidence of persistent pain, particularly on the medial side, for which we were unable to establish a cause. Cite this article: Bone Joint J 2013;95-B:1366–71.
Can computer navigation-assisted surgery reduce the risk of an intralesional margin and reduce the rate of local recurrence in patients with a tumour of the pelvis or sacrum?
Authors: Jeys L. , Matharu G. S. , Nandra R. S. , Grimer R. J. 
Published: September 2013

We hypothesised that the use of computer navigation-assisted surgery for pelvic and sacral tumours would reduce the risk of an intralesional margin. We reviewed 31 patients (18 men and 13 women) with a mean age of 52.9 years (13.5 to 77.2) in whom computer navigation-assisted surgery had been carried out for a bone tumour of the pelvis or sacrum. There were 23 primary malignant bone tumours, four metastatic tumours and four locally advanced primary tumours of the rectum. The registration error when using computer navigation was < 1 mm in each case. There were no complications related to the navigation, which allowed the preservation of sacral nerve roots (n = 13), resection of otherwise inoperable disease (n = 4) and the avoidance of hindquarter amputation (n = 3). The intralesional resection rate for primary tumours of the pelvis and sacrum was 8.7% (n = 2): clear bone resection margins were achieved in all cases. At a mean follow-up of 13.1 months (3 to 34) three patients (13%) had developed a local recurrence. The mean time alive from diagnosis was 16.8 months (4 to 48). Computer navigation-assisted surgery is safe and has reduced our intralesional resection rate for primary tumours of the pelvis and sacrum. We recommend this technique as being worthy of further consideration for this group of patients. Cite this article: Bone Joint J 2013;95-B:1417–24.
Family-Centered Rounds and Medical Student Education: A Qualitative Examination of Students’ Perceptions
Authors: Paradise Black Nicole M. , Kelly Maria N. , Black Erik W. , Sessums Christopher D. , DiPietro Meredith K. , Novak Maureen A. 
Published: September 2013

Background:Although current literature supports the benefits of family-centered rounds on medical education, few studies have explored students’ perceptions of family-centered rounds.Purpose:The aim of this study was to provide a better and broader understanding of the effect of family-centered rounds on medical student education.Methods:During the inpatient portion of the third-year pediatric clerkship at a southeastern United States 4-year medical school, students were exposed to family-centered and conference room work rounds and completed a post-hoc reflective open-ended questionnaire. The study was conducted from July to December 2007 and the inpatient experience was at one of two large academic medical centers. Using a constant comparative approach, the qualitative content of 45 of the 63 potential students’ responses was analyzed.Results:Family-centered rounds served as an opportunity for medical students to build their practice-based knowledge through direct and simultaneous interaction with the medical team, patients, and families. Family member communication, medical team communication, and increased exposure to patients allowed for unique learning opportunities such as augmentation of communication skills, practice with use of lay terms, legitimate peripheral participation, and humanizing cognitive understanding of diseases. Areas of concern noted by the students included space limitations, length of rounds, potential anxiety provoked in the patient, and faculty and resident comfort with teaching certain topics.Conclusions:Our qualitative analysis of medical student perceptions on family-centered rounds suggests that pediatric medical student education may benefit by improving knowledge and practice with communication and humanizing disease processes. However, perceived barriers, such as concerns about space or instructor comfort with teaching certain topics, existed. Further studies are warranted to gain a better understanding of the educational impact of conducting this type of rounds.
Pediatric Hospitalist Research Productivity: Predictors of Success at Presenting Abstracts and Publishing Peer-reviewed Manuscripts Among Pediatric Hospitalists
Authors: Teufel Ronald J. , Bekmezian Arpi , Wilson Karen 
Published: September 2013

Objective:
To identify factors associated with research productivity among pediatric hospitalists.

Methods:
We performed a cross-sectional online survey of pediatric hospitalists recruited from the American Academy of Pediatrics Section on Hospital Medicine from May to August 2009. We used abstract presentations at a national meeting (intermediate outcome) and ≥2 first-author peer-reviewed manuscripts (primary outcome) to measure research productivity. Information was also collected on environmental and physician characteristics. Stepwise logistic regression was performed to identify independent associations with research productivity.

Results:
Two hundred fifteen pediatric hospitalists completed the survey. The respondents included 82% in an academic environment, 15% fellowship trained, 25% with additional degrees, and 67% with no protected time for research. Fifty-six percent presented an abstract, and 17% had 2 or more publications. After adjusting for potential confounders, pediatric hospitalists were more likely to have presented an abstract if they had fellowship training, an additional degree, were “very interested” or “interested” in performing research, or worked in a free-standing children’s hospital or children’s hospital within a hospital. Pediatric hospitalists were more likely to have 2 or more publications if they had an additional degree or had presented an abstract.

Conclusions:
Among pediatric hospitalists, obtaining an additional degree and presenting an abstract at a national meeting are associated with research productivity. A minority of this group of pediatric hospitalists had fellowship training, degree training, or 2 or more first-author manuscripts published even though the majority are in an academic environment. These results suggest that structured training and a focus on abstract presentations at meetings could be a programmatic solution.
La Crosse Viral Infection in Hospitalized Pediatric Patients in Western North Carolina
Authors: Miller Ansley , Carchman Rebecca , Long Rachel , Denslow Sheri A. 
Published: September 2013

Objective:
La Crosse infection, caused by a rare mosquito-transmitted virus, is endemic in Western North Carolina. Given the large number of cases at our institution, our goal was to describe the presentation, management, and clinical course for pediatric patients with this disease.

Methods:
We retrospectively reviewed medical records from pediatric patients with antibody-confirmed La Crosse infection admitted to Mission Hospital July 2004 through August 2009. Demographics, clinical characteristics, management methods, length of hospital stay, and complications were analyzed. Regression analysis was used to assess relationships between presentation and clinical course.

Results:
Forty-seven pediatric patients were identified with antibody-confirmed La Crosse infection. Seventy percent were male, and the median age was 8 years. Admission signs and symptoms included fever (43%), headache (94%), vomiting (78%), altered mental status (58%), and seizures (61%). All patients had pleocytosis on cerebrospinal fluid studies (range 10–1063 cells/mm3). Median length of stay was 5 days. Seizure at admission was associated with an increased length of stay (2.4 additional days, 95% confidence interval 0.7–4.1). Eighteen patients (38%) received intensive care, 7 (19%) received parenteral or enteral (via nasogastric tube) nutrition, and 4 (9%) received mechanical ventilation. No statistically significant associations between presenting signs and symptoms and complications were found. Treatments included antibiotics (87%), antiviral medication (55%), seizure prophylaxis (47%), and isotonic fluids (98%).

Conclusions:
Our data reflect few indicators to predict clinical course during hospital stay. Management strategies should include attention to development of seizure activity and preventive measures for syndrome of inappropriate antidiuretic hormone.
Using Patient Characteristics to Predict Usefulness of Abdominal Computed Tomography in Children
Authors: Biondi Eric , Macduff Sabrina , Capucilli Peter , Tsuboyama Melissa , Wu Shuang , Beck Christopher , Lynn Justin , der Jagt Elise van , Wilson Karen 
Published: September 2013

Objective:The study goal was to determine whether clinical symptoms, physical findings, or laboratory values predict the usefulness of abdominal computed tomography (CT) scans in children.Methods:We conducted a retrospective review of pediatric patients who received an abdominal CT scan between June 2009 and November 2011 at an urban medical center. A panel of pediatric hospitalists independently categorized each CT read as: (1) necessary for diagnosis; (2) unnecessary but helpful for diagnosis; or (3) neither necessary nor helpful for diagnosis. Two multiple logistic regression models examined 21 clinical variables to assess their ability to differentiate between: (1) necessary and unnecessary CT scans; and (2) helpful and unhelpful CT scans.Results:A total of 399 CT scans were analyzed. Seventy (18%) of these were categorized as necessary, 103 (26%) as unnecessary but helpful, and 226 (57%) as neither necessary nor helpful. Three variables were strongly correlated with necessary CT scans: leukocytosis, peritoneal signs, and male gender. The probability of a CT scan being necessary was 57% in patients with all 3 findings and 8% in those with none. Three variables were also strongly correlated with unnecessary but helpful CT scans: history of abdominal surgery, tachypnea, and leukocytosis. The probability of a CT scan being helpful was 84% in patients with all 3 findings and 35% in those with none of the 3 findings.Conclusions:The majority of abdominal CT scans were unnecessary and unhelpful. Knowing which clinical variables correlate strongly with necessary or helpful abdominal CT scans may assist clinicians in deciding whether to order this test; however, the predictive power of these variables remains relatively low.
Pollen Dispersal of Cultivated Soybean into Wild Soybean under Natural Conditions
Authors: Wang Ke‐Jing , Li Xiang‐Hua 
Published: September 2013

ABSTRACTGene flow composed of successful seed migration and pollen dispersal strongly influences geographical population genetic structure in the self‐pollinating wild soybean (Glycine soja Siebold & Zucc.). Pollen outcrossing is important in this species because it is involved in the recombination, spread, and fixation of introgressive genes and also includes the threat of introgression from genetically modified cultivated soybeans [Glycine max (L.) Merr.]. We investigated pollen dispersal in four wild soybean populations situated near farmlands using microsatellite variation. Results showed that interspecies outcrossing occurred in all four study populations. Evidence showed that some soybean individuals in wild soybean natural populations contained cultivated genes, but their genetic backgrounds tended towards wild soybean owing to many generations of gene background selection under the natural environments. A pollen dispersal distance of 40 m was found and a pollen dispersal distance of 50 m was inferred based on the morphological behaviors and geographical and population genetic structures. All the semiwild plants (Glycine gracilis Skvortsov [syn. Glycine max (L.) Merr.]) were genetically close to their mother populations, indicating that they originated in these populations through pollen flow from nearby soybeans into wild plants.
Genetic Analysis of Grain Shape for Paddy and Brown Rice Using Introgression Lines
Authors: Bian Jianmin , He Haohua , Shi Huan , Li Cuijuan , Zhu Changlan , Peng Xiaosong , Yu Qiuying , Fu Junru , He Xiaopeng , Chen Xiaorong , Hu Lifang , Ouyang Linjuan 
Published: September 2013

ABSTRACTGrain shape–related traits are important components determining rice (Oryza sativa L.) grain yield, and they are controlled by quantitative trait loci (QTL). To study the genetic basis of grain shape–related traits, we performed an experiment using a population of rice introgression lines (ILs) in two different environments. The results revealed that the 10 traits investigated were affected by 84 QTL that individually explained 5.04 to 66.26% of the phenotypic variation. Most of these QTL explained a modest proportion of the phenotypic variance, confirming that grain shape was inherited polygenically. Meanwhile, 75 of all the 84 QTL showed a pleiotropic effect or linkage association as a cause of these observed phenotypic correlations between the grain shape traits. Among the regions showing pleiotropic effect or linkage association, 71.4% were associated with both paddy and brown grain shape traits, which suggested that paddy and brown grain shape might be controlled by the same genes. Furthermore, 13 major stable QTL were detected in both environments, which offers an opportunity for marker‐aided improvement of rice grain shape quality and QTL cloning. The introgression lines harboring the 13 major stable QTL also represent a useful genetic resource for rice yield improvement via a design‐breeding approach in the future.
Rapid Cycling Recurrent Selection for Increased Carotenoids Content in Cassava Roots
Authors: Ceballos H. , Morante N. , Sánchez T. , Ortiz D. , Aragón I. , Chávez A.L. , Pizarro M. , Calle F. , Dufour D. 
Published: September 2013

ABSTRACTImproving total carotenoids content (TCC) in cassava roots is an important strategy to reduce vitamin A deficiency in human populations that rely on cassava as a source of energy in their diets. The high heritability for TCC in the roots allowed the International Center for Tropical Agriculture to implement a rapid cycling recurrent selection approach that reduced the standard length of each cycle from the ordinary 8 yr to 3. Data from successive evaluation nurseries suggested that gains have been made through time. However, no comparison of different cycles of selection has been made when representatives of each cycle were grown together. This study compares 4 to 5 clones representative of cycles of selection from 2004 to 2009. Results demonstrated significant gains for TCC as well as for total β‐carotene (TBC) expressed both in a fresh and dry weight basis. Although dry matter content (DMC) was not a selection criterion during the selection process, it increased with the successive cycles of selection. This suggests that indeed, simultaneous gains for TCC, TBC, and DMC are feasible. This finding is relevant for the important ongoing efforts at the International Institute of Tropical Agriculture and African National Programs to release biofortified cassava clones in Africa with adequate levels of dry matter content.
Finding Linked Markers to En for Efficient Selection of Pea Enation Mosaic Virus Resistance in Pea
Authors: Jain Shalu , Weeden Norman F. , Porter Lyndon D. , Eigenbrode Sanford D. , McPhee Kevin 
Published: September 2013

ABSTRACTPea enation mosaic virus (PEMV) causes an important disease of cool‐season food legumes, resulting in significant yield loss worldwide. The present investigation was carried out to study the inheritance and identify the molecular markers linked with the PEMV resistance gene (En) in field pea (Pisum sativum L.) using an F7–derived mapping population developed from the cross ‘Lifter’ (resistant)/‘Radley’ (susceptible). Three hundred ninety‐three recombinant inbred lines (RILs) were phenotyped for reaction to PEMV in the field under natural inoculation and in the greenhouse using artificial inoculation. The RILs segregated in the expected 1:1 ratio for resistance and susceptibility in the field and greenhouse evaluations. Sequence tagged site markers were developed through an intron targeted amplified polymorphism approach based on comparative mapping with Medicago truncatula Gaertn. and a targeted region amplified polymorphism approach was also used to enrich the genomic region segregating for the En gene. Our results demonstrate that resistance to PEMV in pea is governed by a single gene, En, located on linkage group III between markers CNGC (2.5 cM) and tRNAMet2 (1.3 cM) with many other closely associated markers. These two markers in combination predict the presence of En with 99.4% accuracy in the Lifter/Radley mapping population and have implications for marker‐assisted selection for PEMV resistance in pea improvement breeding programs.
The relationship between clinical phenotype and early staged bilateral deep brain stimulation in Parkinson disease
Authors: Sung Victor W. , Watts Ray L. , Schrandt Christian J. , Guthrie Stephanie , Wang Deli , Amara Amy W. , Guthrie Barton L. , Walker Harrison C. 
Published: September 2013

Object
While many centers place bilateral deep brain stimulation (DBS) systems simultaneously, unilateral subthalamic nucleus (STN) DBS followed by a staged contralateral procedure has emerged as a treatment option for many patients. However, little is known about whether the preoperative phenotype predicts when staged placement of a DBS electrode in the opposite STN will be required. The authors aimed to determine whether preoperative clinical phenotype predicts early staged placement of a second STN DBS electrode in patients who undergo unilateral STN DBS for Parkinson disease (PD).

Methods
Eighty-two consecutive patients with advanced PD underwent unilateral STN DBS contralateral to the most affected hemibody and had at least 2 years of follow-up. Multivariate logistic regression analysis determined preoperative characteristics that predicted staged placement of a second electrode in the opposite STN. Preoperative measurements included aspects of the Unified Parkinson's Disease Rating Scale (UPDRS), motor asymmetry index, and body weight.

Results
At 2-year follow-up, 28 (34%) of the 82 patients had undergone staged placement of a contralateral electrode while the remainder chose to continue with unilateral stimulation. Statistically significant improvements in UPDRS total and Part 3 scores were retained at the end of the 2-year follow-up period in both subsets of patients. Multivariate logistic regression analysis showed that the most important predictors for early staged placement of a second subthalamic stimulator were low asymmetry index (OR 13.4, 95% CI 2.8–64.9), high tremor subscore (OR 7.2, CI 1.5–35.0), and low body weight (OR 5.5, 95% CI 1.4–22.3).

Conclusions
This single-center study provides evidence that elements of the preoperative PD phenotype predict whether patients will require early staged bilateral STN DBS. These data may aid in the management of patients with advanced PD who undergo STN DBS.
Les aides publiques à la garde des jeunes enfants [Une analyse à partir du modèle de microsimulation MYRIADE]
Authors: Legendre François , Lorgnet Jean-Paul , Mahieu Ronan , Thibault Florence 
Published: September 2013

State support for childcare. An analysis using the MYRIADE microsimulation model.
The parents of children born after 1 January 2004 are eligible for the Young Child Benefit (Prestation d''Accueil du Jeune Enfant-PAJE), a new benefit intended as a subsidy for parents who use childcare facilities or as financial support for those who reduce their paid employment to look after their children themselves. The MYRIADE microsimulation model of the national family allowance fund (CNAF) has been modified to facilitate evaluation of the budgetary and redistributional effects of the new benefit. By improving the description of the pre-reform situation as regards types of childcare, the aim was to simulate more accurately the potential effects of changes to the rules in this area. In addition to the PAJE, the article examines two alternative reforms of the benefits existing in 2003. Their analysis provides comparative elements that are used to assess the choices made for the new benefit.
Les projets d’implication paternelle à l’épreuve de la première année
Authors: de Ridder Guido , Céroux Benoît , Bigot Sylvie 
Published: September 2013

Projects for fathering : the test of the first year.
The birth of a child to a couple is not neutral. But while this arrival itself is quite well understood, having been studied extensively for the mother, the reactions of the father remain poorly understood. This article seeks to define and analyse the involvement of fathers in the arrival of a child. Drawing on a series of interviews conducted before the birth of the child and in its early months, the authors show how the fathers react and construct their paternal identity on different levels : personal-what notion of fatherhood do they develop ? Familial-how, for example, do they construct their status of father in relation to the mother ? and social-the impact of the birth on their working lives.