bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unstable Intertrochanteric Femur Fracture Fixation with PFNA2: Does Not Require Lateral Wall Fixation? A Study of 278 Patients
Authors: Shetty Vivek , Agashe Vikas , Shekhar Sajeev , Mishra Shaswat , Landge Suhas , Jorule Kailash 
Published: March 2024

Abstract
Lateral wall fracture is considered to be one of the major contributors to failure when such fractures are routinely treated with a sliding hip screw. Later, several publications stressed that the intramedullary device (IM) is the implant of choice in such cases. Hence, PFNA2 has become the implant of choice for unstable IT fractures in the Asian population since the last decade. However, with this background, we have assessed our results over the last 5 years, where PFNA2 was the only implant used for all IT fractures, irrespective of comminution and stability. Methods: This was a retrospective analysis of 309 patients with stable and unstable fractures in 3rd and 4th cranial nerves between June 2008 and June 2022 who were fixed with PFNA2 only, without additional fixation of the lateral wall. Results: All fractures united at an average of 14 weeks, without significant differences between the two groups (with and without lateral wall fracture). There was no statistically significant difference between the two groups with respect to TAD < 20 mm (p = 0.24) or neck-shaft valgus angle at the time of fixation (p = 0.31). There was no significant difference between the union rate, fracture collapse rate (p = 0.41), change in neck shaft angle (p = 0.11) or change in TAD (p = 0.44) between the surgery group and the union group. Two patients who presented with implant failure (one performed elsewhere) were revised and fixed with our technique with a PFNA2 without any lateral augmentation, and both went on to unite well. Conclusion: For a well-aligned anteromedial cortex, coupled with a valgus reduction in the neck shaft angle, a helical blade in the center-center region and a TAD of ˂20 mm, fixation of the lateral wall has no role in preventing fracture collapse or in the healing of unstable IT femur fractures.
Blunted synaptic plasticity in the vHPC-mPFC pathway involving the working memory deficits of mice with perinatal bisphenol-A exposure
Authors: Hu Fan , Li Zimu , Zhang Wentai , Tang Huiping , Chang Jingjing , Zhang Linke , Liang Weifeng , Liu Honglin , Wang Ming 
Published: March 2024

Abstract

Working memory guides human decisions and actions by temporarily holding and manipulating information, yet it has been well-documented as impaired in children with bisphenol A (BPA) exposure. However, neither its underlying neural circuit mechanism nor synaptic basis has been rigorously examined. In the present study, mouse pups were exposed to BPA from dams with BPA exposure (0.735 mg/kg/day) during the gestation and lactation periods to simulate children exposure situation. We found that there was a significant decline in working memory during T maze and objective recognition testing. The in vivo electrophysiological results showed that there was a noticeable decline in theta (θ)/gamma (γ) oscillation power in the medial prefrontal cortex (mPFC) and θ-γ oscillation coupling in the ventral hippocampus (vHPC)-mPFC circuit during retrieval of spatial cues (choice phase) in the novelty-driven T maze task. This fail retrieval of spatial cues and network activity appears to be mediated by down-regulated synaptic plasticity within the vHPC-mPFC circuit. Further patch-clamp recording results revealed a pronounced decrease in the amplitude, rather than the frequency, of excitatory postsynaptic currents (EPSCs) in the mPFC of BPA-exposed mice. Importantly, the spine density of pyramidal neurons and the expression of excitatory receptors (GluA1) in the mPFC were significantly decreased after BPA exposure, providing the postsynaptic basis for BPA-induced synaptic plasticity impairment. Our findings in this study provide rigorous physiological and structural mechanism at circuit and synaptic level underlying working memory deficits resulting from BPA exposure during the critical developmental stage.
Barriers to providing long-term care insurance services by direct care workers: a qualitative study in Shandong Province, China
Authors: Gao Jing , Yin Jia , Sun Qiang 
Published: March 2024

Abstract
Background
China's long-term care insurance (LTCI) system plays a crucial role in addressing the challenges posed by an aging population, while simultaneously placing higher demands on the quantity and quality of long-term care (LTC) services. However, LTCI-designated facilities still face challenges in terms of recruiting and retaining care workers. There is limited knowledge regarding the barriers to service delivery for direct care workers in the context of LTCI.
Objectives
To analyze the barriers faced by direct care workers in providing LTC services from their perspectives and to explore possible reasons.
Methods
Based on Herzberg's two-factor theory, face-to-face semi-structured interviews were conducted with 31 direct care workers. Thematic framework analysis method was used to generate qualitative codes and identify themes.
Results
Direct care workers in designated LTCI facilities faced barriers to meeting motivation and hygiene factors. The motivation factors included three themes: intense and difficult work, tedious and boring work content, and difficulty in gaining recognition and fulfillment at work. Hygiene factors included four themes: difficulty communicating with patients or family members, depressing work environments, incomplete service processes, and inadequate safety measures for home care.
Conclusions
The conditions of people with disabilities or dementia covered by LTCI are complicated, which causes many difficulties and obstacles to the work of direct care workers. We recommend that in the development of the LTCI system, more emphasis should be placed on service providers as the mainstay of policy practice so that both the hygiene and motivation factors of direct care workers are met and put into effect together. Systems related to LTCI assessment and service provision should be optimized to alleviate the stress of direct care workers and eliminate barriers to their work.
Interference and Motor Memory Consolidation Effects of Sequential Gait Interventions: A randomized controlled trial
Authors: Hoque Adila , Kim Seok Hun , Reed Kyle B. 
Published: March 2024

Abstract

Background Sensorimotor adaptation and instructional adaptation have been found to be motor learning processes that exhibit additive characteristics when applied simultaneously. This study investigates the effects on acquisition and retention of gait outcomes when interventions corresponding to sensorimotor and instructional learning processes are applied sequentially, i.e., split-belt treadmill training (SBT) and (asymmetric) rhythmic auditory cueing (ARAC), respectively. Factors evaluated include order of sequential intervention, congruence between subsequent interventions, and the relative contribution(s) of each intervention in the acquisition and retention of gait (a)symmetry.Methods The repeated-measures study involved six randomized sessions; two controls included SBT and ARAC individually. Four sessions included sequential combinations of SBT and ARAC applied congruently and incongruently. Written informed consent was obtained from ten healthy, young subjects and all experiments were performed on the Computer Assisted Rehabilitation Environment (CAREN). Motion analysis was performed using infrared-reflective markers placed on the subjects’ lower limbs and ground reaction forces obtained from the force plates. Gait asymmetries were assessed for changes in step length, step time, and vertical reaction force and compared against baseline conditions. Between-trial comparisons were then performed using Friedman’s test and post-hoc analysis using Wilcoxon signed-rank test.Results Interference (during acquisition) to adaptation and memory consolidation (during retention) patterns exhibited different trends between opposite orders of intervention, and these characteristics were distinctive for step length and step time. Asymmetries during congruent trials were significantly greater than incongruent trials. SBT showed a greater influence (interference) on subsequent adaptation to ARAC than vice versa. Nonetheless, ARAC demonstrated a higher retention of after-effects than SBT – indicating its competitive potential for long-term learning.Conclusion The study shows that the order in which we learn to walk symmetrically can affect how well and how long we remember these skills. Based on the outcomes between different intervention order(s) on acquired asymmetries in step length and step time, future sequentially combined strategies can implement this sequence to balance minimizing interference between learning processes while maximizing consolidation of motor memories. This will help personalize future sequential interventions in terms of the targeted gait parameter and the costs acquired in other parameters to maximize the retained after-effects.
Electronic control of hand hygiene in intensive care unit and its correlation with healthcare-associated infections: a retrospective study
Authors: Gu Yue-Qin , Ye Hui-Ling , Tang Hui , Wang Min-Fang , Zhou Ye , Gu Bing 
Published: March 2024

Abstract

Purpose
To investigate the impact of an electronic monitoring system(EMS) on the adherence to hand hygiene༈HH༉ protocols among healthcare professionals in the intensive care unit༈ICU༉, and analyze the correlation between HH and healthcare-associated infections (HAIs) .
Methods
We implemented the EMS system to monitor the HH compliance and collected HH data throughout the year in 2020. Additionally, a retrospective analysis was conducted on the HH and infection-related indicators of medical staff in the ICU from 2016 to 2019.
Results
HH compliance rate monitored by the EMS system exhibited a noteworthy improvement at 89.44%, and the result of direct observation was 88.5%. Notably, both rates were significantly higher than those observed between 2016 and 2019 (53.0%, 60.1%, 61.11%, and 82.4%). With the enhancement of HH compliance, there was a notable reduction in HAIs’ rate in the ICU ward. Every 1% increasing results in a 5.2% decline of HAIs’ rate (Y = -5.200X + 347.2, r =-0.9991, P = 0.0186). However, HAIs did not exhibit any further decline beyond an 80% HH compliance rate. Over the past five years, no significant changes were observed in terms of average infection rates across three tubes or detection rates for four drug-resistant bacteria within the ICU ward.
Conclusion
The EMS’ efficiency is comparable to that of the direct observation method. The rate of HAIs showed a negative correlation with HH compliance until the compliance rate exceeded 80%.
Carboxymethyl kappa carrageenan derivatives synthesized from kappa carrageenan of the red alga Kappaphycus striatus cultivated in Vietnam: Characterization, structure and biological activity
Authors: Nguyen Hoang Thi Trang , Trung Dinh Thanh , Trang Vo Thi Dieu , Thinh Pham Duc , Thuy Thanh Thi Thu , Hung Le Dinh 
Published: March 2024

Abstract
Carboxymethyl kappa carrageenans (CMKCs) have been synthesized from kappa carrageenan extracted from the red alga Kappaphycus striatus with different molar ratios of monochloroacetic acid (MCA) in the presence of sodium hydroxide. The structural and physicochemical characteristic of products wase evaluated by FT-IR, 13 C and 1 H NMR spectra, degree of substitution, molecular weight, zeta potential and biological activity. Degree of substitution of carboxymethyl group in kappa carrageenan ranged from 0.24 to 1.12. FT-IR and 13 C NMR spectra proved the substitution of carboxymethyl group in kappa carrageenan disaccharide unit. Molecular weight of CMKCs increased slightly while their zeta potential was lower compared to the parent kappa carrageenan. CMKCs exhibited a slight difference in the lowest hemagglutination concentrations on native human blood group types and showed an increase in antioxidant activity. The results indicate that carboxymethyl kappa carrageenan derivatives from kappa carrageenan of the red alga K. striatus cultivated could promise be a good source of materials for application as carriers.
Navigating Uncertainties in Quantifying Water Availability Amidst the Nexus of Climate and Land Use Changes
Authors: Devkota Nirajan , Lamichhane Suraj , Bhattarai Pawan Kumar 
Published: March 2024

Abstract
The intricate interaction between climate and land use changes induces complexities in water balance dynamics amidst global environmental shifts. Substantive impacts are delineated via a case study conducted in the Narayani Basin situated within the Hindu Kush Himalaya region. Quantifying uncertainty for average water yield involves employing Monte Carlo simulation and the Kernel Density Function on SWAT hydrological model output, revealing alterations in water balance components characterized by a generally upward trend and increased variability. The water yield varies spatially and temporally, exhibiting higher uncertainty. Variations in uncertainty specific to each scenario are highlighted, emphasizing the interconnected effects of landscape transformation and climate change. Climate models are categorized into four scenarios, representing wet_cool, wet_warm, dry_cool, and dry_warm. In the Far Future, Wet_Cool scenario (SSP585) exhibits the highest uncertainty in annual water yield (CV: 0.18) with a substantial 167% increase, while minimal uncertainty is seen in the Near Future for SSP245 under Dry_Cool conditions (CV: 0.165) with a modest 9% increase. These results underscore the nexus impact of climate and land use alterations, providing valuable insights for informed decision-making in water resource planning. The study emphasizes considering spatial uncertainties for sustainable water management amid ongoing environmental changes.
Targeted next-generation sequencing of pathogens reveals the profile of secondary infections in COVID-19 patients
Authors: Ren Feng-qin , Ji Feng , Liu Zhao-qi , Yan Li-ru , Gao Zhi-wei , Liu Meng-zhen , Teng Xin-guang , Gao Guang-sheng 
Published: March 2024

Abstract
PURPOSE: To use targeted next-generation sequencing (tNGS) of pathogens for analysing the etiological distribution of secondary infections in patients with severe and critical novel coronavirus pneumonia (COVID-19), to obtain microbial epidemiological data on secondary infections in patients with COVID-19, and to provide a reference for early empirical antibiotic treatment of such patients.
METHODS: Patients with infections secondary to severe and critical COVID-19 and hospitalised at the First Affiliated Hospital of Shandong First Medical University between 1 December 2022 and 30 June 2023 were included in the study. The characteristics and etiological distribution of secondary infections in these patients were analysed using tNGS.
RESULTS: A total of 95 patients with COVID-19 secondary infections were included in the study, of whom 87.37% had one or more underlying diseases. Forty-eight pathogens were detected, the most common being HSV-4, Candida albicans, Klebsiella pneumoniae, Enterococcus faecium, HSV-1, Staphylococcus aureus, Aspergillus fumigatus, Acinetobacter baumannii, HSV-5, and Stenotrophomonas maltophilia, with Pneumocystis jirovecii being detected in 14.29% of cases. The majority (76.84%) of COVID-19 secondary infections were mixed infections, with mixed viral-bacterial-fungal infections being the most common (28.42%).
CONCLUSION: Most secondary infections in severe and critical COVID-19 patients are mixed, with high rates of viral and fungal infections. In clinical settings, monitoring for reactivation or secondary infections by Herpesviridae viruses is crucial; additionally, these patients have a significantly higher rate of P. jirovecii infection. tNGS testing on bronchoalveolar lavage fluid can help determine the aetiology of secondary infections early in COVID-19 patients and assist in choosing appropriate antibiotics.
Dural arteriovenous fistulas in the falx cerebri: case series and literature review
Authors: Su Xin , Song Zihao , YE Ming , Sun Liyong , Hong Tao , Ma Yongjie , Zhang Hongqi , Zhang Peng 
Published: March 2024

Abstract
Background
Dural arteriovenous fistulas (DAVFs) in the falx cerebri are seldomly reported. They may be associated with the falcine sinus/venous plexus. The falcine sinus/venous plexus is often considered a normal venous structure that manifests in a pathological state, different from the persistent fetal falcine sinus.
Methods
We performed a retrospective analysis at a single center, focusing on identifying all DAVFs in the falx cerebri between 2002 and 2022. Our study included the collection and analysis of data on demographics, fistula characteristics, treatment approaches, clinical outcomes, and fistula closure. In addition, we reviewed the literature on DAVFs in this area.
Results
Ten cases in our center and 13 cases of DAVFs in the falx cerevri reported in the literature were identified. At our center, the average age of the patients was 49.4 ± 8.1 years, and 90% were men. Trans-arterial embolization (TAE) alone resulted in immediate complete occlusion in eight cases. In two cases, conservative treatment was performed. There were no treatment-related complications or fistula recurrences found. According to the literature, seven patients underwent direct surgery, three underwent TAE, and one underwent both direct surgery and radiosurgery to completely close the fistula. There were no reported fistula recurrences or treatment complications.
Conclusions
Dural arteriovenous fistulas in the falx cerebri are rare, and there is limited literature available on this topic. Most of them are aggressive lesions. Curative treatment can be achieved by TAE or direct surgery. Further confirmation is needed to determine the involvement of the falcine sinus/venous plexus in falx cerebri DAVFs.
Biofilm on total joint replacement materials can be reduced through electromagnetic induction heating using a portable device
Authors: Cordero-GG Enrique , Medel-Plaza Marina , Correa John Jairo Aguilera , Sarnago Héctor , Acero Jesús , Burdío José M , Lucía Óscar , Esteban Jaime , Gomez-Barrena Enrique 
Published: March 2024

Abstract
Background:
Periprosthetic joint infection is a serious complication following joint replacement. The development of bacterial biofilms bestows antibiotic resistance and restricts treatment via implant retention surgery. Electromagnetic induction heating is a novel technique for antibacterial treatment of metallic surfaces that has demonstrated in-vitro efficacy. Previous studies have always employed stationary, non-portable devices. This study aims to assess the in-vitro efficacy of induction-heating disinfection of metallic surfaces using a new Portable Disinfection System based on Induction Heating.
Methods:
Mature biofilms of three bacterial species: S. epidermidis ATCC 35984, S. aureus ATCC 25923, E. coli ATCC 25922, were grown on 18x2mm cylindrical coupons of Titanium-Aluminium-Vanadium (Ti6Al4V) or Cobalt-chromium-molybdenum (CoCrMo) alloys. Study intervention was induction-heating of the coupon surface up to 70ºC for 210s, performed using the Portable Disinfection System (PDSIH). Temperature was monitored using thermographic imaging. For each bacterial strain and each metallic alloy, experiments and controls were conducted in triplicate. Bacterial load was quantified through scraping and drop plate techniques. Data were evaluated using non-parametric unilateral Wilcoxon test for 2 group comparison. Statistical significance was fixed at p ≤ 0.05.
Results:
All bacterial strains showed a statistically significant reduction of CFU per surface area in both materials. Bacterial load reduction amounted to 0.507 and 0.602 Log10 CFU/mL for S. aureus on Ti6Al4V and CoCrMo respectively, 5.937 and 3.500 Log10 CFU/mL for E. coli, and 1.222 and 0.372 Log10 CFU/mL for S. epidermidis.
Conclusions:
Electromagnetic induction heating using PDSIH is efficacious to reduce mature biofilms of S aureus, E coli and S epidermidis growing on metallic surfaces of Ti6Al4V and CoCrMo alloys.
Early Impressions and Adoption of the AtriAmp for Managing Arrhythmias Following Congenital Heart Surgery
Authors: Leopold Scott M. , Brown Diane H. , Zhang Xiao , Nguyen Xuan T. , Al-Subu Awni M. , Olson Krisjon R. 
Published: March 2024

Abstract
Objective: AtriAmp is a new medical device that displays a continuous real-time atrial electrogram on telemetry using temporary atrial pacing leads. Our objective was to evaluate early adoption of this device into patient care, understand how it affected clinical workflow, and identify unforeseen benefits or limitations.
Design: Qualitative study using inductive analysis of semi-structured interviews to identify dominant themes
Setting: Single center, tertiary, academic 21-bed mixed pediatric intensive care unit (PICU)
Subjects: PICU multidisciplinary team members (Pediatric Intensivists, PICU Nurse Practitioners, PICU nurses and Pediatric Cardiologists) who were early adopters of the AtriAmp (n=14)
Results: Three prominent themes emerged from qualitative analysis of the early adopters’ experiences. (1) Accelerated time from arrhythmia event to diagnosis, treatment, and determination of treatment effectiveness; (2) Increased confidence and security in the accuracy of providers’ arrhythmia diagnosis; and (3) Improvement in the ability to educate providers about post-operative arrythmias where reliance on time consuming consultation is a default. Providers also noted some learning curves with the device; none of which compromised medical care or clinical workflow.
Conclusions: Insights from early adopters of AtriAmp signal the need for simplicity and fidelity in new technologies within the PICU. Further research in the qualitative and observational sphere is needed to understand how technologies, such as AtriAmp, find expanded use in the PICU environment. Our research suggests that such technologies can be pivotal to the support and growth of multi-disciplinary teams, even among those who do not participate in early implementation.