bluuebunny/crossref_metadata_2025_split huggingface dataset:
Avoiding the Deep Plantar Arterial Arch in Transmetatarsal Amputations: A Cadaver Study
Authors: Whelan James H. , Kiser Caroline R. , Lazoritz John P. , Vardaxis Vassilios 
Published: April 2022

Background: The deep plantar arterial arch (DPAA) is formed by an anastomosis between the deep plantar artery and the lateral plantar artery. The potential risk of injury to the DPAA is concerning when performing transmetatarsal amputations, and care must be taken to preserve the anatomy. We sought to determine the positional anatomy of the DPAA based on anatomical landmarks that could be easily identified and palpated during transmetatarsal amputation.
Methods: In an effort to improve our understanding of the positional relationship of the DPAA to the distal metatarsal parabola, dissections were performed on 45 cadaveric feet to measure the location of the DPAA with respect to the distal metatarsal epiphyses. Images of the dissected specimens were digitally acquired and saved for measurement using in-house–written software. The mean, SD, SEM, and 95% confidence interval were calculated for all of the measurement parameters and are reported on pooled data and by sex. An independent-samples t test was used to assess for sex differences. Interrater reliability of the measurements was estimated using the intraclass correlation coefficient.
Results: The origin of the DPAA was located a mean ± SD of 35.6 ± 3.9 mm (95% confidence interval, 34.5–36.8 mm) proximal to the perpendicular line connecting the first and fifth metatarsal heads. The average interrater reliability across all of the measurements was 0.921.
Conclusions: This study provides the positional relationship of the DPAA with respect to the distal metatarsal parabola. This method is easily reproducible and may assist the foot and ankle surgeon with surgical planning and approach when performing partial pedal amputation.
Retrospective Evaluation of Ingrown Toenail Cases in a Tertiary Reference Center
Authors: Dincer Rota Didem , Tanacan Efsun , Aksoy Sarac Gulhan , Erdogan Fatma Gulru 
Published: April 2022

Abstract
Background: To evaluate the clinical characteristics of ingrown toenail cases in one of the biggest reference centers.
Methods: This retrospective cohort study was conducted on patients admitted to Ufuk University Hospital with ingrown toenail between January 1. 2014 and December 31. 2019. Firstly, clinical charactersitcs and demographic features of all cases were evaluated afterwards the study population was divided into two groups: 1) Group1(Patients who were ≤ 20 years old), 2) Group 2 (Patients who were >20 years old) and these groups were compared in terms of their clinical findings.
Results: Duration of diseases, BMI, rate of medications for chronic diseases and rate of joint diseases were significantly higher in group 2. On the other hand, rates of hyperhidrosis and sudden weight gain were significantly higher in group 1(p<0.05). Severity of ingrown toenail was significantly different between the groups (p=0.006). Stage 1 was the most common stage in both groups and rate of stage 3 was higher in group 1. Onycoshisis and was more common in group 1 while nail thickening was more common in group 2 (p<0.05). Medications were also significantly different between the groups as nail wire and Aluminum chloride were the most common treatment modalities in group 2 and 1, respectively (p<0.05). Periungual edema, presence of pus, hypertrophie and granulation were more common in group 1 (p<0.05). Thin nail plate was more common in group 1 while normal and thick nail nail plate were more common in group2 (p<0.05).
Conclusion: Clinical characteristics of ingrown toe nail vary between younger and older populations. Thus, individualized approach should be preferred in the management of ingrown toe nail for different age groups.
Good Clinical Outcomes Following Minor Foot Amputations in People with Diabetes: A Retrospective Clinical Audit of Associated Factors
Authors: Linton Clare , Searle Angela , Chuter Vivienne 
Published: April 2022

Abstract
Background: The purpose of this retrospective audit was to compare patient based clinical outcomes to amputation healing outcomes twelve months after a minor foot amputation in people with diabetes.
Methods: Hospital admission and community outpatient data were extracted for all minor foot amputations in people with diabetes in 2017 in the Central Coast Local Health District.
Results: A total 85 minor foot amputations involving 74 people were identified. At the twelve-month follow-up 74% (n=56) of the minor foot amputations healed, 63% (n=41) of the participants achieved a good clinical outcome (healed, no more proximal amputations, or death within the 12 month follow up period), and the mortality rate was 18%. Poor clinical outcomes were associated with those aged greater than 60 (RR 5.75, 95% CI: 0.85 to 38.7, p=0.013), those undergoing a further surgical debridement procedure during their hospital stay (RR 2.42, 95% CI: 1.3 to 4.4, p=0.005) and those who did not attend CCLHD Podiatry clinics post-amputation (RR 2.3, 95% CI: 1.2 to 4.1, p=0.010).
Conclusions: To improve patient based clinical outcomes post-minor foot amputation, targeted follow-up in a high-risk foot clinic, and tailored discharge treatment plans for people aged over 60 or those undergoing a debridement procedure may be considered.
Cognitive Bias in Postoperative Opioid-Prescribing Practice
Authors: Brooks Bradley M. , Shih Chia-Ding , Bratches Reed W. R. , Arp Allison S. , Coughlin Gerard J. , Wolff Kristina B. , Brooks Brandon M. 
Published: April 2022

Background: Given that excess opioid prescriptions contribute to the US opioid epidemic and there are few national opioid-prescribing guidelines for the management of acute pain, it is pertinent to determine whether prescribers can sufficiently assess their own prescribing practice. We investigated podiatric surgeons’ ability to evaluate whether their own opioid-prescribing practice is less than, near, or above that of an “average” prescriber.
Methods: We administered a scenario-based, voluntary, anonymous, online questionnaire consisting of five surgery-based scenarios commonly performed by podiatric surgeons. Respondents were asked the quantity of opioids they would prescribe at the time of surgery. Respondents were also asked to rate their prescribing practice compared with the average (median) podiatric surgeon. We compared self-reported behavior to self-reported perception (“I prescribe less than average,” “I prescribed about average,” and “I prescribe more than average”). Analysis of variance was used for univariate analysis among the three groups. We used linear regression to adjust for confounders. Data restriction was used to account for restrictive state laws.
Results: One hundred fifteen podiatric surgeons completed the survey in April 2020. Less than half of the time, respondents accurately identified their own category. Consequently, there were no statistically significant differences among podiatric surgeons who reported that they “prescribe less,” “prescribe about average,” and “prescribe more.” Paradoxically, there was a flip in scenario 5: respondents who reported they “prescribe more” actually prescribed the least and respondents who believed they “prescribe less” actually prescribed the most.
Conclusions: Cognitive bias, in the form of a novel effect, occurs in postoperative opioid-prescribing practice; in the absence of procedure-specific guidelines or an objective standard, podiatric surgeons, more often than not, were unaware of how their own opioid-prescribing practice measured up to that of other podiatric surgeons.
Differentiated historical demography and ecological niche forming present distribution and genetic structure in coexisting two salamanders (Amphibia, Urodela, Hynobiidae) in a small island, Japan
Authors: Niwa Keita , Tran Dung Van , Nishikawa Kanto 
Published: April 2022

Background
The climatic oscillations in the Quaternary period considerably shaped the distribution and population genetic structure of organisms. Studies on the historical dynamics of distribution and demography not only reflect the current geographic distribution but also allow us to understand the adaption and genetic differentiation of species. However, the process and factors affecting the present distribution and genetic structure of many taxa are still poorly understood, especially for endemic organisms to small islands.

Methods
Here, we integrated population genetic and ecological niche modelling approaches to investigate the historical distribution and demographic dynamics of two co-existing salamanders on Tsushima Island, Japan: the true H. tsuensis (Group A), and Hynobius sp. (Group B). We also examined the hypothesis on the equivalency and similarity of niches of these groups by identity and background tests for ecological niche space.

Results
Our result showed that Group A is considered to have undergone a recent population expansion after the Last Glacial Maximum while it is unlikely to have occurred in Group B. The highest suitability was predicted for Group A in southern Tsushima Island, whereas the northern part of Tsushima Island was the potential distribution of Group B. The results also suggested a restricted range of both salamanders during the Last Interglacial and Last Glacial Maximum, and recent expansion in Mid-Holocene. The genetic landscape-shape interpolation analysis and historical suitable area of ecological niche modelling were consistent, and suggested refugia used during glacial ages in southern part for Group A, and in northern part of Tsushima Island for Group B. Additionally, we found evidence of nonequivalence for the ecological niche of the two groups of the salamanders, although our test could not show either niche divergence or conservatism based on the background tests. The environmental predictors affecting the potential distribution of each group also showed distinctiveness, leading to differences in selecting suitable areas. Finally, the combination of population genetics and ecological modeling has revealed the differential demographic/historical response between coexisting two salamanders on a small island.
Transcranial direct current stimulation combined with trunk-targeted, proprioceptive neuromuscular facilitation in subacute stroke: a randomized controlled trial
Authors: Tedla Jaya Shanker , Rodrigues Erika , Ferreira Arthur S. , Vicente Jose , Reddy Ravi Shankar , Gular Kumar , Sangadala Devika Rani , Kakaraparthi Venkata Nagaraj , Asiri Faisal , Midde Ajaya Kumar , Dixit Snehil 
Published: April 2022

Background
Stroke is the foremost cause of death and disability worldwide. Improving upper extremity function and quality of life are two paramount therapeutic targets during rehabilitation.

Aim of the study
To investigate the effects of transcranial direct current stimulation (tDCS) combined with trunk-targeted proprioceptive neuromuscular facilitation (PNF) on impairments, activity limitations, and participation restrictions of subjects with subacute stroke.

Methodology
Fifty-four subjects with subacute stroke were divided into three groups using block randomization. All three groups received rehabilitation sessions lasting 90 min in duration, four times per week, for 6 weeks. Group 1 (n = 18) received conventional physical therapy (CPT); group 2 (n = 18) received CPT, trunk-targeted PNF, and sham tDCS; and group 3 (n = 18) received CPT, trunk-targeted PNF, and bihemispheric motor cortex stimulation with tDCS. Changes in motor impairment, motor activity, and health-related quality of life assessments were outcome measures.

Results
A two-way linear mixed model analysis revealed interaction effects (group × time) for all outcome measurements (Trunk Impairment Scale, Fugl-Meyer Assessment of Motor Recovery after stroke upper extremity subsection, Wolf Motor Function Test, 10-Meter Walk Test, and the Stroke-Specific Quality of Life scale; all p < 0.01 or lower). Overall, post–pre mean differences demonstrate more substantial improvement in the active tDCS group, followed by sham stimulation associated with the PNF group and the group that received CPT alone.

Conclusion
Trunk-targeted PNF combined with bihemispheric tDCS along with CPT engender larger improvements in upper extremity and trunk impairment, upper limb function, gait speed, and quality of life in the subacute stroke population.
Chiropractic techniques and treatment modalities included in academic programs: A survey of chiropractic educational institutions
Authors: Dubuc Élisa , Pagé Isabelle , Boucher Pierre B. , Brousseau Danica , Robidoux Sébastien , Blanchette Marc-André 
Published: April 2022

ABSTRACT

Objective
The chiropractic techniques that chiropractors learn during their training strongly influence the nature of treatments provided by chiropractors and their professional identity. The objective of this project is to provide an exhaustive description of all chiropractic techniques and treatment modalities taught in chiropractic educational institutions.

Methods
International experts were solicited to provide feedback on the exhaustivity and clarity of our preliminary questionnaire. Following the expert suggestions, we administered our cross-sectional survey representatives of all chiropractic education institutions listed on the World Federation of Chiropractic website. We also asked the contact information for an additional contact from each institution and surveyed them for triangulation purposes.

Results
Among the 47 chiropractic education institutions surveyed, 29 completed our survey (response rate: 62%) of which 18 (62%) had 2 respondents. Among all the chiropractic techniques and treatment modalities investigated, only the Diversified technique was included in the core curriculum of all responding institutions. A considerable proportion of the techniques or modalities studied were not included in the educational activities of the institutions, particularly within the manual tonal or reflex techniques, instrument-assisted articular techniques, as well as the other techniques or modalities categories. Surprisingly, exercise prescription was not included in the core curriculum of all the institutions. Some scientifically challenged approaches were included in the educational activities of more than 40% of the institutions.

Conclusion
The portfolio of therapeutic teaching varies greatly between chiropractic educational institutions. A more standardized therapeutic curriculum could be beneficial to reduce public and interprofessional confusion toward therapeutic approaches in chiropractic.
Future of Microfinance Institutions in Sri Lanka; Prediction of Financial Distress Using Altman’s Z-Score
Authors: Kulawardena L. K. R. D. , Nissanka Kusal 
Published: April 2022

Microfinance is a valuable developing tool for alleviating poverty. Poverty remains to be one of the biggest policy concerns in Sri Lanka. Amongst various measures to eradicate it, Microfinance has provided a ray of hope. This paper presents a framework to predict the financial distress of such micro finance institutions operating in Sri Lanka using the Altman’s Z score model.
Quantitative research approach was used based on secondary data from 2015 to 2019 on the sample population which comprised ten listed and unlisted microfinance institutions operating in Sri Lanka. This study applied the Altman Z score model on measuring financial health of selected microfinance institutions, where financial health is adopted as the dependent variable. Secondary data for the study were obtained through e-mail surveys at firm level, annual reports, and audited financial statements.
The results of Z” Scores indicated that the mean financial health of the selected microfinance institutions has improved from 2015 to 2016, however there onwards it kept on deteriorating marginally. Thus, the microfinance institutions operating in Sri Lanka have a trend of downgrading their financial health moving closer to the Distress zone overtime.
The distress prediction models used in this research, may not provide information as to what is wrong within the organization, but rather it will only give signals to identify the potential for financial distress which would encourage the firm to identify problems and take effective actions to minimize the incidence of failure.
On the Generalization of Factoriangular Numbers
Authors: Castillo Romer C. 
Published: April 2022

A factoriangular number is a sum of a factorial and its corresponding triangular number. This paper presents some forms of the generalization of factoriangular numbers. One generalization is the \(n^{(m)}\) -factoriangular number which is of the form \((n!)^{m}\) + \(S_m(n)\), where \((n!)^{m}\) is the \(m\)th power of the factorial of \(n\) and \(S_m(n)\) is the sum of the \(m\)-powers of \(n\). This generalized form is explored for the different values of the natural number \(m\). The investigation results to some interesting proofs of theorems related thereto. Two important formulas were generated for \((n)^{m}\) -factoriangular number: \(Ft_{n^{(m)}}\) = \(Ft_{n^{(2k)}}\) = \((n!)^{2k}\) + \(2n+1\over2k+1\)\([n^{2k-2}+P(n^{2k-3})]T_n\) for even \(m=2k\), and \(Ft_{n^{(m)}}\) = \(Ft_{n^{(2k+1)}}\) = \((n!)^{2k+1}\) + \(n(n+1)\over k+1\)\([n^{2k-2}+P(n^{2k-3})]T_n\) for odd \(m=2k+1\)
Phenotypic Profiling of Selected Bacterial Microbes Isolated from Wounds of Diabetic Patients at Jaramogi Oginga Odinga Teaching & Referral Hospital, Kenya
Authors: Mamusavu Tuvei Susan , Kakai Rose , Benard Guyah 
Published: April 2022

Aims: To phenotypically profile selected bacteria microbes, determine antimicrobial resistance patterns and genetic diversity of resistant genes encoding extended spectrum β-lactamases in bacteria isolated from wounds of diabetes mellitus patients at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), Kenya.
Study Design: A hospital based cross sectional study design.
Place and Duration of Study: Jaramogi Oginga Odinga Teaching and Referral Hospital, Kenya between September, 2019 and February, 2020.
Methodology: Pus swabs were collected for isolation of bacteria using conventional techniques and serology involving 117 patients. Samples collected were inoculated onto MacConkey agar, pseudomonas agar media (cetrimide) and blood agar plates then incubated aerobically at 37∘C for 18hours to 24hours. Inoculated plates were examined for growth after 24-48 hours. After attaining pure colonies, Gram staining, colony morphology, and biochemical testing were done. Biochemical tests involving Catalase, Coagulase, Indole, Oxidase, Urease, Citrate utilization tests were done to identify specific bacterial species according to microbiological standard procedures.
Results: The results of analysis showed that the prevalence of Gram positive cocci isolated from diabetic wounds was 34.2% while the prevalence for Gram negative rods was 65.8%. The biochemically profiled bacterial microbes were S. aureus, E. coli, P. aeruginosa, K. pneumoniae and Proteus species. S. aureus was the most commonly isolated bacteria with a prevalence of 34.2%. P. aeruginosa had a prevalence of 24(20.5%), K. pneumoniae 22(18.8%), Proteus species 18(15.4 %) and E. coli 13(11.1%). More importantly, the prevalence basing on chi-square results was significantly associated with education level, age, smoking habit, patient setting, drug uptake and hospital visit at 5% level of significance ().
Conclusion: Diabetic patients with wounds at JOOTRH, Kenya are more exposed to Gram negative rods infection. The most prevalent Gram negative rod was P. aeruginosa with Its prevalence associated with the patient’s education level, smoking habit, patient setting, irregular hospital visit and adherence to taking of prescribe antibiotics regularly. Therefore, JOOTRH, Kenya healthcare providers are urged to initiate wound infection preventive measures that may include awareness campaigns on the importance of wound management, regular hospital visits, stopping smoking and regular uptake of prescribed drugs.
Histochemical and electrophysiological evidence for estrogen receptors on cultured astrocytes: colocalization with cholinergic receptors
Authors: Hösli Elisabeth , Rühl W. , Hösli L. 
Published: July 2002

AbstractBy means of autoradiographic and immunohistochemical methods it was demonstrated that astrocytes in explant and primary cultures of rat neocortex, hippocampus, preoptic area and spinal cord express estrogen α‐ and β‐receptors. Immunoreactivity was mainly distributed over the soma, the nuclei being more intensely stained. Combined autoradiographic and immunohistochemical studies as well as double‐immunostaining revealed a colocalization of estrogen α‐ and β‐receptors on many astrocytes. There was also a coexistence of estrogen receptors and cholinergic muscarinic and nicotinic sites. Electrophysiological investigations have shown that 17β‐estradiol induced hyperpolarizations on the majority of astrocytes in explant cultures of hippocampus and spinal cord, providing evidence for the existence of functional estrogen receptors on these cells. Furthermore, on the same astrocytes, 17β‐estradiol, muscarine and nicotine caused hyperpolarizations, suggesting a coexistence of receptors for estrogen and the cholinergic agonists on glial cells. The presence of glial estrogen receptors and their colocalization with cholinergic receptors is discussed with respect to the effects of these neurotransmitters/neuromodulators in development and maturation of the central nervous system, as well as to neurodegenerative events such as Alzheimer's disease.
Cost‐effectiveness of analgesia after Caesarean section. A comparison of intrathecal morphine and epidural PCA
Authors: Vercauteren M. , Vereecken K. , La Malfa M. , Coppejans H. , Adriaensen H. 
Published: July 2002

Background: Patient‐controlled analgesia (PCA) techniques and intrathecal morphine are the most widely used treatments for post‐Caesarean section pain. However these methods have not been compared with respect to analgesic quality and cost differences.Methods: Fifty‐three patients scheduled for elective or semi‐urgent Caesarean section were randomized to receive for postoperative analgesia either epidural PCA with a mixture containing bupivacaine 0.06% and sufentanil 1 μg · ml−1 or intrathecal morphine 0.15 mg together with the spinal anaesthetic and to be supplemented with paracetamol and tramadol. Analgesic efficacy, side‐effects and costs were calculated during 48 h.Results: VAS pain scores both at rest and during mobilization were lower in the PCA group, more particularly during the second postoperative day. Nausea and vomiting were more frequently registered in the morphine treated patients. PCA treated patients stayed longer in the recovery room but required fewer nurse interventions on the surgical ward. Manpower and drug costs were equal in both groups. The differences in total costs (Euro) amounted to €33 and were mainly caused by the more expensive equipment required for epidural PCA. Satisfaction and hospital discharge were similar for both treatments.Conclusions: It was concluded that epidural PCA induced better pain relief, caused less nausea/vomiting but was more expensive than intrathecal morphine.