bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to entry point and distal locking of intramedullary nails: a methodological phantom study comparing biplanar and uniplanar surgical imaging
Authors: Ström Peter , Hailer Nils P. , Wolf Olof 
Published: February 2022

Abstract
Background
Intramedullary nailing is the method of choice for diaphyseal fractures of the femur and tibia and is also commonly used to treat trochanteric hip fractures. Perioperative imaging is essential for visualising adequate reduction, achieving an optimal entry point (EP) and performing distal locking (DL) of intramedullary nails. This methodological study aims to compare biplanar and uniplanar imaging in some steps of intramedullary nailing.

Methods
We used a biplanar preassembled imaging device (Biplanar™ 600s, Swemac Imaging) and a uniplanar imaging device (Ziehm Solo FD, Ziehm Imaging) to measure procedural and radiation times for antegrade and retrograde femoral and antegrade tibial nailing in fully soft flexible tissue encased legs with radiopaque sawbones (SKU:1515–7-11, Sawbones Europe, Malmö, Sweden). Four orthopaedic surgeons with different levels of experience performed all procedures in all three phantoms with both image techniques in random order, producing in total 12 EPs and nailings with DL with each imaging device. Time to EP, radiation times, time to DL for both devices and the number of swings of the uniplanar device for the two procedures were measured. Comparisons between the biplanar and uniplanar systems with a paired-samples t-test were conducted.

Results
Using the biplanar device, time to optimal EP was shorter for retrograde femoral (26 s (SD15) vs 35 s (SD13), p = 0.01) and for antegrade tibial nailing (23 s (SD13) vs 49 s (SD24), p = 0.001). No statistically significant differences in time to EP, radiation time or time to DL were found for antegrade femoral nailing. A median of two swings of the uniplanar device was needed to obtain optimal EP for all procedures.

Conclusions
Biplanar imaging slightly but statistically significantly reduced time to EP for retrograde femoral and antegrade tibial nailing in this methodological study comparing biplanar and uniplanar imaging techniques. Biplanar imaging can reduce time and radiation exposure when defining the EP around the knee in intramedullary nailing procedures, but the clinical relevance of these time savings remain to be defined. For antegrade femoral nailing we found no clear benefit with biplanar imaging in the investigated steps of nailing.
Cost effectiveness analysis of total laparoscopic hysterectomy versus total abdominal hysterectomy for uterine fibroids in Western China: a societal perspective
Authors: Yang Jinjuan , Fan Xiaojing , Gao Jianmin , Li Dan , Xu Yongjian , Chen Gang 
Published: February 2022

AbstractBackgroundAs a common female pelvic tumor, uterine fibroids remain the leading cause for hysterectomy in China. Hysterectomy provides a good surgical treatment of uterine fibroids, and it guarantees the removal of all uterine fibroids without lower risk of recurrence. This study compares the cost effectiveness of total laparoscopic hysterectomy (TLH) versus total abdominal hysterectomy (TAH) for women with uterine fibroids from a societal perspective.MethodsAn economic analysis was conducted in 392 patients (TLHn = 75; TAHn = 317), including all relevant costs over a 12-month time horizon. Primary outcome was major surgical complications; secondary outcomes were postoperative discomfort symptoms and time of return to normal activities. Clinical, outcomes and costs data were collected from medical records, telephone survey and financial information system. Generalized linear models were used to assess costs and outcomes differences between the two groups. Incremental cost effectiveness ratio (ICER) was used to estimate the cost effectiveness.ResultsMean direct costs were $2,925.71 for TLH, $2,436.24 for TAH, respectively. Mean indirect costs were $1,133.22 for TLH, $1,394.85 for TAH, respectively. Incremental societal costs were $256.86 (95%CI: 249.03–264.69). Mean differences in outcome were: 4.53% (95%CI: 4.35–4.71) for major surgical complications; 6.75% (95%CI: 6.45–7.05) for postoperative discomfort symptoms; 1.27 (95%CI: 1.23–1.30) weeks for time to return to normal activities. ICER of TLH was $5,669.16 (95%CI: 5,384.76–5,955.56) per complication averted, $3,801.54 (95%CI: 3,634.81–3,968.28) per postoperative discomfort symptoms averted and $202.96 (95%CI: 194.97–210.95) per week saved to return to normal activities.ConclusionsTLH is cost effective compared with TAH in preventing additional complications based on our estimated conservative threshold in China. The findings provide useful information for researchers to conduct further cost effectiveness analysis based on prospective study which can provide stronger and more evidence, in China. In addition, the data may be useful for Chinese health care policy-makers and medical insurance payers to make related health care decisions.
Translation and validation of Indonesian version of Pediatric Quality of Life Inventory™ (PedsQL™) Neuromuscular Module
Authors: Wiwaha Guswan , Sari Dian M. , Biben Vitriana , Sunjaya Deni K. , Hilmanto Dany 
Published: February 2022

Abstract
Background
The Pediatric Quality of Life™ 3.0 Neuromuscular Module is an instrument to assess health-related quality of life (HRQoL) among children with neuromuscular diseases (NMDs) aged 2–18 years. This study aimed to determine whether the PedsQL™ 3.0 Neuromuscular Module Indonesian Version is valid and reliable.

Methods
This study used the Indonesian translation of the PedsQL™ 3.0 Neuromuscular Module after getting formal permission from the inventor, and the translation process followed the Mapi linguistic translation guidelines. This study administered the PedsQL™ 3.0 Neuromuscular Module Indonesian Version to 84 parents and 71 children. In addition, we used the Rasch model to analyze the psychometric properties.

Results
The reliability of the total scale of the PedsQL™ Neuromuscular Module Indonesian Version shows good to very good criteria. On the parent proxy-report, Cronbach alpha was 0.95, person reliability was 0.84, item reliability was 0.93, person separation was 2.32, item separation was 3.61, person strata separation was 4 levels, and item strata separation was 5 levels. On the child self-report, Cronbach alpha was 0.93, person reliability was 0.81, item reliability was 0.81, person separation was 2.08, item separation was 2.06, person strata separation was 3 levels, and item strata separation was 3 levels. The total scale of the PedsQL Neuromuscular Module Indonesian Version shows fair to good construct validity in parent proxy-report (explained variance 51.9%; unexplained variance 8.4%) and child self-report (explained variance 40.9%; unexplained variance 12.6%). There were no misfit items in the parent proxy-report (infit 0.66–1.49; outfit 0.51–1.81; point measure correlation 0.36–0.93) and child self-report (infit 0.53–1.65; outfit 0.50–1.73; point measure correlation 0.31–0.90) identified by the Rasch models.

Conclusions
The PedsQL™ 3.0 Neuromuscular Modul Indonesian Version is a valid and reliable instrument in measuring HRQoL in Indonesian children with neuromuscular diseases.
Evidence of accelerated epigenetic aging of breast tissues in patients with breast cancer is driven by CpGs associated with polycomb-related genes
Authors: Rozenblit Mariya , Hofstatter Erin , Liu Zuyun , O’Meara Tess , Storniolo Anna Maria , Dalela Disha , Singh Vineet , Pusztai Lajos , Levine Morgan 
Published: February 2022

AbstractPurposeAge is one of the strongest risk factors for the development of breast cancer, however, the underlying etiology linking age and breast cancer remains unclear. We have previously observed links between epigenetic aging signatures in breast/tumor tissue and breast cancer risk/prevalence. However, these DNA methylation-based aging biomarkers capture diverse epigenetic phenomena and it is not known to what degree they relate to breast cancer risk, and/or progression.MethodsUsing six epigenetic clocks, we analyzed whether they distinguish normal breast tissue adjacent to tumor (cases) vs normal breast tissue from healthy controls (controls).ResultsThe Levine (p = 0.0037) and Yang clocks (p = 0.023) showed significant epigenetic age acceleration in cases vs controls in breast tissue. We observed that much of the difference between cases and controls is driven by CpGs associated with polycomb-related genes. Thus, we developed a new score utilizing only CpGs associated with polycomb-related genes and demonstrated that it robustly captured epigenetic age acceleration in cases vs controls (p = 0.00012). Finally, we tested whether this same signal could be seen in peripheral blood. We observed no difference in cases vs. controls and no correlation between matched tissue/blood samples, suggesting that peripheral blood is not a good surrogate marker for epigenetic age acceleration.ConclusionsMoving forward, it will be critical for studies to elucidate whether epigenetic age acceleration in breast tissue precedes breast cancer diagnosis and whether methylation changes at CpGs associated with polycomb-related genes can be used to assess the risk of developing breast cancer among unaffected individuals.
Serum Thioredoxin-80 is associated with age, ApoE4, and neuropathological biomarkers in Alzheimer’s disease: a potential early sign of AD
Authors: Goikolea Julen , Gerenu Gorka , Daniilidou Makrina , Mangialasche Francesca , Mecocci Patrizia , Ngandu Tiia , Rinne Juha , Solomon Alina , Kivipelto Miia , Cedazo-Minguez Angel , Sandebring-Matton Anna , Maioli Silvia 
Published: February 2022

AbstractBackgroundThioredoxin-80 (Trx80) is a cleavage product from the redox-active protein Thioredoxin-1 and has been previously described as a pro-inflammatory cytokine secreted by immune cells. Previous studies in our group reported that Trx80 levels are depleted in Alzheimer’s disease (AD) brains. However, no studies so far have investigated peripheral Trx80 levels in the context of AD pathology and whether could be associated with the main known AD risk factors and biomarkers.MethodsTrx80 was measured in serum samples from participants from two different cohorts: the observational memory clinic biobank (GEDOC) (N = 99) with AD CSF biomarker data was available and the population-based lifestyle multidomain intervention trial Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) (N = 47), with neuroimaging data and blood markers of inflammation available. The GEDOC cohort consists of participants diagnosed with subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and AD, whereas the FINGER participants are older adults at-risk of dementia, but without substantial cognitive impairment. One-way ANOVA and multiple comparison tests were used to assess the levels of Trx80 between groups. Linear regression models were used to explore associations of Trx80 with cognition, AD CSF biomarkers (Aβ42, t-tau, p-tau and p-tau/t-tau ratio), inflammatory cytokines, and neuroimaging markers.ResultsIn the GEDOC cohort, Trx80 was associated to p-tau/t-tau ratio in the MCI group. In the FINGER cohort, serum Trx80 levels correlated with lower hippocampal volume and higher pro-inflammatory cytokine levels. In both GEDOC and FINGER cohorts, ApoE4 carriers had significantly higher serum Trx80 levels compared to non-ApoE4 carriers. However, Trx80 levels in the brain were further decreased in AD patients with ApoE4 genotype.ConclusionWe report that serum Trx80 levels are associated to AD disease stage as well as to several risk factors for AD such as age and ApoE4 genotype, which suggests that Trx80 could have potential as serum AD biomarker. Increased serum Trx80 and decreased brain Trx80 levels was particularly seen in ApoE4 carriers. Whether this could contribute to the mechanism by which ApoE4 show increased vulnerability to develop AD would need to be further investigated.Trial registrationClinicalTrials.govNCT01041989. Registered on 4 January 2010—retrospectively registered
Compressed spectrum sensing for grant-free NOMA based internet of vehicles
Authors: Zhang Liang , Li Zengqi , Jia Min 
Published: February 2022

AbstractWith the development of communication technology, non-orthogonal multiple access (NOMA) technology is proposed to meet the requirements of high throughput and low latency in massive machine type communication (mMTC) of Internet of Vehicles (IoV). In grant-free NOMA based IoV, mMTC has the characteristics of sparse active users at the same time, which makes the detection and recovery of user information critical. In this paper, considering the sparsity of active users in mMTC, we present a new block sparsity method under compressed sensing model that enables us to detect activity of users and recover user information with high accuracy and low complexity. The recovered algorithm used in our study is known as block sparse ISD algorithm, which exploits block sparse structure based on the ISD algorithm. The simulation results show that the proposed method is able to realize more performance gains in sparse signal recovery than traditional algorithm.
Environmental and economic impact of cloudburst-triggered debris flows and flash floods in Uttarakhand Himalaya: a case study
Authors: Sati Vishwambhar Prasad , Kumar Saurav 
Published: February 2022

AbstractThis paper examines the environmental and economic impact of cloudburst-triggered debris flow and flash flood in four villages of Uttarkashi district, Uttarakhand Himalaya. On 18th July 2021 at 8:30 p.m., a cloudburst took place on the top of the Hari Maharaj Parvat, which triggered a huge debris flows and flash floods, affecting 143 households of four villages of downstream areas. Immediately after the cloudburst occurred, the authors visited four affected villages—Nirakot, Mando, Kankrari, and Siror. A structured questionnaire was constructed and questions were framed and asked from 143 heads of affected households on the impact of debris flows and flash floods on people’s life, settlements, cowsheds, bridges, trees, forests, and arable land in and around the villages. The volume of debris, boulders, pebbles, gravels, and mud was assessed. It was noticed that all four villages got lots of destructions in terms of loss of life—people and animals, and property damage—land, crops, and infrastructural facilities. This study shows that the location of the settlements along with the proximity of the streams, which are very violent during the monsoon season, has led to the high impact of debris flow on the affected villages. We suggest that the old inhabited areas, which are located in the risk zones, can be relocated and the new settlements can be constructed in safe places using suitability analyses.
Creative students in self-paced online learning environments: an experimental exploration of the interaction of visual design and creativity
Authors: Rosar Michaela , Weidlich Joshua 
Published: February 2022

AbstractCreativity is an increasingly recognized construct in technology-enhanced learning. However, our understanding of how creativity interacts with the design of online learning environments to affect learning experiences is still limited. For example, do creative students benefit from different learning environment designs than those benefitting their less creative peers? This experimental study (N = 187) explores this question by investigating the visual design of a self-paced online learning environment, specifically the degree of visual structure, in relation to students' creativity. Creativity was measured in different ways, along the lines of vocational/study choice, self-reported personality and behavior, and creative production. Students were randomly assigned to either a visually unstructured (experimental group) or a visually highly structured (control group) learning environment. They reported their preference, impulse for activation, and situational motivation after the learning experience. Results indicate interaction effects consistent with the role of creativity in perception and learning. More specifically, creative students reported more motivation after learning in an unstructured environment, whereas non-creative students reported relatively better learning experiences in the highly structured condition. These results contribute to resolving previous conflicting findings from separated studies, yet some ambiguities remain. Results and implications are discussed, and recommendations for future research are laid out.
A qualitative assessment tool for innovative waste logistics scenarios: a case study for Flanders
Authors: Willems Jeffrey , Pauwels Tom , van Hassel Edwin , Vanelslander Thierry , Sel Steve 
Published: February 2022

AbstractWith new, innovative logistics tools and frameworks coming to the market rather quickly, developing a decision support framework to assess its value before carrying out extensive, quantitative economic assessment studies and large-scale implementation is necessary. This paper focuses on developing a qualitative decision support framework—aiding the deployment of successful tools in the logistics landscape and avoiding high sunk costs without added value. Resulting in a qualitative tool based on a literature review and industry expert interviews. The derived parameter impact model assesses the importance of different parameters, allowing to find opportunities without the need for extensive information and/or investments. Therefore, the parameter impact model was applied to three different cases of waste logistics located in Flanders: (1) the use of telemetry (i.e., the use of sensors to identify the filling rate of waste collection points remotely), (2) small waste compactors on the business side, and (3) inland waterways to transport waste to treatment centers. The qualitative results can vary depending on the specific case, establishing the fundament for future innovations.
A micro-credentialing methodology for improved recognition of HE employability skills
Authors: Maina Marcelo Fabián , Guàrdia Ortiz Lourdes , Mancini Federica , Martinez Melo Montserrat 
Published: February 2022

AbstractIncreasingly, among international organizations concerned with unemployment rates and industry demands, there is an emphasis on the need to improve graduates’ employability skills and the transparency of mechanisms for their recognition. This research presents the Employability Skills Micro-credentialing (ESMC) methodology, designed under the EPICA Horizon 2020 (H2020) project and tested at three East African universities, and shows how it fosters pedagogical innovation and promotes employability skills integration and visibility. The methodology, supported by a competency-based ePortfolio and a digital micro-credentialing system, was evaluated using a mixed-method design, combining descriptive statistics and qualitative content analysis to capture complementary stakeholder perspectives. The study involved the participation of 13 lecturers, 169 students, and 24 employers. The results indicate that the ESMC methodology is a promising approach for supporting students in their transition from academia to the workplace. The implementation of the methodology and the involvement of employers entails rethinking educational practices and academic curricula to embed employability skills. It enables all actors to broaden their understanding of the relationship between higher education and the business sector and to sustain visibility, transparency, and reliability of the recognition process. These findings indicate that there are favourable conditions in the region for the adoption of the approach, which is a meaningful solution for the stakeholder community to address the skills gap.
Autism and attachment disorders – how do we tell the difference?
Authors: Davidson Claire , Moran Heather , Minnis Helen 
Published: February 2022

SUMMARYClinicians assessing children with autism are sometimes faced with a dilemma, especially if there is a definite or suspected history of abuse or neglect: is this autism or attachment disorder? This is important because the attachment disorders (reactive attachment disorder and disinhibited social engagement disorder) are thought to be caused by abuse or neglect, whereas autism is not. We discuss the Coventry Grid, a clinical tool aiming to aid differentiation between autism and attachment disorders. We examine the small body of empirical studies focusing on this differential diagnosis and find that the Coventry Grid can be regarded as an evidence-based tool. We also discuss preliminary findings regarding a relatively unstructured observational method involving two assessors who engage the child in jokes and playful social dilemmas, which might help clinicians elicit the information required to complete the Coventry Grid.
Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature
Authors: DeLeo Kristiana , Maconick Lucy , McCabe Rose , Broeckelmann Eva , Sheridan Rains Luke , Rowe Sarah , Johnson Sonia 
Published: February 2022

BackgroundMental health crises are common in people with complex emotional needs (our preferred working term for people diagnosed with a 'personality disorder'), yet this population is often dissatisfied with the crisis care they receive. Exploring their experiences and views on what could be improved, and those of carers and healthcare staff, is key to developing better services.AimsWe aimed to synthesise the relevant qualitative literature.MethodFive databases were searched. Eligible studies included service users with a diagnosis of personality disorder and their carers or relevant staff, focused on crisis responses and used a qualitative design. Data were analysed with thematic synthesis.ResultsEleven studies were included, most focusing on emergency departments. Four meta-themes emerged: (a) acceptance and rejection when presenting to crisis care: limited options and lack of involvement of carers; (b) interpersonal processes: importance of the therapeutic relationship and establishing a framework for treatment; (c) managing recovery from a crisis: clear recovery plan and negotiating collaboration; and (d) equipping and supporting staff: training and emotional support.ConclusionsOur findings suggest that emergency departments have major limitations as settings to provide crisis care for people with complex emotional needs, but there is a lack of research exploring alternatives. The quality of the therapeutic relationship was central to how care was experienced, with collaborative and optimistic staff highly valued. Staff reported feeling poorly supported in responding to the needs of this population. Research looking at experiences of a range of care options and how to improve these is needed.