Exclusive Fibula Osteosynthesis for Treating Open Fractures Gustillo I-III B of the Distal Half of the Leg Bones in a Resources-Limited Setting

Introduction: Management of open leg bones fractures is a challenging health issue for the surgeon, particularly true in resource-limited settings. In this study, we evaluate exclusive fibular osteosynthesis in the treatment of open fractures of the distal half of the leg bones as a therapeutic option in our context. Methods: This is a prospective, experimental, multicenter study of 30 open fractures of the distal half of the leg bones treated with exclusive fibula osteosynthesis, conducted in 3 hospitals in the DRC from January 1, 2013 to September 30, 2016. Results: The age range of 20 to 40 years grouped 22 (73.4%) patients, the sex ratio was 1:1 and the unemployed were the most involved with 16 (53.3%) cases. The Gustilo II, I, III B and III A types represented 40%, 33.3%, 20% and 6.7%, respectively. The fractures were located in the distal third in 12 (40%) cases, in the middle third in 11 (36.7%) cases, and in both malleoli in 7 cases (23.3%). Osteosynthesis of the fibula by screw plate was applied in 22 (73.3%) patients and pinning in 8 (26.7%). Satisfactory reduction of the tibial fracture site was achieved in 29 (96.7%) cases and 100% bone healing was achieved within an average of 10 weeks. Four (13.3%) loss of alignment, 1 (3.3%) infection, 1 (3.3%) skin necrosis and 2 (6.7%) ankle stiffness complicated our fractures. Conclusion: Exclusive osteosynthesis of the fibula as a common technique for fractures of the distal half of the leg bones allowed us to reduce, immobilize and consolidate the tibial fracture in the required time and to preserve the mobility of the ankle.

Outage Probability Analysis for D2D-Enabled Heterogeneous Cellular Networks with Exclusion Zone:A Stochastic Geometry Approach

Interference management is one of the most important issues in the device-to-device(D2D)-enabled heterogeneous cellular networks(HetCNets)due to the coexistence of massive cellular and D2D devices in which D2D devices reuse the cellular spectrum.To alleviate the interference,an efficient interference management way is to set exclusion zones around the cellular receivers.In this paper,we adopt a stochastic geometry approach to analyze the outage probabilities of cellular and D2D users in the D2D-enabled HetCNets.The main difficulties contain three aspects:1)how to model the location randomness of base stations,cellular and D2D users in practical networks;2)how to capture the randomness and interrelation of cellular and D2D transmissions due to the existence of random exclusion zones;3)how to characterize the different types of interference and their impacts on the outage probabilities of cellular and D2D users.We then run extensive Monte-Carlo simulations which manifest that our theoretical model is very accurate.

The Barrier of the Child and Parent Expected Models for Entering the School System-A Secondary Publication

The recognition of the positive value of student diversity and their right to full participation are key aspects of inclusion as a means of managing heterogeneity of the school population from an equality perspective.As the school cannot welcome the diversity of children without including their families,the same logic needs to apply to the relationship between the school and parents,particularly in the current environment where the school-family partnership appears as a privileged institutional leverage in the fight against inequalities at school.Based on an ethnographical study exploring how the relationship between the school and the families builds up in a Swiss school located in a context of strong cultural diversity,this paper interrogates how the school norm can be the main limitation to the inclusion of students and parents who are unfamiliar with the school.Derived from field observations and interviews,our results show how the teachers tend to approach their relationship with new students and their parents from the standpoint of narrowly defined expected models,leading them to engage in a vain attempt to conform the students and parents when they deviate from these models.The possibility of entering the school system for students and parents unfamiliar with school is hindered by the exclusive and excluding normativity on which the models of the child and the parent expected by the teachers are grounded.Based on these observations,we discuss how an inclusive approach seems to us to require in the first place a necessary process of decentering from the school and teachers,as a condition for recognition of the actual child and parent.

Metamorphoses of the University and the Pathways of Indigenous Students in Quebec:Issues of Accessibility to Studies and Academic Persistence from a Perspective of the Decolonization of Education-A Secondary Publication

In connection with the historical context of social segregation and the assimilative aim of formal education imposed on them,the Indigenous Peoples of Québec have long been excluded from higher education.Today,even if their graduation rates are increasing,a persistent gap with the non-Indigenous population is maintained.The data in this article are drawn from 23 interviews with students and university graduates of the First Nations of Québec,as part of a thesis in educational sciences.Our paper analyzes how these students manage to combine the contributions of Indigenous education with those of Western education by developing paths that are part of the decolonization movement of education.Their relationship to Indigenous identity and cultures clearly influences their educational background and is analyzed taking into account power relations with the dominant culture.Our paper emphasizes more particularly the relationship to studies,the adaptation to the student profession,and the balance between studies,work,and family among Indigenous students,in a context of transition from university to multiversity which contributed to the increase of Indigenous university attendance.

Relations Between School and Immigrant Families in Albertan Francophone School: Perspectives of Settlement Workers in Schools - A Secondary Publication

In recent years,Francophone schools in Alberta,a province in western Canada,have seen significant ethnocultural diversification of their school population,thus reflecting recent migratory changes in Canada.The population of a Francophone school board located in an agglomeration of Alberta reflects these new migratory trends.A partial ethnodemographic portrait carried out in 2003 in six of its schools indicates that 50%of the pupils come from an immigrant background and come from 23 different countries;mostly from sub-Saharan African countries.This demographic reality,confirmed more than a decade later,represents a major structural change for Francophone schools.In Alberta,as in other Canadian provinces,inclusion is at the heart of discourse and educational practices.With a transformative aim,it intends to promote ethnocultural diversity in the classroom and equal opportunities through school equity practices.This article focuses on the settlement workers in schools responsible for bridging family,community,and school cultures.The analysis of the interviews of the four workers sheds light on and questions both the institutional practices and the personal strategies put in place to face the challenges encountered in this tripartite collaboration.

Exclusive Breastfeeding Practice and Its Factors in Rural Areas of Burkina Faso

Background: The recommendation of the WHO and UNICEF is that all infants should be exclusively breastfed up to 6 months of age. Identifying associated factors to exclusively breastfeeding is crucial to improve this key public health intervention. The objectives of the study were to investigate rates of exclusive breastfeeding and to identify potential associated factors. Methods: A Community based cross-sectional study design was conducted in three health districts. Cluster sampling was used. For the community based cross-sectional study, a total of 1832 infants was included. Exclusive breastfeeding have been investigated among the 563 under 6 month’s infants. The associations between exclusive breastfeeding and independent variables were tested using the Chi-square test. Crude Odds ratios with 95 % confidence intervals were used to investigate the factors independently associated with exclusively breastfeeding. Results: Proportion of infant 0 - 5.9 months of age who are fed exclusively with breastmilk was 40.0%. Ear of age for mother was found to be more likely to practice exclusive breastfeeding, COR [95CI%] = 2.11 [1.24 - 3.60] for 15 - 20 years of age and 2.0 [1.22 - 3.26]. Receiving advices, on exclusive breastfeeding was found to be more likely to practice exclusive breastfeeding, COR: 2.07, 95% CI: [1.44 - 2.98]. Mothers who have practice early initiation to breastfeeding were found to be more likely to practice exclusive breastfeeding COR: 1.62, 95% CI: [1.15 - 2.27]. Skilled delivery was found to be more likely to practice exclusive breastfeeding than non-skilled deliveries, COR: 1.66, 95% CI: [1.16 - 2.35]. Low numbers of living children by mother, young children, were found to be more likely to practice exclusive breastfeeding. Conclusions: Exclusive breastfeeding continues to be low in rural areas of Burkina Faso. As Exclusive breastfeeding is associated to lower morbidity and mortality risk, improving the skills of health providers to give adequate feeding support to the mothers is critical for promoting exclusively breastfeeding.

Threshold values of traffic flow for the provision of exclusive bus lanes

A simulation network model was established using VISSIM software and verified by the T- test. The model took into consideration the road conditions, pedestrian crossing, traffic composi- tion, bus stops and traffic signal. The operating characteristics of buses and cars under different flow conditions were studied using the simulation model, and the speed-flow models of buses and cars were established based on the simulation results. Finally, the threshold values of traffic flow for the provision of exclusive bus lanes was determined with the target of optimal travel benefits （per capi- ta） , which would provide a basis for the planning and design of exclusive bus lanes on urban roads.

Bus Priority Control for Dynamic Exclusive Bus Lane

One problem with the existing dynamic exclusive bus lane strategies is that bus signal priority strategies with multi-phase priority request at intersections are not adequately considered.The principle of bus signal priority level was designed based on the isolated multi-phase structure principle consideration of the bus signal priority,and a new priority approach for the dynamic exclusive bus lane was proposed.Two types of priority strategies,green extension and red truncation,were proposed for current phase and next phase buses,respectively.The control parameters including minimum green time,green extension time,maximum green time and bus arrival time are calculated.The case studies for this paper were carried out using four consecutive intersections of Huaide Middle Road in Changzhou City.The signal control scheme was designed using the conventional,exclusive bus lane method,the dynamic exclusive bus lane without signal priority method,and the proposed approach,respectively.The authors used the VISSIM simulation platform to evaluate the efficiency of each approach.Results showed that the method of approach can significantly decrease delays caused by social and conventional buses and make up for the negative impact social buses have on the bus rapid transit(BRT)operation,which allows the method to complement the dynamic,exclusive bus lane design.

Exclusive Charmonium Photo-Production at HERA and LHC with Color Glass Condensate

We calculate the exclusive charmonium photo-production in the framework of color glass condensate.To obtain a good description of the vector meson production experimental data at HERA,we introduce a vector meson mass dependent skewness factor into the skewness effect.Then we extend the skewness improved model to the LHC energies.The numerical results of our model are in good agreement with theΨ/Ψ and Ψ（2S）data in ultraperipheral proton-proton collisions at LHC,which show the significance of the vector meson mass-dependent skewness factor.A prediction of the exclusive charmonium photo-production in ultra-peripheral nucleus-nucleus collisions is performed since it can provide a good way to test the effectiveness of the color glass condensate.

Moral Education, Legal Practice——Exclusive Interview with Lu Jianping, Dean of BNU Law School

BNU Law School is one of the youngest and most dynamic faculties at Beijing Normal University.Its precursor was the Law major established by the Department of Philosophy in 1995,the Department of Law established in 2002,and the Criminal Law Science Research Institute was established in 2005.It culminated in the formal establishment of BNU Law School in 2006.Although BNU Law School was established in recent time,it has made outstanding achievements in various fields.

Explore Business Opportunities of Jaboticaba and Build A Long Term Enterprise一Exclusive Interview with Ally Biz International Group CEO John Soo

'Acompany shall have its commitment to build a century-old business if it hopes to continue operation for a long time.'John Soo is the third generation of Chinese immigrants in Malaysia and CEO of Ally Biz International Group. His forefathers were engaged in traditional plantation business. As a new-generation Malaysian Chinese who have received higher education and worked in many international companies as accountant or CEO, John Soo found that the business opportunities in traditional plantation industry has becoming slim. The challenge is to seek a better business project for new breakthroughs.

“Malaysia Has Certainly Benefited from China’s Prominence on the World Stage”——Exclusive Interview with See Chee Kong Leonard, Business Minister of Embassy of Malaysia in PRC

Relations between China and Malaysia have been developing steadily.Recently,See Chee Kong Leonard,Business Minister of Embassy of Malaysia in PRC,accepted an interview with Chinas Foreign Tradey and talked about the 45 years of economic and trade cooperation and achievements of the two countries.

Cultivate Talents with Both Noble Qualities and Knowledge of Chinese and Western Culture——Exclusive Interview with Professor Yin Meiqun, Dean of the Business School of Beijing International Studies University

Although it was frigid outside mid-winter, classrooms in the Business School of Beijing International Studies University are still as warm as spring,because of the passionate teachers and students. Professors were conducting lectures in English, as the students listen carefully and occasionally answered the questions posed in fluent English.If hearing their voices only, audiences might easily mistake that they were in a university in an English-speaking country.'

Predictors of Exclusive Breastfeeding Duration among Mothers Attending Immunization Clinic in a Tertiary Health Facility in Enugu, Nigeria

Background: Breastfeeding is cost effective means towards the realization of some key United Nations Sustainable Development Goals by the year 2030 particularly in resource limited settings. The objectives of the study were to evaluate the predictors of exclusive breastfeeding duration among mother and child pairs utilizing a tertiary immunization clinic facility. Methods: This was a cross-sectional descriptive study. Respondents were mother-and-child pairs who were recruited consecutively. Relevant maternal and child characteristics were collected using a semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences version 20.0 (p Results: Four hundred and twenty seven mother-child pairs were studied. Majority of the mothers have at least secondary education, 383 (80.7%). 407 (95.3%) of the mothers fully understood the actual meaning of EBF. 189 (42.7%) reported practicing EBF in their index child for six months. Maternal perception of insufficient milk production, 52/99 (52.5%) was the most common reason for practicing EBF for Maternal education and occupation and gender of the child were significantly associated with completion of EBF for 6 months among respondents. Conclusion: EBF duration in the current study is low and is significantly associated with maternal education, maternal occupation and gender of the child. Improving girl child education, complementing baby friendly hospital initiative with baby friendly community initiative should be adopted to improve EBF duration in our setting.

Determinates of Childhood Pneumonia and Diarrhea with Special Emphasis to Exclusive Breastfeeding in North Achefer District, Northwest Ethiopia: A Case Control Study

Studies showed that exclusive breast feeding reduced infant morbidity and mortality. In low income countries such as Ethiopia where under-five mortality is very high, the role of exclusively breastfeeding could be even more critical. However, studies assessing the place of exclusive breast freeing in the prevention of childhood illnesses in our area are scarce. The aim of the study was to identify determinant factors of childhood pneumonia and diarrhoea. An institution based case control study was conducted in Achefer District in July, 2012. The cases were 122 children of 7 - 24 months old who had repeated attack of diarrhoea or pneumonia over three months prior to the survey while controls were 122 children who visited well baby clinic for vaccination. Data were collected by using pre-tested and structured questionnaire, and analysed using SPSS version 16 for windows. Logistic regression was performed, and strength of associations was estimated using odds ratio and 95% confidence interval. About 83% of the controls and only 12.3% of the cases were exclusively breast fed. Children who were exclusively breast fed were 83 times less likely to develop pneumonia or diarrhea than those who were not exclusively fed. Marital status, monthly income, prelacteal feeding, and late initiation of breast feeding were found to have statistically significant association with childhood diarrhea and pneumonia. This study brought local evidence that exclusive breast feeding had a protective effect against common childhood infectious diseases—pneumonia and diarrhoea—in the study area. Therefore, culture sensitive and plausible health education is recommended to strengthen exclusive breast feeding practices in order to decrease mortality and morbidity of infants and children from pneumonia and diarrhoea.

What Will Expo Milan Bring to China?——An exclusive interview with Italian Ambassador to China,H.E.Mr.Alberto Bradanini

We still remember the S hanghai World Expo in 2010,which impressed the whole world.After a blink,another World Expo is here soon.Milan in Italy will be the host next year,and the China Council for the Promotion of International Trade(CCPIT)will host the China pavilion there.To know more about the Milan World Expo2015,China’s Foreign Trade magazine had an exclusive interview with Italian Ambassador to China,H.E.Mr.Alberto Bradanini.

Legal Issues and Scientific Constraints in the Environmental Assessment of the Deepwater Horizon Oil Spill in Mexico Exclusive Economic Zone (EEZ) in the Gulf of Mexico

The largest accidental marine oil spill (4.9 million barrels) in the Gulf of Mexico (GoM) seabed (1600 m) caused by the sinking of the Deepwater Horizon oil rig in 2010, put to the test once again the resilient capacity of the pelagic and benthic realms of this Large Marine Ecosystem. Many are the ecological services provided by its waters (fisheries, tourism, aquaculture and fossil fuel reserves) to neighboring countries (US, Mexico and Cuba). However, the unprecedented volumes of hydrocarbons, gas and chemical dispersants (Corexit) introduced in the system, represent ecological stressors whose deleterious effects are still the subject of civil claims and scientific controversy. Presumably, the short scale effects were confined to the Gulf’s northeastern shallow waters, and the combined actions of weathering, biodegradation, and oil recovery left the system almost under pre-spill conditions. Unfortunately, surface and subsurface oil plumes were detected in the spill aftermath, and their dispersion trajectories threatened Mexico EEZ. Surface oil slicks were detected in the pristine waters of northern Yucatán, while subsurface oil plumes from the Macondo’s well blowout were dangerously advancing southwest towards key fishing grounds in the northwestern GoM. This disaster prompted the Mexican government to implement an ambitious ocean monitoring program adopting a bottom-up approach focused on building a base line for more than 42 physicochemical and biological variables for water, sediment and biota from the continental shelf-slope region of the NW GoM. Technological constraints have precluded systematic observations in the vast Mexican EEZ that could discriminate natural variability and oil seep emissions from antropic disturbances. Therefore, preliminary risk analyses relied on seasonal and historical records. Two years of field observations revealed subtle environmental changes in the studied area attributed to antropic disturbances. Waters maintained oligotrophic conditions and zooplankton and benthic infaunal biomass were also poor. Biomarkers in sediments and biota did not exceed EPA’s benchmarks, and sediment’s fingerprinting (δ13C) indicated marine carbon sources. Geomarkers revealed an active transport from the Mississippi towards the NW GoM of phyllosilicates bearing a weathered oil coating. Consequently, shelf and slope sediment toxicity begins to show an increasing trend in the region. The complexity of hydrocarbons bioaccumulation and biodegradation processes in deep waters of the GoM seems to indicate that meso-and large-scale observations may prove to be essential in understanding the capacity of the GoM to recover its ecological stability.

Reasons and effects of the decline of willing related potential living kidney donors

BACKGROUND Although the availability of related living donors(LDs)provides a better chance for receiving kidney transplantation(KT),the evaluation protocols for LD selection remain a safeguard for the LD’s safety.These protocols are variable from one center to another,resulting in variable rates of decline of the potential LDs(PLDs).The decline of willing PLDs may occur at any stage of evaluation,starting from the initial contact and counseling to the day of operation.AIM To identify the causes of the decline of PLDs,the predictors of PLD candidacy,and the effect on achieving LDKT.METHODS A retrospective study was performed on the willing PLDs who attended our outpatient clinic for kidney donation to their related potential recipients between October 2015 and December 2022.The variables influencing their candidacy rate and the fate of their potential recipients were studied.Two groups of PLDs were compared:Candidate PLDs after a completed evaluation vs non-candidate PLDs with a complete or incomplete evaluation.A multivariate logistic regression was performed to assess the factors contributing to the achievement of PLD candidacy.RESULTS Of 321 willing PLDs,257 PLDs(80.1%)accessed the evaluation to variable extents for 212 potential recipients,with a mean age(range)of 40.5±10.4(18-65)years,including 169 females(65.8%).The remaining 64 PLDs(19.9%)did not access the evaluation.Only 58 PLDs(18.1%)succeeded in donating,but 199 PDLs(62.0%)were declined;exclusion occurred in 144 PLDs(56.0%)for immunological causes(37.5%),medical causes(54.9%),combined causes(9.7%),and financial causes(2.1%).Regression and release occurred in 55 PLDs(17.1%).The potential recipients with candidate PLDs were not significantly different from those with non-candidate PLDs,except in age(P=0.041),rates of completed evaluation,and exclusion of PLDs(P<0.001).There were no factors that independently influenced the rate of PLD candidacy.Most patients who failed to have KT after the decline of their PLDs remained on hemodialysis for 6 mo to 6 years.CONCLUSION The rate of decline of willing related PLDs was high due to medical or immunological contraindications,release,or regression of PLDs.It reduced the chances of high percentages of potential recipients in LDKT.

The Young Star Bridging the World to China——Exclusive Interview with World Youth Leadership Foundation Chairman Franco Ng

My f irst impression of Franco Ng came during his visit to our Beijing offices.At that time,he was in Beijing as a guest with the National Bank of Canada speaking about his educational experiences growing up in Canada,while promoting“The Win”,a Global Youth Venture Competition he established with the World Youth Leadership Foundation this year.

Approach in A People-Oriented and Diversifying Way——Exclusive Interview with Professor Wu Guangjun, Dean of SELLC, BISU

This autumn fruitful autumn,Beijing International Studies University(BISU)is about to celebrate the54th anniversary since its foundation.Meanwhile,the Department of English established in1964turned into the School of English Language,Literature and Culture(SELLC)in2009.Are there any moving stories behind these name-changes,and did the teaching philosophy change accordingly?