bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of the Recommended Resident Experience with Common Orthopaedic Procedures
Authors: Stotts Alan K. , Kohring Jessica M. , Presson Angela P. , Millar Morgan M. , Harrast John J. , Van Heest Ann E. , Zhang Chong , Saltzman Charles L.
Published: July 2019

Background

U.S. orthopaedic residency training is anchored by the Accreditation Council for Graduate Medical Education (ACGME) requirements, which include minimum numbers for 15 categories of procedures. The face validity of these recommendations and expectations for exposure to other common procedures has not been rigorously investigated. The main goals of this investigation were to understand the perceptions of program directors and early practice surgeons regarding the number of cases needed in residency training and to report which of the most commonly performed procedures residents should be able to perform independently upon graduation.

Methods

We sent surveys to 157 current program directors of ACMGE-approved orthopaedic surgery residency programs and to all examinees sitting for the American Board of Orthopaedic Surgery (ABOS) Part II Oral Examination in 2017, requesting that they estimate the minimum number of exposures for the 22 adult and 24 pediatric procedures that are most commonly performed during residency and the first 2 years in practice. Where applicable, we compared these with the ACGME “Minimum Numbers” and the average ACGME resident experience data from 2010 to 2012 for resident graduates. For each of the 46 procedures, participants were asked if every orthopaedic resident should be able to independently perform the procedure upon graduation. We compared the percent for independence between the early practice surgeons and the program directors.

Results

For the majority of adult and pediatric procedures, the early practitioners reported significantly higher numbers of cases needing to be performed during residency than the program directors. ACGME Minimum Numbers were always lower than the case numbers that were recommended by the early practice surgeons and the program directors. Overall we found good-to-excellent agreement for independence at graduation between program directors and early practitioners for adult cases (intraclass correlation coefficient [ICC], 0.98; 95% confidence interval [CI], 0.82 to 0.99) and moderate-to-good agreement for pediatric cases (ICC, 0.96; 95% CI, 0.74, 0.99).

Conclusions

The program directors frequently perceived the need for resident operative case exposure to common orthopaedic procedures to be lower than that estimated by the early practice surgeons. Both program directors and early practice surgeons generally agreed on which common cases residents should be able to perform independently by graduation.
The Effect of Coronal Alignment on Tibial Component Migration Following Total Knee Arthroplasty
Authors: van Hamersveld Koen T. , Marang-van de Mheen Perla J. , Nelissen Rob G.H.H.
Published: July 2019

Background:

Recent short-term studies of total knee arthroplasty (TKA) have claimed improved clinical outcomes and implant survival when aiming to restore constitutional joint kinematics, as compared with neutral mechanical axis alignment. However, implant durability may be compromised when aligned in varus or valgus. With use of data pooled from 3 long-term radiostereometric analysis (RSA) studies, the aim of the present study was to assess the effects of coronal alignment on tibial component migration.

Methods:

Coronal alignment parameters from full-leg radiographs were measured and the constitutional leg alignment was determined for each patient. We evaluated the effect of the postoperative hip-knee-ankle angle, relative to both the mechanical axis and the constitutional alignment, on tibial component migration. In-range knees were defined as within ±3° of either the neutral mechanical axis or constitutional alignment of the patient. Analysis was performed with a linear mixed-effects model, corrected for study, age, sex, preoperative alignment, diagnosis, and body mass index.

Results:

A total of 85 cemented TKAs were included, of which 3 were revised for aseptic loosening and another 4 were considered loose. The median follow-up was 11 years. No loose tibial components were observed in mechanically in-range knees, whereas all loose tibial components were out of range. Mechanically varus knees showed the highest mean migration (maximum total point motion) of 1.55 mm (95% confidence interval [CI], 1.16 to 2.01 mm) after 5 years, compared with 1.07 mm (95% CI, 0.63 to 1.64 mm) and 0.77 mm (95% CI, 0.53 to 1.06 mm) for valgus and in-range knees, respectively (p < 0.001). In contrast, looking at constitutional alignment, loose tibial components were found among both constitutionally in-range and out-of-range knees. Mixed-model analysis showed comparable migration among constitutionally in-range, more-in-varus, and more-in-valgus aligned knees.

Conclusions:

Mechanically out-of-range alignment, especially mechanical varus, led to higher tibial component migration. However, matching the constitutional alignment of the patient did not preclude high implant migration. RSA trials randomizing different alignment techniques are needed to confirm the results of the present study.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Povidone-Iodine Wound Lavage to Prevent Infection After Revision Total Hip and Knee Arthroplasty
Authors: Hart Adam , Hernandez Nicholas M. , Abdel Matthew P. , Mabry Tad M. , Hanssen Arlen D. , Perry Kevin I.
Published: July 2019

Background:

Postoperative infection remains a major challenge in revision total hip arthroplasty (THA) and revision total knee arthroplasty (TKA). Wound irrigation with dilute povidone-iodine (PI) solution has emerged as a simple, inexpensive, and potentially successful means of reducing postoperative infections. The aim of this study was to assess its effectiveness in reducing infection following revision THA and TKA in, to our knowledge, the largest revision cohort to date.

Methods:

Using our institution’s total joint registry, we identified 1,402 revision THAs and 1,482 revision TKAs performed during the study period (2013, when the PI irrigation protocol was first implemented, to 2017). The PI lavage protocol was employed in 27% of the revision THA cases and 34% of the revision TKA cases; in the remaining cases, the protocol was not used. Demographics, comorbid conditions, underlying surgical diagnoses, and whether the revision was for a septic or an aseptic etiology were compared between the groups (use or no use of PI irrigation). Any reoperation due to infection, as assessed at 3 and 12 months following revision arthroplasty, was compared between the groups and propensity scores were calculated to account for differences in baseline characteristics between the groups.

Results:

After adjusting for baseline differences between the groups using the propensity-score weighted models, we found no significant difference in the rate of reoperation for infection at 3 months (p = 0.58 for revision THA, and p = 0.06 for revision TKA) and at 12 months (p = 0.78 for revision THA, and p = 0.06 for revision TKA). Nonetheless, the hazard ratios from the propensity-score model trended higher for patients who received PI lavage: 1.6 and 1.3 for revision THA at 3 and 12 months, respectively, and 2.9 at both 3 and 12 months for revision TKA.

Conclusions:

PI wound lavage demonstrated no benefit in reducing any reoperation for infection following revision THA and TKA. Moreover, the trend toward higher rates for reoperation for infection among patients who received PI irrigation merit further consideration.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Association of Race and Ethnicity with Total Hip Arthroplasty Outcomes in a Universally Insured Population
Authors: Okike Kanu , Chan Priscilla H. , Prentice Heather A. , Navarro Ronald A. , Hinman Adrian D. , Paxton Elizabeth W.
Published: July 2019

Background:

Prior studies have documented racial and ethnic disparities in total hip arthroplasty (THA) outcomes in the U.S. The purpose of this study was to assess whether racial/ethnic disparities in THA outcomes persist in a universally insured population of patients enrolled in an integrated health-care system.

Methods:

A U.S. health-care system total joint replacement registry was used to identify patients who underwent elective primary THA between 2001 and 2016. Data on patient demographics, surgical procedures, implant characteristics, and outcomes were obtained from the registry. The outcomes analyzed were lifetime revision (all-cause, aseptic, and septic) and 90-day postoperative events (infection, venous thromboembolism, emergency department [ED] visits, readmission, and mortality). Racial/ethnic differences in outcomes were analyzed with use of multiple regression with adjustment for socioeconomic status and other potential confounders.

Results:

Of 72,755 patients in the study, 79.1% were white, 8.2% were black, 8.5% were Hispanic, and 4.2% were Asian. Compared with white patients, lifetime all-cause revision was lower for black (adjusted hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.66 to 0.94; p = 0.007), Hispanic (adjusted HR, 0.73; 95% CI, 0.61 to 0.87; p = 0.002), and Asian (adjusted HR, 0.49; 95% CI, 0.37 to 0.66; p < 0.001) patients. Ninety-day ED visits were more common among black (adjusted odds ratio [OR], 1.15; 95% CI, 1.05 to 1.25; p = 0.002) and Hispanic patients (adjusted OR, 1.18; 95% CI, 1.08 to 1.28; p < 0.001). For all other postoperative events, minority patients had similar or lower rates compared with white patients.

Conclusions:

In contrast to prior research, we found that minority patients enrolled in a managed health-care system had rates of lifetime reoperation and 90-day postoperative events that were generally similar to or lower than those of white patients, findings that may be related to the equal access and/or standardized protocols associated with treatment in the managed care system. However, black and Hispanic patients still had higher rates of 90-day ED visits. Further research is required to determine the reasons for this finding and to identify interventions that could reduce unnecessary ED visits.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Intimate Partner Violence and Orthopaedics
Authors: Della Rocca Gregory J. , Tornetta Paul , Schneider Prism S. , Sprague Sheila
Published: July 2019

One in 50 women presenting to an orthopaedic clinic with an injury have been injured from intimate partner violence (IPV). This number does not include the additional patients who have experienced psychological or emotional abuse. Musculoskeletal injuries, such as fractures, sprains, strains, and dislocations, are the second-most prevalent injury type after head and neck injuries that occur after physical violence. Therefore, it is incumbent on health-care workers who provide care in fracture clinics to recognize musculoskeletal manifestations of IPV. Given the serial follow-up assessments for routine fracture care, orthopaedic surgeons are uniquely positioned to provide assistance to these patients. Escalating violence is the single greatest predictor of intimate partner homicide. Identification of patients at risk for IPV and provision of resources beyond their orthopaedic needs may reduce ongoing harm to our patients.
Musculoskeletal Injuries and Depression in Athletes
Authors: Hitshew Jordan
Published: July 2019

It has been documented that athletic musculoskeletal injury can cause psychological consequences such as depression. Studies have shown athletes who experience injury report significantly greater rates of depression than noninjured athletes. Understanding athletes' psychosocial responses to injury will assist medical providers in assessing the athlete's holistic needs to ensure proper recovery and prevent further harm such as depression. The purposes of this article are to (1) assess the current literature on the correlation between depressive symptoms in adolescent and collegiate athletes with musculoskeletal injuries and (2) identify ways for providers to prevent injury and the correlated depression.
TEACHER SKILLS IN DEVELOPING INSTRUMENTS OF TEST ESSAY IN SCIENCE LESSONS IN JUNIOR HIGH SCHOOL: Case Study In Kediri, East Java-Indonesia
Authors: Rosdiana Laily , Martini Martini , Purnomo Aris Rudi , Fauziah An-Nuril Maulida
Published: July 2019

Assessment and evaluation must always be carried out. The evaluation process is one of the teacher's tasks that will determine the direction of the next learning process. Therefore, the teacher must be skilled in compiling the question test instrument, one of which is a matter of description. Regarding this objective, teachers need to be equipped with ways to prepare these instruments so that the quality of the questions made meets the standards and by the indicators of learning. Briefing on the science teachers MGMPs Kediri shows that teachers already have skills in preparing the description of the test instrument with a percentage of 53.12% about the level and 46.88% HOTS LOTS level. Based on the results, the skills of science teachers in Kediri District are not expectations.  The teachers must continue to practice in making the test instruments.
Behind the Covers of Australian Rolling Stone: Negotiating the Persona of a Female Music Magazine Editor
Authors: Johinke Rebecca
Published: July 2019

Singers, songwriters and musicians create personas and perform the (gendered) role of rock star, punk, heart-throb, crooner, diva, or rock chick. Magazine covers are a key factor in consolidating and marketing that constructed persona. Magazine covers have visual power that is calibrated for maximum impact with a defined audience and a key part of the editor’s role is to decide on the cover image and cover lines. Moreover, there is now an expectation that editors of glossy magazines are recognisable ‘influencers’ who personify the values and commodities that their titles promote. We expect performers to put on a show, but do we expect music magazine editors to adopt a gendered celebrity persona and a public self too? This article examines the persona of the music magazine editor and the construction of music celebrity with a particular focus on Australian Rolling Stone magazine. Interviews with Kathy Bail and Elissa Blake, the first two women to edit the title in magazine format, underscore the self-fashioning of cultural intermediaries and the challenges for women in leadership roles in Australian media workplaces.
Gaga: Notes on the Management of Public Identity
Authors: Deflem Mathieu
Published: July 2019

Lady Gaga distinctively exemplifies the contemporary celebrity in popular culture because of the extent of her fame as well as because of the peculiar persona she presents to her audience of both fans and onlookers. In this paper, I discuss how the persona of the person born as Stefani Germanotta was created and subsequently maintained in a variety of ways related to her naming as Lady Gaga. Invoking the work of Erving Goffman, my discussion extends beyond an analysis of the effectiveness and fame of Lady Gaga’s presentation of self to the ensuing essence of her persona itself, that is, of Lady Gaga as Gaga rather than gaga. Not merely a brand, Lady Gaga is in more ways than only economic also what Lady Gaga has become to herself and to others. As the performer slips in and out of the many public personae she has created in her name, I argue, she has become Gaga to the public at large and, with only minimal qualification, among her once personal friends as well as in the privacy of her socially constituted self. The truth that has to be acknowledged today is that Lady Gaga has indeed become Lady Gaga.
Strategi Pengembangan Institutional Repository Perpustakaan Institut Teknologi Sepuluh Nopember Surabaya Berbasis Eprints
Authors: Mursidah Eva , Wahyuni Davi , Gonti Yeni Anita
Published: July 2019

Abstrak: Institutional repository (IR) berbasis eprints adalah repository Perpustakaan Institut Teknologi Sepuluh Nopember Surabaya (ITS) yang diimplementasikan pada tahun 2016 menggantikan digilib (Digital Library). Parameter kualitas repository yang diukur dari posisi rangking yang dikeluarkan oleh rangking web of repositories mendorong dilakukannya penelitian ini.  Dalam menentukan kinerja dan strategi pengembangan IR, analisis SWOT digunakan sebagai metode untuk mengidentifikasi faktor-faktor yang dominan baik internal maupun eksternal. Responden pada penelitian ini adalah seluruh staf layanan bagian Teknologi Informasi dan Perpustakaan Digital (TIPD) Perpustakaan ITS berjumlah 6 orang yang terdiri dari, 1 koordinator , 1 sub koordinator, 1 teknisi, dan 3 administrator. Hasil penilaian responden terhadap faktor internal yang dominan pada IR diperoleh total skor bobot rating kekuatan sebesar 3.38, dan total skor bobot rating kelemahan sebesar 1.8. Sedangkan penilaian responden terhadap faktor eksternal yang dominan pada IR diperoleh total skor bobot rating peluang sebesar 3.15 dan total skor bobor rating ancaman sebesar 2.18. Dengan demikian posisi IR berada pada kuadran I, yang merupakan situasi yang sangat menguntungkan dimana IR memiliki peluang dan kekuatan sehingga dapat memanfaatkan peluang yang ada. Strategi yang tepat untuk diterapkan adalah strategi pertumbuhan (growth oriented strategy). Abstract : Institutional repository (IR) based on eprints is a repository library of  Institute of Technology Sepuluh Nopember Surabaya (ITS)  which was implemented in 2016 replacing Digilib (Digital Library). The quality repository parameters measured by the ranking position issued by the web of repositories rankings encourage this research. In determining IR performance and development strategies, SWOT analysis is used as a method to identify dominant factors both internally and externally. Respondents in this study were all service staff of the Digital Information and Library Technology (TIPD) section of the ITS Library totaling 6 people consisting of, 1 coordinator, 1 sub-coordinator, 1 technician, and 3 administrators. The results of respondents' assessment of the dominant internal factors in the IR obtained a total weight rating of 3.38, and a total score score of 1.8%. While the respondent's assessment of the dominant external factors in the IR was obtained by the total score of the opportunity rating of 3.15 and the total score of the threat rating of 2.18. Thus the position of the IR is in quadrant I, which is a very favorable situation where the IR has the opportunity and strength so that he can take advantage of the opportunities available. The right strategy to implement is a growth oriented strategy.
GhFAD2-3 is Required for Anther Development in Gossypium hirsutum
Authors: Liu Feng , Ma Lihong , Wang Youwu , Li Yanjun , Zhang Xinyu , Xue Fei , Nie Xinhui , Zhu Qianhao , Sun Jie
Published: July 2019

Background

In higher plants, FAD2 gene encodes the microsomal oleate Δ12-desaturase, one of the key enzymes essential for biosynthesis of polyunsaturated lipids that serve many important functions in plant development and stress responses. FAD2 catalyzes the first step, towards biosynthesis of polyunsaturated fatty acids (PUFAs) found in cell membrane and wall, and it is thus of great importance to investigate the regulatory role of FAD2 in anther development.

Results

We reported the molecular characterization of the cotton (Gossypium hirsutum) GhFAD2 gene family and the essential role of GhFAD2-3 in cotton anther development. G. hirsutum contains four pairs of homoeologous FAD2 genes (GhFAD2-1 to GhFAD2-4). GhFAD2-3 is ubiquitously and relatively highly expressed in all tissues analyzed, particularly in anthers. Specific inhibition of GhFAD2-3 using the RNA interference approach resulted in male sterility due to impaired anther development at the stages from meiosis to maturation. The cellular phenotypic abnormality observed at the meiosis stage of the GhFAD2-3 silenced plant (fad2-3) coincides with the significant reduction of C18:2 in anthers at the same stage. Compared with that of wild type (WT), the content of C18:1 was 41.48%, accordingly increasing by 5 fold in fad2-3 anther at pollen maturation stage. Moreover, the ratio of monounsaturated to polyunsaturated fatty acid reached to 5.43 in fad2-3 anther, which was much higher than that of the WT (only 0.39). Based on compositional analysis of anthers cuticle and transcriptome data, we demonstrated it was unfavorable to the development of anther by regulating GhFAD2-3 expression level to increase the oleic acid content.

Conclusions

Our work demonstrated the importance of C18:2 and/or C18:3 in development of pollen exine and anther cuticle in cotton, and provided clue for further investigation of the physiological significance of the fatty acid composition in plant growth and development.
Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district
Authors: Iramiot Jacob Stanley , Rwego Innocent B. , Kansiime Catherine , Asiimwe Benon B
Published: July 2019

Background

Cholera has continued to be a global threat to public health and a key indicator of lack of social development in developing countries. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda.

Materials and methods

This was a descriptive cross-sectional study to describe the epidemiology of the 2017 cholera outbreak in Kasese district. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar.

Results

A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Antibiotic susceptibility using Kirby-Bauer disc diffusion method showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/sulfamethoxazole whereas gentamicin showed 100% susceptibility. The general trend also showed increased susceptibility to combination therapy as opposed to mono-therapy.
Increased prevalence of obesity, diabetes mellitus, and hypertension with associated risk factors in a mine-based workforce, Democratic Republic of Congo
Authors: Mawaw Paul Makan , Yav Thierry , Mukuku Olivier , Lukanka Olivier , Kazadi Patrick Mumba , Tambwe Daniel , Omba Jules , Kakoma Jean-Baptiste , Bangs Michael John , Luboya Oscar Numbi
Published: July 2019

Background

The burden of non-communicable diseases (NCDs) is increasing rapidly in low- and middle-income countries, with the largest portion occurring in Africa. Results from earlier baseline measures on obesity, diabetes and hypertension (ODH) in the Tenke Fungurume Mining (TFM) workforce in 2010 showed high proportions of overweight, pre-diabetic and pre-hypertensive individuals, predicting an upward trend in the burden of ODH over time. The 2010 – 2015 longitudinal trends on ODH and related risk factors among the TFM workforce is presented herein, and projects the consequent burden of these diseases on the workforce by 2025 if an effective prevention program is not implemented.

Methods

A longitudinal, retrospective cohort study with 3-time intervals was conducted using occupational health records collected on all employees and contractors who had a pre-employment or follow up medical checkups covering the period between January 2010 and December 2015. Repeated paired t tests measured changes in mean values of quantitative risk factors, while a chi-square test assessed changes in prevalence and categorical risk factors over time. A linear projection model was used to predict the consequent morbidity of ODH for the subsequent 10 years up to 2025.

Results

Between 2010 and 2015, prevalence increased from 4.5% to 11.1% for obesity, 11.9% to 15.6% for diabetes, and 18.2% to 26.5% for hypertension. By 2025, provided no prevention program is implemented, prevalence is predicted to reach 25%, 24% and 42% respectively for obesity, diabetes and hypertension.

Conclusion

Without implementation of a comprehensive NCD prevention plan, the burden of ODH and other NCDs is predicted to increase dramatically in the TFM workforce. Alone or combined, NCDs have the potential to dramatically increase operational costs while decreasing productivity over time.
TUBERCULOSIS TREATMENT OUTCOMES: A FIFTEEN YEAR COHORT STUDY IN JOS NORTH AND MANGU, PLATEAU STATE, NORTH - CENTRAL NIGERIA
Authors: Sariem Comfort Nanbam , Odumosu Patricia , Dapar Maxwell Patrick , Musa Jonah , Ibrahim Luka , Aguiyi John Chinyere
Published: July 2019

Background

Tuberculosis (TB) is an infectious disease with a major global health problem; being the tenth leading cause of death worldwide, and the leading cause of death from a single infectious agent. Nigeria is among the countries with high burden of tuberculosis and the highest global mortality rate. Medication adherence has been shown to have profound effect on other treatment outcomes.

Objective

To examine a fifteen-year cohort of tuberculosis treatment outcomes in Jos North and Mangu Local Government Areas of Plateau State.

Methods

The study was done in five treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. The retrospective study was done from 2001 to 2015, where TB patient records who had completed treatment were evaluated. Treatment outcomes were classified as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death) and analyzed using binomial logistic regression.

Results

Males composed 58.1% of the population (10,156). Mean age ±SD was 35.5±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment; sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes from 83.8% to 64.4%, with a corresponding increase in unsuccessful treatment outcomes was observed. The Predictors of medication non-adherence were patients with unknown HIV status (OR 4.29, 95% CI: 3.74-4.91, p < 0.001); being male (OR 1.15, CI: 1.37-1.66, p = 0.008) and having a history of non-adherence (OR 2.27, CI: 1.34-3.87, p = 0.002) and treatment failure (OR 2.83, CI: 0.98 – 8.19, p = 0.05).

Conclusion

Underlying reasons for medication non-adherence and treatment failure identified should be resolved by the patient, treatment supporter and health worker. Increased awareness and education on voluntary counseling and testing of HIV among TB patients is advocated, particularly among the male population.
Effects of Education on Symptom Recognition and Management of Pseudobulbar Affect: A Mixed-Methods Evaluation of Clinician Knowledge and Behavior Changes
Authors: Turell Wendy , Roc Anne , Pioro Erik , Howson Alexandra
Published: July 2019

Background

Pseudobulbar affect (PBA) is under-recognized and often undertreated in clinical practice. There are few resources to support clinicians in the recognition and treatment of PBA symptoms, despite the approval by the United States Food and Drug Administration of a PBA-specific treatment. We evaluated the impact of a virtual education symposium on clinician knowledge and competence designed to improve knowledge and skills associated with identifying and managing PBA in patients with neurologic injury.

Methods

We designed a mixed methods outcomes methodology that included survey-based methods and qualitative interviews to measure trends in knowledge and competence. We measured changes in knowledge and competence via pre- and post-test online surveys that included case-based competence questions and knowledge-focused questions. McNemar test compared matched pair responses. Effect size was computed using Cohen’s d for all significant findings. Significance testing was conducted for matched pairs of learners who completed both pre/post and pre/survey, respectively. We explored the impact of the educational intervention on clinician knowledge, competency, and perspectives on PBA via qualitative interviews with a subsample of education participants. We used a process of constant comparison to structure analysis of participant responses to questions both across and within interviews.

Results

Participants’ PBA symptom recognition knowledge and skills increased following program participation and were maintained at follow-up. Responses to post-activity case-based questions showed that exposure to education enabled participants to better recognize and describe symptoms redolent of PBA. Following education, most participants said they would initiate therapy with on-label versus off-label medications. Qualitative descriptions of what interviewees say they would do in clinical practice were reflected in actual responses to knowledge and competence questions.

Conclusions

This mixed-method study demonstrates that online education is an effective and accessible tool for building knowledge and supporting clinical competence concerning PBA symptom recognition and management.
Comparative transcriptome profiling provides insights into plant salt tolerance in seashore paspalum (Paspalum vaginatum)
Authors: Luo Hong , Wu Peipei , Cogill Steven , Qiu Yijian , Li Zhigang , Zhou Man , Hu Qian , Chang Zhihui , Noorai Rooksana E. , Xia Xiaoxia , Saski Christopher , Raymer Paul
Published: July 2019

Background

Seashore paspalum (Paspalum vaginatum), a halophytic warm-seasoned perennial grass, is tolerant of many environmental stresses, especially salt stress. To investigate molecular mechanisms underlying salinity tolerance in seashore paspalum, physiological characteristics and global transcription profiles of highly (Supreme) and moderately (Parish) salinity-tolerant cultivars under normal and salt stressed conditions were analyzed.

Results

Physiological characterization comparing highly (Supreme) and moderately (Parish) salinity-tolerant cultivars revealed that Supreme’s higher salinity tolerance is associated with higher Na+ and Ca2+ accumulation under normal conditions and further increase of Na+ under salt-treated conditions (400 mM NaCl), possibly by vacuolar sequestration. Moreover, K+ retention under salt treatment occurs in both cultivars, suggesting that it may be a conserved mechanism for prevention of Na+ toxicity. We sequenced the transcriptome of the two cultivars under both normal and salt-treated conditions (400 mM NaCl) using RNA-seq. De novo assembly of about 153 million high-quality reads and identification of Open Reading Frames (ORFs) uncovered a total of 82,608 non-redundant unigenes, of which 3,250 genes were identified as transcription factors (TFs). Gene Ontology (GO) annotation revealed the presence of genes involved in diverse cellular processes in seashore paspalum’s transcriptome. Differential expression analysis identified a total of 828 and 2,222 genes that are responsive to high salinity for Supreme and Parish, respectively. GO enrichment analysis demonstrated that genes involved in “oxidation-reduction process” and “nucleic acid binding” are significantly associated with salinity tolerance in both cultivars. Interestingly, compared to Parish, a number of salt stress induced transcription factors are enriched and show higher abundance in Supreme under normal conditions, possibly due to enhanced Ca2+ signaling transduction out of Na+ accumulation, which may be another contributor to Supreme’s higher salinity tolerance.

Conclusion

Physiological and genomics analyses of seashore paspalum reveal major molecular underpinnings contributing to plant response to salt stress in this halophytic warm-seasoned perennial grass. The data obtained provide valuable molecular resources for functional studies and developing strategies to engineer plant salinity tolerance.
Increased serum IL-36β and IL-36γ levels in patients with neuromyelitis optica spectrum disorders: Association with disease activity
Authors: Yang Chun-Sheng , Zhang Qiu xia , Deng Yu , Zhou Bing jie , Zhang Lin jie , Li Li min , Qi Yuan , Wang Jing , Yang Li , Shi Fu-Dong
Published: July 2019

Background: Interleukin 36 (IL-36) cytokines belong to the IL-1 family and play an important role in some autoimmune diseases. However, the relationship between IL-36 and neuromyelitis optica spectrum disorders (NMOSD) remains unclear. Methods: We determined serum IL-36α, IL-36β and IL-36γ levels and assessed correlations with clinical characteristics in 50 NMOSD patients and 30 healthy controls (HC). Results: The concentrations of serum IL-36β and IL-36γ were significantly higher in patients with NMOSD than in HCs and decreased during remission. Serum IL-36β levels were positively correlated with the annual relapse rate (ARR), spinal cord lesion length and Expanded Disability Status Scale (EDSS) scores. Conclusions: Serum IL-36β and IL-36γ levels were related to disease activity in NMOSD patients and may be important biomarkers of NMOSD.
Diagnosing, Ameliorating, and Monitoring Soil Compaction in No‐Till Brazilian Soils
Authors: Peixoto Devison Souza , Silva Bruno Montoani , Godinho Silva Sérgio Henrique , Karlen Douglas L. , Moreira Silvino Guimarães , Pereira da Silva Alessandro Alvarenga , Vilela de Resende Álvaro , Norton Lloyd Darrell , Curi Nilton
Published: July 2019

Core Ideas

One‐time tillage increased soybean yield as a result of improving soil physical properties.

Penetration resistance, air capacity, macroporosity, relative field capacity, and S index were the soil physical properties that best predicted soybean yield.

The most sensitive soil physical properties for detecting structural related alterations were equally important for predicting soybean yield.

Penetration resistance is the indicator that addresses no‐tillage soil compaction and its effect on soybean yield.

Soil compaction can significantly reduce crop yield. Our objective was to identify the most sensitive soil physical property and process indicators related to crop yield using a Random Forest algorithm (RFA). This machine‐learning, decision‐making tool was used with field‐scale data from five soil management treatments designed to ameliorate compaction in no‐tillage (NT) fields. The treatments were: T1, NT for 10 yr (control); T2, NT with surface application of 3.6 Mg ha−1 of agricultural gypsum; T3, NT with subsoiling plus 1.44 Mg ha−1 of highly reactive limestone applied to a depth of 0.60 m; T4, NT planting following chisel plowing at a depth of 0.26 m; and T5, NT with subsoiling to a depth of 0.60 m plus 1.44 Mg ha−1 of surface‐applied, highly reactive limestone. Fifteen soil physical properties and processes related to growth and yield of soybean [Glycine max (L.) Merr.] were measured. Mechanical intervention, specifically subsoiling, improved soil physical properties and increased soybean yield cultivated following occasional tillage. The RFA ranked penetration resistance (PR), air capacity, macroporosity, relative field capacity, and the Dexter‐S index as the most sensitive soil physical indicators affecting soybean yield. Those indicators were also sensitive to changes in soil structure due to subsoiling. We conclude that the RFA was an effective tool for screening indicators and that those chosen can be effective for monitoring soil compaction and its effect on soybean yield. Penetration resistance may be used to guide on‐farm decision‐making regarding when and how NT soil compaction should be addressed.
Understanding the Fertilizer Management Impacts on Water and Nitrogen Dynamics for a Corn Silage Tile‐Drained System in Canada
Authors: He Wentian , Smith W. N. , Grant B. B. , VanderZaag A. C. , Schwager E. A. , Qi Z. , Reynolds D. , Wagner‐Riddle C.
Published: July 2019

Effective management of dairy manure is important to minimize N losses from cropping systems, maximize profitability, and enhance environmental sustainability. The objectives of this study were (i) to calibrate and validate the DeNitrification‐DeComposition (DNDC) model using measurements of silage corn (Zea mays L.) biomass, N uptake, soil temperature, tile drain flow, NO3− leaching, N2O emissions, and soil mineral N in eastern Canada, and (ii) to investigate the long‐term impacts of manure management under climate variability. The treatments investigated included a zero‐fertilizer control, inorganic fertilizer, and dairy manure amendments (raw and digested). The DNDC model overall demonstrated statistically “good” performance when simulating silage corn yield and N uptake based on normalized RMSE (nRMSE) < 10%, index of agreement (d) > 0.9, and Nash–Sutcliffe efficiency (NSE) > 0.5. In addition, DNDC, with its inclusion of a tile drainage mechanism, demonstrated “good” predictions for cumulative drainage (nRMSE < 20%, d > 0.8, and NSE > 0.5). The model did, however, underestimate daily drainage flux during spring thaw for both organic and inorganic amendments. This was attributed to an underestimation of soil temperature and soil water under frequent soil freezing and thawing during the 2013–2014 overwinter period. Long‐term simulations under climate variability indicated that spring applied manure resulted in less NO3− leaching and N2O emissions than fall application when manure rates were managed based on crop N requirements. Overall, this study helped highlight the challenges in discerning the short‐term climate interactions on fertilizer‐induced N losses compared with the long‐term dynamics under climate variability.

Core Ideas

A new tile drainage mechanism implemented in DNDC was successfully evaluated.

DNDC performed well in simulating silage corn biomass, N uptake, and soil inorganic N.

Soil temperature and tile drainage was sometimes underestimated in the overwinter period.

Seasonal N losses were better simulated than nonseasonal N losses.

Long‐term simulation indicated lower N leaching and N2O for spring than fall manure.
Fall Tillage Reduced Nutrient Loads from Liquid Manure Application during the Freezing Season
Authors: Stock Melanie N. , Arriaga Francisco J. , Vadas Peter A. , Good Laura W. , Casler Michael D. , Karthikeyan K. G. , Zopp Zachariah
Published: July 2019

Reducing agricultural runoff is important year round, particularly on landscapes that receive wintertime applications of manure. No‐tillage systems are typically associated with reduced runoff loads during the growing season, but surface roughness from fall tillage may aid infiltration on frozen soils by providing surface depressional storage. The timing of winter manure applications may also affect runoff, depending on snow and soil frost conditions. Therefore, the objective of this study was to evaluate runoff and nutrient loads during the freezing season from combinations of tillage and manure application timings. Six management treatments were tested in south‐central Wisconsin during the winters of 2015–2016 and 2016–2017 with a complete factorial design: two tillage treatments (fall chisel plow vs. no‐tillage) and three manure application timings (early December, late January, and unmanured). Nutrient loads from winter manure application were lower on chisel‐plowed versus untilled soils during both monitoring years. Loads were also lower from manure applied to soils with less frost development. Wintertime manure applications pose a risk of surface nutrient losses, but fall tillage and timing applications to thawed soils can help reduce loads.

Core Ideas

Fall tillage reduced winter runoff and manure nutrient losses compared with no‐tillage.

Nutrient loads were greatest on no‐tillage soil with winter‐applied liquid manure.

Timing liquid manure application to unfrozen or partially thawed soil reduced loss.
Seasonal Efficacy of Vegetated Filter Strips for Phosphorus Reduction in Surface Runoff
Authors: Vanrobaeys J. A. , Owens P. N. , Lobb D. A. , Kieta K. A. , Campbell J. M.
Published: July 2019

A vegetated filter strip (VFS) is a measure commonly implemented in agricultural landscapes for the purpose of improving water quality. However, much of the evidence to support their effectiveness comes from warm regions dominated by rainfall driven runoff. This study assessed the performance of VFS plots and compared them with annual crop strips to reduce phosphorus (P) levels in runoff in the cold climate of the Canadian Prairies. Analysis of water samples from 22 events during the study indicated no significant difference in the inflow and outflow concentrations of total dissolved P (TDP) or total P (TP) for either the VFS or the annual crop strips. Although the VFS plots had little effect on TDP or TP during the spring, they performed better during the growing season, reducing mean TP concentrations in five out of seven, or 71%, of these events. The VFS plots did not perform as well during the fall events, with the overall mean TP concentration in runoff increasing after flowing through the filters during this time period.

Core Ideas

Vegetated filter strips are dynamic in cold climates and P retention capacity changes seasonally.

Vegetated filter strips were not effective at retaining P outside the growing season.

New designs and management are required for vegetated filter strips for P retention in cold climates.
Seasonal Variation in Sediment and Phosphorus Yields in Four Wisconsin Agricultural Watersheds
Authors: Good Laura Ward , Carvin Rebecca , Lamba Jasmeet , Fitzpatrick Faith A.
Published: July 2019

Agricultural water quality projects in two distinct topographic regions in Wisconsin collected 5 to 10 yr of continuous stream discharge, suspended sediment (SS), total P (TP), and total dissolved P (TDP) in four watersheds (2100–5000 ha) from 2006 to 2016. Previous agricultural nonpoint SS and TP reduction efforts in two of these watersheds documented cold versus warm season differences in water quality response. The goal of this study was to identify seasonal partitioning of SS, TP, and TDP in storm event loads to inform stream water quality protection efforts. We used National Weather Service Coop Observer frost depth reports to identify dates when watershed soils were frozen. By comparing daily mean event discharge for dates relative to frost, we identified a 32‐d post‐frost high‐discharge “thaw” period. Combined, the frozen and thaw periods contributed about half of the annual SS and TP runoff event loads, ranging from 47 to 63% for SS and from 45 to 51% for TP. The proportion of runoff event TDP during this time was even higher, 62 to 79%, with the majority during thaw. Watershed average volumetric runoff coefficients (event flow/precipitation and snowmelt) were two to four times higher during the freeze and the thaw compared with the rest of the year. To reduce total stream loads in regions with similar climates to Wisconsin, this study indicates that using management practices that curb sediment and P delivery to streams in the winter and early spring may be as important as those designed for nonfrozen conditions.

Core Ideas

About half of stream event suspended sediment and total P loads were during frost and thaw.

A majority of annual event total dissolved P loading was during thaw.

Watershed average runoff coefficients were higher in frost and thaw.
Discrete Zr and REE mineralization of the Baerzhe rare-metal deposit, China
Authors: Qiu Kunfeng , Yu Haocheng , Wu Mingqian , Geng Jianzhen , Ge Xiangkun , Gou Zongyang , Taylor Ryan D.
Published: July 2019

Although REE (lanthanides + Sc + Y) mineralization in alkaline silicate systems is commonly accompanied with Zr mineralization worldwide, our understanding of the relationship between Zr and REE mineralization is still incomplete. The Baerzhe deposit in Northeastern China is a reservoir of REE, Nb, Zr, and Be linked to the formation of an Early Cretaceous, silica-saturated, alkaline intrusive complex. In this study, we use in situ laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) analyses of zircon and monazite crystals to constrain the relationship between Zr and REE mineralization at Baerzhe.

Three groups of zircon are identified and are differentiated based upon textural observations and compositional characteristics. Type Ia zircons display well-developed oscillatory zoning. Type Ib zircons are darker in cathodoluminescence images and have more irregular zoning and resorption features than type Ia zircons. In addition, type Ib zircons can locally occur as overgrowths on type Ia zircons. Type II zircons contain irregular but translucent cores and rims with oscillatory zoning that are murky brown in color and occur in aggregates. Textural features and compositional data suggest that types Ia and Ib zircon crystallized at the magmatic stage, with type Ia being least-altered and type Ib being strongly altered. Type II zircons, on the other hand, precipitated during the magmatic to magmatichydrothermal transition. Whereas the magnitude of the Eu anomaly is moderate in the barren alkaline granite, both magmatic and deuteric zircon exhibit pronounced negative anomalies. Such features are difficult to explain exclusively by feldspar fractionation and could indicate the presence of fluid induced modification of the rocks. Monazite crystals occur mostly through replacement of zircon and sodic amphibole; monazite clusters are also present. Textural and compositional evidence suggests that monazite at Baerzhe is hydrothermal.

Types Ia and Ib magmatic zircon yield 207Pb-corrected 206Pb/238U ages of 127.2 ± 1.3 and 125.4 ± 0.7 Ma, respectively. Type II deuteric zircon precipitated at 124.9 ± 0.6 Ma. The chronological data suggest that the magmatic stage of the highly evolved Baerzhe alkaline granite lasted less than two million years. Hydrothermal monazite records a REE mineralization event at 122.8 ± 0.6 Ma, approximately 1 or 2 million years after Zr mineralization. We therefore propose a model in which parental magmas of the Baerzhe pluton underwent extensive magmatic differentiation while residual melts interacted with aqueous hydrothermal fluids. Deuteric zircon precipitated from a hydrosilicate liquid, and subsequent REE mineralization, exemplified by hydrothermal monazite, correlates with hydrothermal metasomatic alteration that postdated the hydrosilicate liquid event. Such interplay between magmatic and hydrothermal processes resulted in the formation of discrete Zr and REE mineralization at Baerzhe.
CONSIDERAÇÕES NA ANESTESIA DE ANIMAIS DE LABORATÓRIO
Authors: Dobler Guilherme Hammarstrom , Ferreira Márcio Gonçalves , Bedendo Gustavo Henrique Mendes , Da Cruz Fernando Silvério Ferreira
Published: July 2019

A anestesia em animais de laboratório tem como diretriz de conduzir os experimentos científicos com a mais rigorosa maestria, de modo a gerar mínimo estresse aos animais e por outro lado, ter a possibilidade de coletar dados com excelência. A história da medicina possibilita desvendarmos os caminhos pelos quais a anestesiologia se guiou de modo a incorporar a ética humana e animal juntamente com o rigor metodológico e científico. Esta revisão surge a partir de pesquisa nos bancos de dados Pubmed, Scielo e Bireme, juntamente com consulta literária. Os achados apontam para as principais particularidades entre as espécies e técnicas de anestesiologia utilizados nos dias atuais. Foram descritos os principais fármacos e vias para utilização em camundongos, ratos wistar e coelhos. Os resultados encontrados nesta revisão confirmam a necessidade de compreender as diferenças entre as espécies e o conhecimento farmacológico para realizar a conduta anestésica adequada para cada espécie.