bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Commercial Neighbors on The Online Popularity of Peer-To-Peer Accommodation-Sharing Properties
Authors: Liu Jianwei , Park Jinah , Xie Karen , Song Haiyan , Chen Wei
Published: March 2020

Commercial hosts are becoming increasingly common in peer-to-peer (P2P) accommodation sharing. Yet the interplay between commercial and individual hosts has been unclear. This study investigates the effect of properties managed by commercial hosts on the individual hosts in the neighborhood. Specifically, we hypothesize that an increase in commercial properties, which have competitive advantages, would penetrate neighborhood markets and cannibalize the online popularity of individual properties. We test these hypotheses using a large-scale, longitudinal data set collected from a leading P2P accommodation-sharing platform in Beijing. The findings show that an increase in commercial properties is associated with a decline in the popularity of individual properties in the neighborhood. However, the negative effect of commercial properties is weakened when there is a higher price difference between the two ownership types and a higher density of tourist attractions. The implications for service operations and strategies for P2P accommodation-sharing businesses are discussed.
Transition of care of stable ischaemic heart disease patients from tertiary to primary care with telemedicine support: Randomized noninferiority clinical trial
Authors: Ruschel Karen B , Rados Dimitris RV , Furtado Mariana V , Batista Joanna d’Arc L , Katz Natan , Harzheim Erno , Polanczyk Carisi A
Published: March 2020

Introduction

Evidence of telehealth for chronic disease management is scarce and contradictory.

Objectives

We aimed to evaluate the safety and efficacy of teleconsultations as support in the care transition of patients with stable coronary artery disease (CAD) from tertiary to primary care.

Methods

A randomized noninferiority clinical trial was undertaken in patients with CAD from a tertiary hospital in a middle-income country. Patients with functional angina class 1 or 2 and meeting discharge criteria were randomized to remain in the cardiology outpatient clinic for 12 months (control group, CG) or continue follow-up in a primary care unit with clinical support via telemedicine (intervention group, IG). The primary outcome was the maintenance of the functional angina class after 12 months. Secondary outcomes included control of risk factors and clinical outcomes.

Results

In total 271 patients (mean age, 66 years) were included; 81.1% and 91% of the IG and CG, respectively, maintained stable angina symptoms, thus noninferiority could not be shown between the groups. Regarding emergency room visits at 1 year, the IG (7.6%) was noninferior to the CG (6.0%) (absolute difference, 1.6%; noninferiority margin (NIM), –4.8% to 8.2%). For control of risk factors, 30.7% and 29.6% of the IG and CG, respectively, had blood pressure <130/80 mmHg (absolute difference, 1.1%; NIM, –10.5% to 12.8%), and 48.9% and 33.3% of diabetic patients in the IG and CG, respectively, had glycated haemoglobin <7% (absolute difference, 15.6%; NIM, –6.8% to 36%).

Conclusions

In our study, the difference in the patients’ angina functional class did not result in greater seeking of emergency care, supporting that discharge from the outpatient clinic with telemedicine is safe for patients with stable CAD treated at the tertiary level. The control of risk factors in these patients was noninferior to patients followed up in primary care. ClinicalTrials.gov (NCT02489565).
Embarking on a memory assessment voices of older persons living with memory impairment
Authors: Tyrrell Marie , Religa Dorota , Fossum Bjöörn , Hedman Ragnhild , Skovdahl Kirsti , Hillerås Pernilla
Published: March 2020

Aim

To describe older persons who had commenced a memory assessment, experiences of living with memory impairment and related symptoms.

Background

Persons with subjective memory impairment are two times more likely to develop dementia over the years than their peers. Older persons seldom seek help from primary health care clinics solely for subjective memory impairment. Of those who seek help, it can take up to 35 months from the person experiencing initial symptoms to referral to a memory clinic. Further research is needed regarding how older persons live with memory impairment with related symptoms before they receive a memory diagnosis.

Method

A qualitative study with 23 participants who had commenced a memory assessment in primary care. Semi-structured interviews were held. During the interviews, the Neuropsychiatric Inventory was completed and discussed with the participants. Interview data were analysed using Interpretive Description.

Results

The results are presented under four themes: Conflicting views about the situation, Unveiling the presence of neuropsychiatric symptoms, Compensating with external and internal strategies to recall and Worrying about self and future. Persons with memory impairment were encouraged by family members or others to seek a memory assessment. Few persons were self-referred as memory impairment was often seen as a part of aging. Polarised viewpoints existed within the families regarding the impact of memory impairment on daily life. The presence of neuropsychiatric symptoms appeared unexplored in the participants seeking a memory assessment. In this study, the majority of participants experienced neuropsychiatric symptoms at the time of contact for a memory assessment.

Conclusions

Memory problems experienced were often viewed by the person as being part of an aging process. The presence of neuropsychiatric symptoms was not acknowledged as being connected to memory impairment. Contextualising ‘memory impairment’ as a part of a ‘cognitive process’ may help the person in identifying the presence of neuropsychiatric symptoms.
A survey of surveys on the use of visualization for interpreting machine learning models
Authors: Chatzimparmpas Angelos , Martins Rafael M. , Jusufi Ilir , Kerren Andreas
Published: March 2020

Research in machine learning has become very popular in recent years, with many types of models proposed to comprehend and predict patterns and trends in data originating from different domains. As these models get more and more complex, it also becomes harder for users to assess and trust their results, since their internal operations are mostly hidden in black boxes. The interpretation of machine learning models is currently a hot topic in the information visualization community, with results showing that insights from machine learning models can lead to better predictions and improve the trustworthiness of the results. Due to this, multiple (and extensive) survey articles have been published recently trying to summarize the high number of original research papers published on the topic. But there is not always a clear definition of what these surveys cover, what is the overlap between them, which types of machine learning models they deal with, or what exactly is the scenario that the readers will find in each of them. In this article, we present a meta-analysis (i.e. a “survey of surveys”) of manually collected survey papers that refer to the visual interpretation of machine learning models, including the papers discussed in the selected surveys. The aim of our article is to serve both as a detailed summary and as a guide through this survey ecosystem by acquiring, cataloging, and presenting fundamental knowledge of the state of the art and research opportunities in the area. Our results confirm the increasing trend of interpreting machine learning with visualizations in the past years, and that visualization can assist in, for example, online training processes of deep learning models and enhancing trust into machine learning. However, the question of exactly how this assistance should take place is still considered as an open challenge of the visualization community.
Analysis of longitudinal and innovative transversal 3D printed lattice tubular braid textures subjected to internal compression as reinforcement
Authors: Rahiminia Mohammad Amin , Latifi Masoud , Sadighi Mojtaba
Published: March 2020

The longitudinal tubular braid texture (maypole braid) is an important texture in industrial textiles with extensive applications for composites reinforcement as a continuous form in a continuous process. This texture has a high strength in the longitudinal direction, while it is weak in its circumferential direction. The present work is to introduce an innovative structure named transversal tubular braid texture, whose structure is formed by the combination of braid and Leno technique in order to eliminate the weakness of longitudinal tubular braid texture and subsequently resist to the internal compression in its composite. Considering the complex production process of the introduced texture, prior to design a machine for its production, the structures of longitudinal and transversal tubular braid texture samples were produced as longitudinal and transversal lattice tubular braid textures using a 3D printer with the fused deposition modeling method in order to analyze and compare their mechanical properties. The required textures were primarily simulated by Rhino Ceros software and their lattice model data were transferred to the 3D printer. The produced tubular lattice samples were assessed by the standard Split Disk Mechanical Test for obtaining their hoop stresses. The hoop modulus of elasticity in transversal lattice tubular braid texture was approximately 120 times the longitudinal lattice tubular braid texture specimens. This suggests the proper design of this structure and resolves the weakness of longitudinal lattice tubular braid textures. The theoretical analysis of longitudinal and transversal lattice tubular braid textures was done by ANSYS software employing the data from the simulation software. The experimental results adequately correlated with the output results from the finite element analysis of the structures. This research work ensured that the mechanical strength of the introduced texture is desired to be produced continuously by a specially designed machine and used to reinforce tubular composites in an industrial continual process as the further work to be applied for high pressure fluids flows.
Defining the Role of Duplex Ultrasound Assessment to Determine Severity of Arterial Calcification: An Analysis of the Superficial Femoral Artery
Authors: Taylor Charlotte , Zielinski Lukasz P. , Chowdhury Mohammed M. , Coughlin Patrick A.
Published: March 2020

Lower limb arterial calcification associates with poor cardiovascular outcomes. The gold standard method of assessment is via computed tomography, yet duplex is our primary imaging modality. Currently, there is no standardized objective assessment of lower limb arterial calcification using duplex. We aimed to define the role of duplex in the assessment of lower limb arterial calcification. Initial consensus was achieved between a cohort of vascular scientists on objective imaging specific markers of lower limb arterial calcification severity using duplex. This resulted in objective descriptions to grade calcification from 0 to 3 (no calcification through to severe calcification) which formed the duplex lower limb arterial calcification score. Reproducibility of the duplex lower limb arterial calcification score was assessed and further validation was undertaken by comparing the duplex lower limb arterial calcification with computed tomography–based assessment in a separate cohort of 44 patients investigated with both modalities. The intra- and inter-class correlation coefficient were > 0.87 . The Spearman rank correlation coefficient between the duplex and CT based arterial calcium measurements was (ρ = 0.644, P < .001). The duplex lower limb arterial calcification score provides a standardized and reproducible modality for assessment of lower limb arterial calcification and may aid with risk stratification in patients with peripheral arterial disease.
Clinical and Patient-Reported Outcomes After Hybrid Russe Procedure for Scaphoid Nonunion
Authors: Shapiro Lauren M. , Roe Allison K. , Kamal Robin N.
Published: March 2020

Background: Hybrid Russe technique for the treatment of scaphoid nonunion with humpback deformity has been described with a reported 100% union rate. We sought to evaluate the reproducibility of this technique. Methods: We completed a retrospective chart review of patients with a scaphoid waist nonunion and humpback deformity treated with the hybrid Russe technique from 2015 to 2019 with a minimum of 3-month follow-up. Twenty patients with 21 nonunions were included (mean follow-up: 7.0 months). Scapholunate angle was the primary outcome measure. Secondary outcomes included: intrascaphoid angle, radiolunate angle, pain on the visual analog scale (VAS), and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score. Other variables included: time to computed tomography (CT) union, range of motion, and complications. Descriptive statistics were presented. Pre- and postoperative angles, VAS, and QuickDASH scores were evaluated with Wilcoxon signed rank tests. Results: The mean scapholunate angle improved −17.6° ± 6.4°. The mean intrascaphoid angle improved 28.2° ± 6.3°. The mean radiolunate angle improved 12.8° ± 8.8°. Of the 21 scaphoids, 20 (95%) demonstrated union on a CT scan. One patient was diagnosed with a nonunion. In total, 90% of patients noted symmetric range of motion compared with the contralateral side. The mean VAS pain score improved 6 ± 3 points. The mean QuickDASH score improved 10 ± 8 points. Complications (aside from nonunion) included 1 patient with persistent wrist pain that resolved with removal of hardware. Conclusions: The hybrid Russe technique for the treatment of scaphoid nonunions with humpback deformity demonstrates a 95% union rate. This technique is effective, reproducible, and may serve as an alternative to techniques that include structural grafts from distant sites.
Lifestyle Medicine in Australia: A Potted History—So Far
Authors: Egger Garry , Binns Andrew , Stevens John , Penman Stephen
Published: March 2020

Lifestyle medicine commenced in Australia in response to the rise in chronic diseases following the epidemiological transition that began in the 1980s. Today, it is flourishing with an annual conference, a variety of multidisciplinary members, and a developed pedagogy for the “art-science.”
Enrollment and transition challenges in the International Maternal Pediatric and Adolescent AIDS Clinical Trials (IMPAACT) network’s PROMISE trial for resource-limited regions
Authors: Angelidou Konstantia , Fowler Mary Glenn , Flynn Pat , Coletti Anne , McCarthy Katie , Browning Renee , McIntyre James , Brummel Sean S , Shapiro David E , Tierney Camlin ,   for the PROMISE study team
Published: March 2020

Background:

We describe enrollment and accrual challenges in the “Promoting Maternal and Infant Survival Everywhere” (PROMISE) trial conducted in resource-limited countries, as well as the challenges in transitioning participants from the antepartum to the postpartum components of the study.

Methods:

PROMISE was a large multi-national randomized controlled trial of the safety and efficacy of interventions to reduce perinatal transmission of HIV-1 (HIV) during pregnancy and breastfeeding and of interventions to preserve maternal health after cessation of perinatal transmission risk. The PROMISE study included two protocols for HIV-infected pregnant women in resource-limited countries who intended to either breastfeed or formula-feed their infants and did not meet country criteria for antiretroviral treatment. The PROMISE breastfeeding protocol (1077BF) used a sequential randomization design with up to three randomizations (Antepartum, Postpartum, and Maternal Health). The PROMISE formula-feeding protocol (1077FF) had two randomizations (Antepartum and Maternal Health). Women presenting to the clinic during early or active labor or in the immediate postpartum period were registered as Late Presenters and screened to determine whether eligible to participate in the Postpartum randomization.

Results:

The study was conducted at 14 sites in seven countries and opened to enrollment in April 2011. A total of 3259 pregnant women intending to breastfeed and an additional 284 pregnant women intending to formula feed were randomized in the Antepartum component. A total of 204 Late Presenters were registered during labor or after delivery. Enrollment was high among breastfeeding women (representing 96% of the target of 3400 women) but was lower than expected among women intending to formula feed (28% of 1000 expected) and late-presenting women (8% of 2500 expected). The successful overall enrollment and final primary study analyses results were attributed to substantial preparation before the study opened, collaboration among all stakeholders, close study monitoring during implementation and the flexibility to change and streamline the protocol.

Conclusions:

Experiences from the PROMISE study illustrate the challenges of enrolling in longer term studies in the setting of rapidly evolving prevention and treatment standards priorities. The lessons learned will help the community, site investigators, and study coordinators in the design and implementation of future clinical trials.
Sensory communication in YouTube reviews: The interactional construction of products
Authors: Gibson Will
Published: March 2020

This study draws on interactionist frameworks of sensorial communication to analyse product reviews on YouTube. Existing studies of YouTube review work have focused on how vloggers manage conflicting neoliberal identity discourses such as ‘authenticity’, ‘being entertaining’ and ‘selling’. I argue that this focus has been at the expense of the communicative work involved in constructing products in reviews, and I suggest that identity issues should be conceptually expanded through a much broader focus on communicative action and conventions of practice. In order to achieve a first step in this expansion, my analysis focusses on reviewers’ sensorial engagement with objects and explores the communicative processes through which they symbolically transform products into enlivened, sensorially rich phenomena. I argue that these communicative strategies are important for situating neoliberal discourses within ‘mundane’ actions of description and in broader cultural practices of reviewing.
Diagnostic and management challenges of intraventricular neurocysticercosis presenting in the third trimester of pregnancy: A case report
Authors: Ramesh Devika , Maurya Dilip K , Gopalakrishnan Madhavan S , Pegu Bhabani , Ananthakrishnan Ramesh , Nair Pradeep P , Keepanasseril Anish
Published: March 2020

The diagnosis of neurocysticercosis in pregnancy is challenging, even in endemic areas, as other neurological conditions with similar manifestations are common. Obstetricians and physicians may be reluctant to do neuroimaging in pregnancy and often the availability is limited in endemic areas. Management of neurocysticercosis depends on the symptomatology. In those presenting with features of increased intracranial pressure early treatment is necessary, taking into consideration the gestational age and the maternal condition at presentation. Presence of intraventricular cysts causing obstructive hydrocephalus necessitates their removal due to the risk of intracranial hypertension which could be life-threatening, particularly peripartum. We report a case of a woman with intraventricular neurocysticercosis, who presented in the third trimester, and described the management dilemmas that were encountered. The differential diagnoses and other aspects of the medical and surgical management of neurocysticercosis in pregnancy are also discussed.
Recalibrating the EU’s Approach to the Western Balkans
Authors: Kmezić Marko
Published: March 2020

Almost two decades after the European Council summit in Thessaloniki, the promise of EU membership remains unfulfilled in the Western Balkans. Although the process of EU accession is continuing, the current pace throws the Thessaloniki promise into doubt. Despite initial success, the current approach to enlargement has reached its limits, as it seems to be slowing down the integration process rather than accelerating it. At the same time, the transformative power of the EU is too weak to positively impact on democratic and economic setbacks in the region. That is why this article considers various strategies that the EU could employ to recalibrate the accession of the Western Balkans, notwithstanding the need for sincere reforms in the aspiring member states.
Shape Loss of Autoclaved, Machine-Bent Cobalt-Chrome and Titanium Spine Surgery Rods
Authors: Willson Rob , Zhou Haitao , Fulzele Sadanand , Mitchell Sean M. , Chutkan Norman
Published: March 2020

Study Design:

This was a biomechanical study.

Objective:

Shape loss of surgical spine rods has been implicated as a factor leading to postsurgical loss of alignment correction. Our objective was to compare the degree of shape loss in surgical spine rods of different compositions under physiological conditions that were bent before or after being autoclaved.

Methods:

10 CoCr and 10 commercially pure titanium (CPTi) surgical spine rods were contoured using a machine press. Five CoCr and 5 CPTi rods were bent before being autoclaved (preoperative bent group); 5 CoCr and 5 CPTi rods were bent after being autoclaved (intraoperative bent group). All rods were immersed in a phosphate-buffered saline bath at body temperature (37.2°C ± 2°C). Changes in radius of curvature were measured at different time intervals over an 8-week course using a high-definition scanner.

Results:

Each rod demonstrated shape loss in radius of curvature (range = 1.04-9.99 mm) over the duration of the study. Intraoperatively bent CPTi rods demonstrated the largest shape loss (range = 8.73-9.99 mm; median 9.33 mm; P < .01). Preoperatively bent CPTi (range = 1.04-1.71 mm; median = 1.39 mm; P < .01) and intraoperatively bent CoCr (range = 1.11-2.11 mm; median = 2.01 mm; P < .01) rods underwent the least amount of shape loss.

Conclusion:

CPTi spinal rods bent after autoclave may lead to considerable loss of alignment correction. In addition, our results suggest that preautoclave bent CPTi and CoCr spinal rods bent after autoclave may be a more ideal choice of implant because they may provide more resistance to shape loss over time.
Ultrasound-Guided Percutaneous Tenotomy for Gluteal Tendinopathy
Authors: Baker Champ L. , Mahoney J. Ryan
Published: March 2020

Background:

Gluteal tendinopathy is a common cause of lateral hip pain. Percutaneous ultrasonic tenotomy (PUT) has been used successfully for the treatment of tendinopathy of the elbow, knee, and ankle, but its use in the hip has not been described.

Purpose:

To evaluate the efficacy of PUT in patients who did not respond to nonsurgical management of gluteal tendinopathy.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 29 patients with gluteal tendinopathy (mean age, 62 years) who did not respond to nonsurgical treatment were enrolled in this prospective study and underwent ultrasound-guided PUT in an outpatient setting. Patients with a history of ipsilateral hip surgery were excluded. All patients initially underwent magnetic resonance imaging or a computed tomography arthrogram demonstrating tendinopathy and/or partial tearing of the gluteus minimus or medius tendon or both tendons. Outcomes were assessed with a visual analog scale (VAS) for pain, the Harris Hip Score evaluation, and the 12-Item Short Form Health Survey (SF-12) before the procedure and at subsequent follow-up visits or by telephone interviews at 3 weeks, 3 months, 6 months, and final follow-up (range, 18-30 months).

Results:

The mean final follow-up was at 22 months postoperatively. At final follow-up, VAS scores had improved from a preprocedural mean ± SD of 5.86 ± 1.73 to 2.82 ± 2.22 ( P < .01). Harris Hip Scores improved from a preprocedural mean of 60.03 ± 10.86 to 77.47 ± 14.34 ( P < .01). Total SF-12 scores improved from a mean of 29.93 ± 5.39 (51% optimal) to 34.41 ± 4.88 (64% optimal) ( P < .01). No complications were reported. At final follow-up, when asked whether they would have the procedure again, 15 patients replied “yes definitely,” 3 replied “yes probably,” 3 replied “maybe,” 1 replied “likely not,” and 2 replied “definitely not.” There were 3 patients who eventually had hip abductor tendon repair, and their PUT procedures were considered failures.

Conclusion:

PUT is an effective treatment, with good results for patients with gluteal tendinopathy.
To Disclose or Not? Understanding Employees’ Uncertainty and Behavior Regarding Health Disclosure in the Workplace: A Modified Socioecological Approach
Authors: Li Jo-Yun , Lee Yeunjae
Published: March 2020

The health disclosure of employees may facilitate effective workplace health programs and policy design and implementation of an organization. Given the complexity of the decision-making process of health disclosure, the present study seeks to understand the health disclosure behavior of employees from an interdisciplinary perspective. We incorporated the socioecological model of disclosure from the public health field, uncertainty reduction theory from the interpersonal communication discipline, and organizational relationship concepts from the public relations area. Guided by the above theoretical frameworks, a survey of 409 full-time employees in the United States found that individual-, interpersonal-, and organizational-level factors were significantly associated with employees’ perceived uncertainty—a perquisite variable that predominates individuals’ decision-making process. Engaging in different communication behaviors also helped employees reduce uncertainty about health disclosure in the workplace. The findings implore organizations to implement interventions targeting multiple levels of the socioecological framework to reduce employees’ perceived uncertainty, which in turn facilitate their disclosure decision-making process.
Thinking beyond success and failure: Dutch water expertise and friction in postcolonial Jakarta
Authors: Colven Emma
Published: March 2020

In 2014, a consortium of Dutch firms revealed the master plan for Jakarta’s Great Garuda Sea Wall project, combining urban development and flood risk management. Though a ground-breaking ceremony was held, little progress has since been made, and the yet-to-be materialized project faces an uncertain future. Taking this project as its case study, this article examines the efforts of Dutch consultants to realize the proposed Great Garuda Sea Wall project in Jakarta, and the frictions encountered during this process. This article contributes to a growing scholarship in policy mobilities that interrogates instances of policy failure. I begin from the premise that there are valuable insights to be gleaned by examining projects and policies that occupy the space in between failure and success. By using the lens of friction, this article aims to think beyond these categories and their limitations. I demonstrate how friction can be simultaneously productive and disruptive to policymaking and mobilizing, therefore complicating binary representations of success and failure. Abandoning these limiting categories holds the possibility of enriching policy mobilities scholarship by opening up space for analyses of the messy and indeterminate processes that are central to policymaking, and which categories of success and failure are unable to capture. This is especially important for understanding policymaking in the context of the “global South” where projects often remain unrealized and such categories are less analytically useful.
Association of timed up and go test outcomes with future incidence of cardiovascular disease and mortality in adults aged 66 years: Korean national representative longitudinal study over 5.7 years
Authors: Son Ki Young , Shin Dong Wook , Lee Ji Eun , Kim Sang Hyuck , Yun Jae Moon , Cho Belong
Published: March 2020

Background

The timed up and go test (TUG) is one of the most widely used tests of mobility. We aimed to examine whether the TUG is associated with cardiovascular (CV) events, CV mortality, and all-cause mortality.

Methods

Subjects in the senior cohort database of the Korean National Health Insurance Service (2002–2013) who completed the TUG as part of the National Screening Program for Transitional Ages (NSPTA) during 2007–2008 were identified. An abnormal TUG result was defined as a time ≥ 10 s. Cox proportional hazard models were used to assess the associations between TUG results and CV events, CV mortality, and all-cause mortality.

Results

The mean follow-up period was 5.7 years. Incidence rates of CV events in the normal and abnormal TUG groups were 7.93 and 8.98 per 1000 person-years, while CV mortality rates were 0.96 and 1.51 per 1000 person-years, respectively. In a fully adjusted model, we found that abnormal TUG results were not associated with the incidences of CV events and CV mortality. However, abnormal TUG results (≥10 s) resulted in a 2.9-fold increase in CV mortality in women (adjusted hazard ratio 2.90, 95% confidence interval 1.15–7.30). Further, participants lacking certain CV risk factors, such as current cigarette smoking, obesity, or diabetes, had a higher CV mortality rate when TUG results were abnormal.

Conclusions

Abnormal TUG results in subjects aged 66 years were associated with future CV mortality in women and in subjects without obesity, diabetes, or cigarette smoking. In patient with mobility impairment, physicians should consider CV disease risk, especially in women.
Burden of Staphylococcus aureus infections after orthopedic surgery in Germany
Authors: Hardtstock Fraence , Heinrich Kirstin , Wilke Thomas , Mueller Sabrina , Yu Holly
Published: March 2020

Background

This study assessed incidence, risk factors, and outcomes of Staphylococcus aureus infections (SAI) following endoprosthetic hip or knee, or spine surgeries.

Methods

Adult patients with at least one of the selected surgeries from 2012 to 2015 captured in a German sickness fund database were included. SAI were identified using S. aureus-specific ICD-10 codes. Patients with certain prior surgeries and infections were excluded. Cumulative incidence and incidence density of post-surgical SAI were assessed. Risk factors, mortality, healthcare resource utilization and direct costs were compared between SAI and non-SAI groups using multivariable analyses over the 1 year follow-up.

Results

Overall, 74,327 patients who underwent a knee (28.6%), hip (39.6%), or spine surgery (31.8%) were included. The majority were female (61.58%), with a mean age of 69.59 years and a mean Charlson Comorbidity Index (CCI) of 2.3. Overall, 1.92% of observed patients (20.20 SAI per 1000 person-years (PY)) experienced a SAI within 1 year of index hospitalization. Knee surgeries were associated with lower SAI risk compared with hip surgeries (Hazard Ratio (HR) = 0.8; p = 0.024), whereas spine surgeries did not differ significantly from hip surgeries. Compared with non-SAI group, the SAI group had on average 4.4 times the number of hospitalizations (3.1 vs. 0.7) and 7.7 times the number of hospital days (53.5 vs. 6.9) excluding the index hospitalization (p < 0.001). One year post-orthopedic mortality was 22.38% in the SAI and 5.31% in the non-SAI group (p < 0.001). The total medical costs were significantly higher in the SAI group compared to non-SAI group (42,834€ vs. 13,781€; p < 0.001). Adjusting for confounders, the SAI group had nearly 2 times the all-cause direct healthcare costs (exp(b) = 1.9; p < 0.001); and 1.72 times higher risk of death (HR = 1.72; p < 0.001).

Conclusions

SAI risk after orthopedic surgeries persists and is associated with significant economic burden and risk of mortality. Hence, risk reduction and prevention methods are of utmost importance.
Burkholderia pseudomallei peri-prosthetic infection following medial malleolar internal fixation: a case report
Authors: Jayarajah Umesh , Arulanantham Arulprashanth , Koculen Vimaleswaran , Palkumbura Chamikara , Faleel Aadil , Sooriyarachchi Rukshan
Published: March 2020

Background

Melioidosis-associated peri-prosthetic infection is extremely rare. To date, melioidosis associated septic arthritis of the ankle joint following a medial malleolar internal fixation has not been reported.

Case presentation

We describe a 49-year-old male with a history of long standing diabetes who presented with fever, constitutional symptoms and right ankle pain for 1 week. Ten years ago, he underwent a medial malleolar screw fixation following a traumatic closed fracture. His initial right ankle radiographs showed no evidence of osteomyelitis. He underwent a wound debridement and washout of the right ankle joint. The peripheral blood and pus from the ankle joint was culture positive for Burkholderia pseudomallei with very high antibody titres. His subsequent radiographs showed features of chronic osteomyelitis. He was treated with a prolonged course of antibiotics and repeated wound debridement. At follow up after 6 months, he had no clinical features of recurrent infection.

Conclusions

Melioidosis should be entertained in the differential diagnosis of peri-prosthetic infections in high risk patients.
Triple infection with Cryptococcus, varicella-zoster virus, and Mycobacterium abscessus in a patient with anti-interferon-gamma autoantibodies: a case report
Authors: Rujirachun Pongprueth , Sangwongwanich Jirath , Chayakulkeeree Methee
Published: March 2020

Background

The most common infection in patients positive for anti-interferon-gamma autoantibodies (anti-IFN-γ AAbs) is disseminated nontuberculous mycobacterial (dNTM) infection. Here, we report a rare case of triple infection caused by Cryptococcus, varicella-zoster virus (VZV), and nontuberculous mycobacterium in a patient with anti-IFN-γ AAbs.

Case presentation

A 53-year-old Thai man presented with a progressively enlarging right cervical mass with low-grade fever and significant weight loss for 4 months. He also developed a lesion at his left index finger. A biopsy of that lesion showed granulomatous inflammation with yeast-like organisms morphologically consistent with cryptococcosis. Serum cryptococcal antigen was positive. Histopathology of a right cervical lymph node revealed chronic granulomatous lymphadenitis, and the lymph node culture grew Mycobacterium abscessus. One month later, he complained of vision loss in his left eye and subsequently developed a group of painful vesicles at the right popliteal area of S1 dermatome. Lumbar puncture was performed and his cerebrospinal fluid was positive for VZV DNA. His blood test for anti-HIV antibody was negative. Anti-IFN-γ AAbs was positive, but test for anti-granulocyte-macrophage colony-stimulating factor autoantibodies (anti-GM-CSF AAbs) was negative. He was treated with amphotericin B plus fluconazole for cryptococcosis; a combination of amikacin, imipenem, azithromycin, and levofloxacin for dNTM infection; and, intravenous acyclovir for disseminated VZV infection. After treatment, our patient’s fever and cervical lymphadenopathy were subsided, and his vision and visual acuity were both improved.

Conclusions

This is the first case of triple infection with cryptococcosis, VZV, and dNTM in a patient who tested positive for anti-IFN-γ AAbs and negative for anti-GM-CSF AAbs. This case will increase awareness and heighten suspicion of these infections in patients with the described presentations and clinical characteristics, and this will accelerate diagnosis and treatment.
Glutathione S-transferase M1 and T1 genes deletion polymorphisms and risk of developing essential hypertension: a case-control study in Burkina Faso population (West Africa)
Authors: Sombié Herman Karim , Sorgho Abel Pegdwendé , Kologo Jonas Koudougou , Ouattara Abdoul Karim , Yaméogo Sakinata , Yonli Albert Théophane , Djigma Florencia Wendkuuni , Tchelougou Daméhan , Somda Dogfounianalo , Kiendrébéogo Isabelle Touwendpoulimdé , Bado Prosper , Nagalo Bolni Marius , Nagabila Youssoufou , Adoko Enagnon Tiémoko Herman Donald , Zabsonré Patrice , Millogo Hassanata , Simporé Jacques
Published: March 2020

Background

Glutathione S-transferases play a key role in the detoxification of persistent oxidative stress products which are one of several risks factors that may be associated with many types of disease processes such as cancer, diabetes, and hypertension. In the present study, we characterize the null genotypes of GSTM1 and GSTT1 in order to investigate the association between them and the risk of developing essential hypertension.

Methods

We conducted a case-control study in Burkina Faso, including 245 subjects with essential hypertension as case and 269 control subjects with normal blood pressure. Presence of the GSTT1 and GSTM1 was determined using conventional multiplex polymerase chain reaction followed by gel electrophoresis analysis. Biochemical parameters were measured using chemistry analyzer CYANExpert 130.

Results

Chi-squared test shows that GSTT1-null (OR = 1.82; p = 0.001) and GSTM1-active/GSTT1-null genotypes (OR = 2.33; p <  0.001) were significantly higher in cases than controls; the differences were not significant for GSTM1-null, GSTM1-null/GSTT1-active and GSTM1-null/GSTT1-null (p > 0.05). Multinomial logistic regression revealed that age ≥ 50 years, central obesity, family history of hypertension, obesity, alcohol intake and GSTT1 deletion were in decreasing order independent risk factors for essential hypertension. Analysis by gender, BMI and alcohol showed that association of GSTT1-null with risk of essential hypertension seems to be significant when BMI < 30 Kg/m2, in non-smokers and in alcohol users (all OR ≥ 1.77; p ≤ 0.008). Concerning GSTT1, GSTM1 and cardiovascular risk markers levels in hypertensive group, we found that subjects with GSTT1-null genotype had higher waist circumference and higher HDL cholesterol level than those with GSTT1-active (all p <  0.005), subjects with GSTM1-null genotype had lower triglyceride than those with GSTM1-active (p = 0.02) and subjects with the double deletion GSTM1-null/GSTT1-null had higher body mass index, higher waist circumference and higher HDL cholesterol than those with GSTM1-active/GSTT1-active genotype (all p = 0.01).

Conclusion

Our results confirm that GSTT1-null genotype is significantly associated with risk of developing essential hypertension in Burkinabe, especially when BMI < 30 Kg/m2, in non-smokers and in alcohol users, and it showed that the double deletion GSTM1-null/GSTT1-null genotypes may influence body lipids repartition.
Retraction Note: Correlation of CD44v6 expression with ovarian cancer progression and recurrence
Authors: Shi Jun , Zhou Zhou , Di Wen , Li Ningli
Published: March 2020

The authors have retracted this original article [1] because a number of the figures exhibit irregularities.
Classification of optical coherence tomography images using a capsule network
Authors: Tsuji Takumasa , Hirose Yuta , Fujimori Kohei , Hirose Takuya , Oyama Asuka , Saikawa Yusuke , Mimura Tatsuya , Shiraishi Kenshiro , Kobayashi Takenori , Mizota Atsushi , Kotoku Jun’ichi
Published: March 2020

Background

Classification of optical coherence tomography (OCT) images can be achieved with high accuracy using classical convolution neural networks (CNN), a commonly used deep learning network for computer-aided diagnosis. Classical CNN has often been criticized for suppressing positional relations in a pooling layer. Therefore, because capsule networks can learn positional information from images, we attempted application of a capsule network to OCT images to overcome that shortcoming. This study is our attempt to improve classification accuracy by replacing CNN with a capsule network.

Methods

From an OCT dataset, we produced a training dataset of 83,484 images and a test dataset of 1000 images. For training, the dataset comprises 37,205 images with choroidal neovascularization (CNV), 11,348 with diabetic macular edema (DME), 8616 with drusen, and 26,315 normal images. The test dataset has 250 images from each category. The proposed model was constructed based on a capsule network for improving classification accuracy. It was trained using the training dataset. Subsequently, the test dataset was used to evaluate the trained model.

Results

Classification of OCT images using our method achieved accuracy of 99.6%, which is 3.2 percentage points higher than that of other methods described in the literature.

Conclusion

The proposed method achieved classification accuracy results equivalent to those reported for other methods for CNV, DME, drusen, and normal images.
Correction to: Association between dietary acid load and the risk of hypertension among adults from South China: result from nutrition and health survey (2015–2017)
Authors: Chen Shao-wei , Ji Gui-yuan , Jiang Qi , Wang Ping , Huang Rui , Ma Wen-jun , Chen Zi-hui , Peng Jie-wen
Published: March 2020

It was highlighted that in the original article [1] the data on categorical variables was wrongly arranged in Table 1 and there was an incorrect statement in the fourth paragraph of the Discussion section.
Clinical efficacy of single intraoperative 500 mg methylprednisolone management therapy for thoracic myelopathy caused by ossification of the ligamentum flavum
Authors: Huo Xiaoyang , Zhou Jiaming , Liu Shiwei , Guo Xing , Xue Yuan
Published: March 2020

Background

The objective of our study was to compare clinical outcome and postoperative complications between patients with thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) treated with and without intraoperative methylprednisolone (MP).

Methods

This retrospective study enrolled 101 patients who underwent posterior approach surgery for OLF and were followed up at least 1 year. Patients were divided into two groups according to MP use in the operation: MP group (n = 47) and non-MP group (n = 54). Clinical outcomes and complications were evaluated before and after operation and at the last follow-up.

Results

Significant differences were found in modified Japanese Orthopedics Association (mJOA) scores and proportion of Frankel grade (A-C) between the two groups immediately after surgery and at 2-week follow-up. No significant differences were found between the two groups in mJOA score before operation and at the final follow-up. Moreover, no significant differences were observed in recovery rate according to mJOA score at any time points, and there was no significant difference in the proportion of Frankel grade (A-C) between the two groups at final follow-up. There were 13 documented infections: 10 in the MP group and 3 in the non-MP group (P = 0.034).

Conclusion

Management therapy with intraoperative 500 mg MP showed better recovery of nerve function within 2 weeks in patients with thoracic myelopathy caused by OLF compared with those did not receive MP. However, long-term follow-up results showed that there was no significant difference in neurological recovery between patients with intraoperative MP or not. Moreover, intraoperative MP increased the rate of wound infection.
Artificial intelligence in fixed implant prosthodontics: a retrospective study of 106 implant-supported monolithic zirconia crowns inserted in the posterior jaws of 90 patients
Authors: Lerner Henriette , Mouhyi Jaafar , Admakin Oleg , Mangano Francesco
Published: March 2020

Background

Artificial intelligence (AI) is a branch of computer science concerned with building smart software or machines capable of performing tasks that typically require human intelligence. We present a protocol for the use of AI to fabricate implant-supported monolithic zirconia crowns (MZCs) cemented on customized hybrid abutments.

Methods

The study protocol consisted of: (1) intraoral scan of the implant position; (2) design of the individual abutment and temporary crown using computer-aided design (CAD) software; (3) milling of the zirconia abutment and the temporary polymethyl-methacrylate (PMMA) crown, with extraoral cementation of the zirconia abutment on the relative titanium bonding base, to generate an individual hybrid abutment; (4) clinical application of the hybrid abutment and the temporary PMMA crown; (5) intraoral scan of the hybrid abutment; (6) CAD of the final crown with automated margin line design using AI; (7) milling, sintering and characterisation of the final MZC; and (8) clinical application of the MZC. The outcome variables were mathematical (quality of the fabrication of the individual zirconia abutment) and clinical, such as (1) quality of the marginal adaptation, (2) of interproximal contact points and (3) of occlusal contacts, (4) chromatic integration, (5) survival and (6) success of MZCs. A careful statistical analysis was performed.

Results

90 patients (35 males, 55 females; mean age 53.3 ± 13.7 years) restored with 106 implant-supported MZCs were included in the study. The follow-up varied from 6 months to 3 years. The quality of the fabrication of individual hybrid abutments revealed a mean deviation of 44 μm (± 6.3) between the original CAD design of the zirconia abutment, and the mesh of the zirconia abutment captured intraorally at the end of the provisionalization. At the delivery of the MZCs, the marginal adaptation, quality of interproximal and occlusal contacts, and aesthetic integration were excellent. The three-year cumulative survival and success of the MZCs were 99.0% and 91.3%, respectively.

Conclusions

AI seems to represent a reliable tool for the restoration of single implants with MZCs cemented on customised hybrid abutments via a full digital workflow. Further studies are needed to confirm these positive results.
A conjoint analysis study on self-sampling for human papillomavirus (HPV) testing characteristics among black women in Indiana
Authors: Biederman Erika , Champion Victoria , Zimet Gregory
Published: March 2020

Background

Self-sampling for HPV testing may be a method to increase overall cervical cancer screening rates among Black women, who are underscreened for cervical cancer in parts of the US. The purpose of this study was to assess preferred characteristics for delivery of HPV self-sampling kits, return of HPV self-sampling kits, and communication of HPV test results and explore sociodemographic factors (income, education, and marital status) associated with acceptability of self-sampling for HPV testing.

Methods

Survey data were gathered at an Indiana minority health fair. Participants evaluated 9 scenarios that varied along 3 dimensions: HPV self-sampling kit delivery (mail, pharmacy pick-up, or clinic pick-up), HPV self-sampling kit return (mail, pharmacy drop-off, or clinic drop-off), and HPV test results (mail, phone call, or text message). The 9 scenarios were produced from a fractional factorial design and rated on a 0 to 100 scale. Ratings-based conjoint analysis (RBCA) determined how each dimension influenced ratings. A measure for acceptability of self-sampling was obtained from the ratings of all 9 scenarios. The acceptability measure was regressed on sociodemographics.

Results

The 98 participants ranged in age from 21 to 65 (M = 45). Across the 9 scenarios, overall acceptability to self-sample had a mean of 60.9 (SD = 31.3). RBCA indicated that HPV self-sampling kit return had the most influence on ratings, followed by HPV self-sampling kit delivery, and finally, HPV test result communication. Thirty-six percent of participants rated all self-sampling scenarios the same. Sociodemographic characteristics were not associated with acceptability of self-sampling.

Conclusions

Self-sampling for HPV testing was found to be generally acceptable to Black women in this pilot survey study. This information could be used by researchers developing self-sampling interventions and the implementation of self-sampling among providers.