bluuebunny/crossref_metadata_2025_split huggingface dataset:
The M2 Cotidal Chart in the Bohai, Yellow, and East China Seas from Dynamically Constrained Interpolation
Authors: Zheng Junyong , Mao Xinyan , Lv Xianqing , Jiang Wensheng 
Published: July 2020

AbstractThe harmonic constants extracted from tidal gauge stations and satellite altimeter observations are usually sparsely distributed in the continental marginal seas, but they are precious data for addressing the main characteristics of different constituents. In this paper, a dynamically constrained interpolation methodology (DCIM) is developed and applied to interpolate the observed harmonic constants of the M2 constituent from satellite altimeter observations in the Bohai, Yellow, and East China Seas (BYECS) with those from tidal gauge stations for validation. In the DCIM, the tide model provides dynamical constraints to interpolate the observations, and the adjoint assimilation method provides iterative optimization for the interpolated results by adjusting key model parameters. In particular, a substantial quantity of enhanced “observations” generated from the interpolated results of the domain are further interpolated with the sparse observations in the subdomain. The final interpolated results for each subdomain, naturally blending the dynamical constraints from the dynamical model with statistical information from observations, can describe the main characteristics of the M2 constituent in the BYECS, the continental shelf sea of the East China Sea, and the Zhejiang–Fujian coastal area, respectively. The results indicate that the DCIM is feasible and effective to utilize the observations to obtain high-accuracy cotidal charts for regional ocean.
Operative Versus Nonoperative Management of Hemorrhage in the Postoperative Kidney Transplant Patient
Authors: Buggs Jacentha , Shaw Robert , Montz Frederic , Meruva Venkat , Rogers Ebonie , Kumar Ambuj , Bowers Victor 
Published: July 2020

Background Postoperative hemorrhage has been described at rates of 14% in kidney transplant (KT) literature. The preferred management of postoperative hemorrhage in this population is not well described. We hypothesized a difference in outcomes with operative versus nonoperative management of hemorrhage after kidney transplantation. Methods We conducted a retrospective cohort study of consecutive KTs from 2012 to 2019 (living and deceased donors). We defined hemorrhage based on the objective finding of hematoma on either ultrasound or CT scan. Management was defined as operative (surgical intervention with or without transfusion) or nonoperative (with or without transfusion). Results We performed 1758 KTs of which 135 (8%) demonstrated hematoma on ultrasound or CT scan (66 operative vs 69 nonoperative management). The clinical signs and symptoms of low urine output ( P = .044), drop in hemoglobin ( P < .001), abdominal pain ( P = .005), and MAP < 70 mm Hg ( P = .034) were 92.5% predictive of postoperative hemorrhage in our KT patients. There were no differences between groups based on medical history, preop anticoagulation, anastomosis type, cold ischemic time, lowest hemoglobin, delayed graft function, or complications. Patients with nonoperative treatment of postoperative hemorrhage had shorter lengths of stay ( P = .003), better graft survival ( P = .01), and better patient survival ( P = .01). Discussion We found better outcomes of graft and patient survival with shorter lengths of stay when we utilized nonoperative management of postoperative hemorrhage in KT patients. Our findings suggest a role for conservative nonoperative management in select patients. Ultimately, it is the surgeon’s choice on how best to manage postoperative hemorrhage.
Review of COVID-19 Outcomes in Surgical Patients
Authors: Aziz Hassan , Filkins Alexandra , Kwon Yong Kyong 
Published: July 2020

COVID-19 emerged as a viral pandemic in the year 2019. The practice and scope of surgery and medicine transformed radicially as the virus spread across the world. There is an urgent need to understand the outcomes of COVID-19 infected patients who undergo surgery. We present a comprehensive review of the current literature on the management of surgical patients who develop COVID-19. Findings Poor outcomes were most frequent in general surgery or oncological surgery patients who were older with chronic comorbidities. In contrast, outcomes among transplant surgery and obstetric patients were not signficantly altered by COVID-19. Surgical societies have released specialty specific guidelines on the managment of patients who require surgical care during the pandemic. Conclusion COVID-19 is associated with adverse outcomes and increased mortality in surgical patients. Data is currently limited, often restricted to single sites and smaller cohorts. As the sequelae of the virus is better understood, the revisions to the guidelines on managment of surgical patients may help improve outcomes.
Aging affects responsiveness of peripheral blood mononuclear cells to immunosuppression of periodontal ligament stem cells
Authors: Li Xiaoyu , Zhang Bowen , Wang Hong , Zhao Xiaolu , Zhang Zijie , Ding Gang , Wei Fulan 
Published: July 2020

Objectives The effect of age on the response of peripheral blood mononuclear cells (PBMCs) to immunosuppression induced by human periodontal ligament stem cells (hPDLSCs) is unclear. The identity of the cytokines most effective in inducing the PBMC immune response remains unknown. This study investigated the effects of age on immunophenotype, proliferation, activation, and cytokine secretion capacities of PBMCs following co-culture with hPDLSCs. Methods PBMCs were collected from younger (16–19 years) and older (45–55 years) donors, then co-cultured with confirmed hPDLSCs for various lengths of time. T lymphocyte proliferation and cell surface marker expression were analyzed by flow cytometry. Cytokine expression levels were measured by quantitative polymerase chain reaction assays and enzyme-linked immunosorbent assays. Results CD28 expression by T lymphocytes decreased with age, indicating reduced proliferation; CD95 expression increased with age, indicating enhanced apoptosis. Moreover, hPDLSCs inhibited T lymphocyte proliferation in both age groups; this inhibition was stronger in cells from older donors than in cells from younger donors. Age reduced the secretion of interleukin-2 and interferon-γ, whereas it increased the secretion of tumor necrosis factor-β by PBMCs cultured with hPDLSCs. Conclusions Aging may have a robust effect on the response of PBMCs towards hPDLSC-induced immunosuppression.
Patellar Malalignment Is Associated With Patellofemoral Lesions and Cartilage Relaxation Times After Hamstring Autograft Anterior Cruciate Ligament Reconstruction
Authors: Liao Tzu-Chieh , Martinez Alejandro G. Morales , Pedoia Valentina , Ma Benjamin C. , Li Xiaojuan , Link Thomas M. , Majumdar Sharmila , Souza Richard B. 
Published: July 2020

Background: There is growing evidence suggesting a link between patellofemoral joint (PFJ) osteoarthritis in anterior cruciate ligament (ACL)–reconstructed knees and altered joint alignment. Purpose: To determine whether patellar alignment differs between participants with and without ACL reconstruction (ACLR) and to identify possible associations between patellar alignment and PFJ osteoarthritis features over 3 years. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 37 participants with ACLR (sex, 23 male; mean ± SD age, 28.1 ± 7.4 years) and 20 healthy controls (13 male; 30.4 ± 4.8 years) participated. Patients underwent magnetic resonance imaging: (1) sagittal T2-weighted fat-saturated fast spin echo images to calculate patellar alignment, (2) sagittal 3-dimensional intermediate-weighted fast spin echo Cube sequence for clinical morphological grading (modified Whole-Organ Magnetic Resonance Imaging Score [WORMS]), and (3) sagittal combined T1ρ/T2 mapping sequence for performing voxel-based relaxometry. Patellar alignment of the ACLR knees were assessed at 6 months (baseline). One-way analysis of variance was used to compare patellar alignment among the ACLR (at 6 months), contralateral, and control knees. Within the ACLR group, a logistic regression model was used to identify if patellar alignment measures at baseline were risk factors for worsening of PFJ structural changes over 3 years. Statistical parametric mapping was used to evaluate the longitudinal associations between patellar alignment and cartilage relaxation times at 3 years. Results: When compared with control knees, ACLR knees exhibited a laterally and anteriorly displaced patella ( P = .045 and P = .041), less flexion ( P = .031), and less lateral spin ( P = .012). Furthermore, excessive lateral displacement was a significant predictor of worsening of WORMS ( P = .050). Lateral displacement was positively correlated with increased T1ρ and T2 in the patellar and trochlear cartilage at 3 years. Patellar lateral spin revealed similar negative findings. Conclusion: Participants with ACLR exhibited a laterally and anteriorly displaced patella, less flexion, and less lateral spin when compared with healthy controls. Excessive patellar lateral displacement was the strongest predictor to the development of PFJ osteoarthritis features longitudinally.
An In-Depth Analysis of Graft Rupture and Contralateral Anterior Cruciate Ligament Rupture Rates After Pediatric Anterior Cruciate Ligament Reconstruction
Authors: DeFrancesco Christopher J. , Striano Brendan M. , Bram Joshua T. , Baldwin Keith D. , Ganley Theodore J. 
Published: July 2020

Background: Reported rates of graft rupture and contralateral anterior cruciate ligament (ACL) rupture after ACL reconstruction (ACLR) are higher among pediatric patients than adults. Previous series may have underestimated postoperative event risk because of small sample sizes and high proportions of dropouts. Purpose: To calculate rates of graft rupture and contralateral ACL rupture after ACLR in a large pediatric series. Study Design: Case series; Level of evidence, 4. Methods: ACLRs performed in our tertiary care children’s hospital system over a period of >7 years were identified through billing review. Cases were sorted based on operative technique, with all-epiphyseal ACLRs considered separately. Transphyseal ACLRs were divided into 2 groups based on patient age, with a cutoff of 16 years. Clinic follow-up data as well as prospectively collected survey data were used to note graft rupture and contralateral ACL rupture events. Rates of graft rupture and contralateral ACL rupture were calculated using Kaplan-Meier survival analysis. Results: The final data set included 996 patients. A total of 161 patients underwent all-epiphyseal ACLR. Of the remaining transphyseal surgeries, 504 patients were <16 years of age at the time of surgery and 331 were ≥16 years. The 4-year cumulative rate of graft rupture via Kaplan-Meier survival analysis was 19.7% among all patients. The rate was 18.2% among all-epiphyseal ACLRs, 21.6% among transphyseal ACLRs in patients <16 years, and 16.4% among transphyseal ACLRs in patients ≥16 years ( P = .855). Survival analysis estimated the 4-year cumulative rate of contralateral ACL rupture at 12.0% among all patients: 6.63% among all-epiphyseal ACLRs, 15.7% among transphyseal ACLRs in patients <16 years, and 8.05% among transphyseal ACLRs in patients ≥16 years ( P = .093). Conclusion: This is the largest series of pediatric ACLRs yet reported, and it shows that the risks of another ACL injury after first-time ACLR are higher than previously reported. The risk of contralateral ACL rupture was lower than that for graft rupture. Our methods, including prospective follow-up surveys and survival analysis to generate cumulative rate estimates, provide a best-practice example for future case series calculations. Our results provide insight into the postoperative course of pediatric patients undergoing ACLR and are crucial for preoperative patient and family counseling. Understanding these risks may also influence return-to-play decisions.
Hip Arthroscopy in the High-Level Athlete: Does Capsular Closure Make a Difference?
Authors: Hassebrock Jeffrey D. , Makovicka Justin L. , Chhabra Anikar , Anastasi Matthew B. , Menzer Heather M. , Wilcox Justin G. , Economopoulos Kostas J. 
Published: July 2020

Background: Hip arthroscopy has been shown to be effective in athletes who have femoral acetabular impingement and labral tearing. The effect of complete capsular closure versus nonclosure on return to play is unknown. Hypothesis: Complete capsular closure after hip arthroscopy would lead to a higher rate and faster return to sports in high-level athletes. Study Design: Cohort study; Level of evidence, 3. Methods: A nonrandomized retrospective review was performed of high school, collegiate, and professional athletes undergoing hip arthroscopy by a single high-volume hip arthroscopic surgeon. Athletes were divided into those undergoing complete capsular closure (CC group) and non–capsular closure (NC group) after hip arthroscopy. Rate and time to return to play were determined between the 2 groups. Patient-reported outcomes including modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADL), and Hip Outcome Score Sport-Specific Subscale (HOS-SSS) were obtained at a minimum of 2 years. Results: A total of 111 athletes with a minimum 2-year follow-up were included in the study. There were 62 in the CC group and 49 in the NC group. A higher percentage of athletes in the CC group returned to play compared with that in the NC group (90.3% vs 75.5%, respectively; P = .03). The CC group returned to play at a mean ± SD of 4.7 ± 1.9 months compared with 5.8 ± 2.6 months in the NC group ( P < .001). Patients in the CC group met the minimal clinically important difference for the mHHS, HOS-ADL, and HOS-SSS patient-reported outcomes at higher percentages: mHHS, 98.3% vs 87.7% for CC vs NC, respectively ( P = .02); HOS-ADL, 98.3% vs 87.7% ( P = .02); and HOS-SSS, 96.7% vs 89.7% ( P = .13). The difference between groups was statistically significant for mHHS and HOS-ADL. Conclusion: Complete capsular closure after hip arthroscopy was associated with faster return to play and a higher rate of return compared with that of nonclosure of the capsule in this sample population of high-level athletes. At a minimum 2-year follow-up, complete capsular closure was associated with significantly higher patient-reported outcomes compared with those of nonclosure in athletes who underwent hip arthroscopy.
Ethical Coffee Room: An international collaboration in learning ethics digitally
Authors: Manninen Katri , Björling Gunilla , Kuznecova Jelena , Lakanmaa Riitta-Liisa 
Published: July 2020

Background: Ethics is a fundamental part of health care professionals’ competence and one of the major quality factors in good nursing care. Research shows challenges in learning and applying ethics. Ethical Coffee Room (ECR) is an electronic platform, where the students, nurses and teachers discuss anonymously ethical issues during students’ clinical practice. ECR offers 1 credit (27 working hours) for the students. This work included reading theoretical material, contributions for discussion of ethical dilemmas and reflection of one’s own learning. Every user – student, nurse supervisor or teacher – could choose her or his own pseudonym. Aim: The aim of this study was to describe how nursing students experience learning ethics with digital learning activity during clinical practice, how usable the Ethical Coffee Room platform is and how this learning activity should be developed further. Research design, participants and context: The study employed a qualitative descriptive design and was an EU project between Finland, Sweden and Latvia. In total, 34 second-year nursing students participated in the study. The data collection methods were semi-structured interviews and written comments in the discussion forum Ethical Coffee Room. The data were analysed using content analysis. Ethical considerations: Ethical approval and research permission were obtained from each partner organization, according to their national standards. Findings: The results are presented under three themes: positive learning experiences of Ethical Coffee Room, challenges in learning during Ethical Coffee Room and practical suggestions for future development of Ethical Coffee Room. The results showed that the Ethical Coffee Room was experienced as a novel type of learning activity and an interesting way to learn ethics. Discussion and conclusion: Ethical Coffee Room seems to be a promising learning activity enhancing students’ ethical competence in clinical practice. However, active participation of the mentor nurses and teachers is essential. Therefore, mentor nurses and teachers need in-depth knowledge of ethical theories and concepts and how to apply them in clinical context.
Possible Pharmacodynamic Interaction of Azelnidipine with Citicoline Against Ischemic Brain Injury: Behavioral, Biochemical and Histological Alterations
Authors: Gupta Varun , Bader Zein Eddin , Aakriti  , Kumar Anil 
Published: July 2020

Background: Currently, no drug has been approved for the management of postischemic neuronal damage. Existing studies show that calcium channel blockers have neuroprotective properties, while citicoline is involved in maintaining neuronal integrity. Purpose: This study was envisaged to investigate the effect of azelnidipine (novel calcium channel blocker) alone and in combination with citicoline (phosphatidyl-choline analogue) against ischemic brain damage in Wistar rats. Methods: Previously standardized bilateral common carotid artery occlusion model was used to induce cerebral ischemic injury in Wistar rats. Pretreatment with azelnidipine (1.5 mg/Kg and 3 mg/Kg; p.o.) or citicoline (250 mg/Kg; i.p.) was done every 24 h starting 7 days before the bilateral common carotid artery occlusion surgery. Pharmacological assessments (behavioral, biochemical, mitochondrial, molecular, and histological) were done after 48 h of the reperfusion period. Results: Azelnidipine and citicoline were found to protect the brain from progressive neuronal damage as seen by improved sensorimotor behavior (locomotion, rota rod, and beam balance performance) and reduced oxidative stress (decreased malondialdehyde (MDA), nitrite, increased glutathione (GSH), superoxide dismutase (SOD)). Impairment of mitochondrial enzyme system and increase in the infarct area were found to be arrested by individual treatments with azelnidipine and citicoline. These effects were further potentiated synergistically as the combination of citicoline and azelnidipine was found to decrease glutamate levels, caspase-3 activity and histological alterations as compared to their individual effects. Conclusion: Azelnidipine and citicoline synergistically decrease excitotoxic and oxidative damage against ischemic brain injury in Wistar rats and, therefore, propose a clinically relevant combination for the prevention of postischemic neuronal damage.
Simulation training to improve aseptic non-touch technique and success during intravenous cannulation—effect on hospital-acquired blood stream infection and knowledge retention after 6 months: The snowball effect theory
Authors: Balachander Bharathi , Rajesh Deepa , Pinto Bonita Viona , Stevens Sofia , Rao PN Suman 
Published: July 2020

Background: Intravenous cannulation is a common procedure and a valuable skill in the neonatal intensive care unit. Standardized procedure and personnel training are needed in the unit to prevent hospital-acquired blood stream infections. Hence, we evaluated the effect of training using a low-fidelity simulation on the improvement of the aseptic non-touch technique during intravenous cannulation and knowledge retention after 6 months. Methods: The study was conducted in a tertiary care neonatal unit from June 2017 to July 2018. All the staff nurses and junior resident doctors posted in the neonatal intensive care were included in the study. A protocol and checklist score sheet was developed. The score sheet consisted of 23 items with a total score of 46. Participants were expected to obtain a minimum of 80%. A pre-test was conducted initially, followed by a formal training and then a post-test. The NITA newborn venous access mannequin was used to facilitate the training. A re-training for new nurses was conducted after 6 months. Data were analyzed using paired t-test. Results: A total of 29 doctors and nurses were enrolled in the training. The mean pre-test score was 29.93 compared to 42.66 in the post-test scores (mean difference 12.24(95% confidence interval: 9.39–16.05), p < 0.01. The mean scores were higher when the simulation was conducted after 6 months. There was a significant decline in blood stream infection rates from 5.5 to 1.65 per 1000 patient days (p = 0.05). Conclusion: Simulation-based training of health care personnel is a good modality to improve aseptic non-touch technique during intravenous cannulation in the neonatal intensive care unit. Simulation-based training also helps in knowledge retention and standardization of training procedures.
Social workers’ views about children’s and parents’ competence in child protection decision-making
Authors: Korpinen Johanna , Pösö Tarja 
Published: July 2020

Summary Competence is an essential part of any decision-making process. In child protection, it is challenged by the controversial nature of child removals and the vulnerable situations which children and parents experience therein. This article examines how and on what grounds social workers view parents and children to be competent to give their informed view in care order proceedings and what they do if doubts about competence arise. The analysis is based on 30 interviews with social workers in Finland. Findings The professional ethos and ethics of social work were embedded in the social workers’ descriptions of children’s and parents’ competence. The social workers were confident that the parents and children (of certain age) were competent to give their informed view about whether to consent to the care order proposal and the proposed substitute home. When they spoke about competence ascribed with hesitation, they described the vulnerability of service users, as well as their attitudes and withdrawal from contact. In the cases, social workers emphasized a strength-based view of children and parents and aimed to ‘talk more’ with them and to ‘give them more time’ to support their right to give an informed view. Applications Social vulnerability and competence should be explored reflectively in relation to decision-making in child protection. A better understanding of their interrelation makes social workers more competent to support the service users’ right to be included in decision-making. Critical awareness is needed to recognize when ‘more talk’ is not enough to realize children’s and parents’ rights.