bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lack of Bone-on-Bone Arthritis Is Not a Strict Contraindication for Mobile-Bearing Unicompartmental Knee Arthroplasty
Authors: Carlson Samuel W. , Vargas-Hernandez Juan S. , Carlson Bayard C. , Sierra Rafael J. 
Published: August 2020

Background:
Unicompartmental knee arthroplasty (UKA) is a viable option for patients with symptomatic knee arthritis isolated to 1 compartment. Previous articles have suggested that mobile-bearing UKA should not be performed in patients without bone-on-bone arthritis. The purpose of this study was to compare the clinical outcomes and survivorship of mobile-bearing UKA in patients with severe osteoarthritis with bone-on-bone contact and patients with severe osteoarthritis but without bone-on-bone contact.

Methods:
We retrospectively reviewed a single surgeon’s experience with medial compartment mobile-bearing UKA in 219 patients (271 knees) who underwent the procedure between 2007 and 2015. Anteroposterior and posteroanterior radiographs were reviewed, and arthritis was graded using the International Knee Documentation Committee (IKDC) grading system. Only patients with grade D (severe arthritis) were studied. Of the patients who had grade-D arthritis, there were 81 patients (94 knees) with bone-on-bone arthritis and 82 patients (91 knees) without bone-on-bone contact. Functional outcomes were assessed using the Knee Society pain and function scores. Survivorship free of revision in these 2 groups was determined using Kaplan-Meier curves at 8 years.

Results:
There were no significant differences between the 2 groups in terms of age (p = 0.91), sex (p = 0.21), or body mass index (p = 0.63). At the time of the final follow-up, there was no significant difference in Knee Society pain scores (p = 0.59) or Knee Society function scores (p = 0.9) between the 2 groups. There were 5 revisions in the group with bone-on-bone contact and 2 revisions in the group without bone-on-bone contact. The survivorship free of revision at 8 years was 95% for the group with bone-on-bone contact and 98% for the group without bone-on-bone contact (p = 0.45).

Conclusions:
Patients with severe knee arthritis (IKDC grade D) without bone-on-bone contact had similar outcomes of mobile-bearing UKA compared with patients with bone-on-bone contact. UKA is a safe and reliable option in patients with severe osteoarthritis who do not have bone-on-bone contact on preoperative radiographs and it should therefore not be considered a contraindication for mobile-bearing UKA as long as the patient’s symptoms are severe enough to warrant surgical intervention.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Availability and Readability of Online Patient Information on Osteosarcoma
Authors: Young Jason , Dee Edward Christopher , May Collin 
Published: August 2020

Background:
Online patient information (OPI) plays an important role in pediatric orthopaedic patient/caregiver education and decision-making. We assessed the availability and readability of OPI about osteosarcoma found at pediatric hospital and U.S. National Cancer Institute-designated cancer center (NCIDCC) websites.

Methods:
The websites of all NCIDCCs and the top 50 pediatric hospitals identified using U.S. News & World Report were included. The names of NCIDCCs and pediatric hospitals along with the terms “osteosarcoma,” “bone sarcoma,” and “sarcoma” were entered into Google.com, and were classified according to the availability of osteosarcoma-specific web pages. Unpaid monthly visits were assessed using the Ahrefs.com Organic Traffic Score (OTS) metric. Readability was assessed using 5 validated metrics and the composite grade level (CGL), the rounded mean of the 5 metrics.

Results:
Of the 71 NCIDCCs and 50 pediatric hospitals, 48 (67.6%) and 18 (36.0%), respectively, did not have at least 1 web page dedicated to osteosarcoma-specific OPI. The mean OTS for all 116 NCIDCC and pediatric hospital osteosarcoma-specific web pages assessed was 177 estimated visits per month, which was less than the mean OTS for the top 10 Google.com “osteosarcoma” search results (3,287.9; p < 0.001). The 52 NCIDCC web pages with osteosarcoma OPI (representing 23 centers) had an average CGL of 12.9, representing a readability level of at least a high school degree. The mean CGL for the 64 pediatric hospital web pages with osteosarcoma OPI (representing 32 hospitals) was 12.8, also representing readability of at least a high school degree. Only 8 (12.5%) of the 64 web pages were written at a seventh or eighth-grade level.

Conclusions:
Taken together, the majority of NCIDCCs and pediatric hospitals did not have a dedicated page of OPI for osteosarcoma. Of those that did, NCIDCC and pediatric hospital sites were visited much less frequently than sites visited through the most common Google.com searches. None of the osteosarcoma web pages offering OPI from NCIDCCs and pediatric hospitals met the American Medical Association readability recommendation (sixth-grade reading level). Therefore, greater effort must be made to create and direct patients and parents toward high-quality OPI of the appropriate level.

Clinical Relevance:
The clinical relevance of this study lies in its evaluation of OPI and its ability to impact the patient experience of clinical care.
Mechanics of SAGD Efficiency Improvement Using Combination of Chemicals: An Experimental Analysis through 2D Visual Models
Authors: Huang Jingjing , Babadagli Tayfun 
Published: August 2020

Summary
Steam-assisted gravity drainage (SAGD) is (and will be) a dominating method for in-situ recovery of heavy oil and bitumen in Canada. Its efficiency, however, has been a chronic problem due to the excess use of water and energy causing inflated costs. Solutions are needed to both maintain the production, especially at the late stages, and reduce the amount of steam. One method to improve efficiency is injection of chemicals with steam. This study addresses this problem by focusing on three critical aspects of SAGD: sweep improvement (faster and larger chamber growth), better displacement efficiency (lower residual oil), and reducing the amount of steam (lower steam/oil ratio and lowered steam temperature). By addressing these issues, we provide answers for the proper formulation of chemical blends, optimal injection strategies (continuous or slug), and the right time to introduce chemicals (beginning, midstream, or mature phase).
The efficiency of a single chemical additive in recovery improvement is limited because it serves for only one of the mechanisms previously listed. For a better performance, blending chemicals with different functionalities was proposed in this study. Additives showing the highest microscopic oil displacement efficiency (heptane, Novelfroth® 190) and the highest areal sweep efficiency EA [LTS-18, silicon dioxide (SiO2) nanoparticle, Tween™ 80, deep eutectic solvent (DES) 11] in our previous studies were selected. Eleven different combinations of these six chemical additives were tested for different injection strategies, and the SAGD process was visualized on Hele-Shaw cells filled with heavy oil. The interaction between different chemical additives was determined by analyzing emulsification, wettability alteration, and the growth and shape of the steam chamber. The optimal formulation and ideal injection strategy were selected by analyzing ultimate EA, microscopic oil displacement efficiency, ultimate oil recovery, energy and water consumption, and the price of chemical additives.
The interaction rule of combined chemical additives and their contribution to the recovery during SAGD were clarified, and the optimal injection strategies (best blends and proper time to introduce chemicals) were identified to provide a reference for chemical selection for field applications. This is a critical attempt to reduce the steam/oil ratio (particularly the amount of steam used) in SAGD applications, especially at mature stages.
An Equivalent Representation of Multiple Hydraulic Fractures with a Fewer Number of Fractures
Authors: Dontsov Egor , Suarez-Rivera Roberto 
Published: August 2020

Summary
Multiple hydraulic fractures are often generated simultaneously from a wellbore to increase efficiency of reservoir stimulation. Numerical modeling of such a system of fractures is computationally costly, especially if the goal is to simulate numerous stages, each containing multiple fractures, on different wells, which is the current trend in the petroleum industry. To address the challenge, this study defines a method and a workflow to represent the simultaneous propagation of multiple fractures with a reduced number of equivalent fractures that accurately describes the overall fracture geometry, the created surface area, the propped surface area, the fluid leakoff, and the resulting induced stresses, as resulting from the original configuration. A hybrid approach is used, in which a combination of physical modeling and data science is involved. We first develop a database of numerical solutions using a fully coupled hydraulic fracturing simulator. The equivalent fracture representation is quantified for each set of problem parameters presented in the database. Then, the results of the database solutions are used to tackle more general cases with field pumping schedules and rock properties. Several numerical examples are presented to validate and illustrate the developed concept.
Dental care for drug users in Norway: Dental professionals’ attitudes to treatment and experiences with interprofessional collaboration
Authors: Hovden Ewa , Ansteinsson Vibeke , Klepaker Ingrid Volden , Widström Eeva , Skudutyte-Rystad Rasa 
Published: August 2020

Abstract
Background: The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs). Methods: The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with RIs. The Norwegian Centre for Research Data (NSD) approved the study.Results: Thirty-five percent of the dentists and 10% of the dental hygienists had treated five or more drug users per month (p < 0.05). The majority of dentists and dental hygienists used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. Multivariable logistic regression analyses showed that attitudes and experiences with dental treatment of drug users were significantly associated with background characteristics of professionals. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs . Most of the respondents agreed that personnel from RIs could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment.Conclusions: Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users’ expectations. Attitudes and experiences related to dental treatment of drug users were significantly associated with background characteristics of clinicians. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.
Younger age of patients with myocardial infarction is associated with a higher number of relatives with a history of premature atherosclerosis.
Authors: Ambroziak Michał , Niewczas-Wieprzowska Katarzyna , Maicka Agnieszka , Budaj Andrzej 
Published: August 2020

Abstract
Background. Premature coronary artery disease is one of the most pressing global issues in modern cardiology. The aim of the study was to investigate the role of family history of premature cardiovascular disease (CVD) in patients aged <50 years with myocardial infarction (MI) compared to that in patients aged ≥50 years with MI and to that in young people without MI (no-MI<50). Methods. The studied group (MI<50) consisted of 240 patients aged 26-49 years with MI. The control groups consisted of 240 patients (MI≥50) with MI aged 50-92 years and 240 healthy people aged 30-49 years without a history of MI (no-MI<50). Results. There were statistically significant differences between the MI<50 and MI≥50 and no-MI<50 groups regarding the family history of premature MI/ischaemic stroke and the percentage of patients with ≥2 relatives affected (10.8%, 2.9%, and 3.7%, respectively; p<0.0001). There was a statistically significant difference in the patient age at the first MI occurrence among patients without a family history of premature CVD, those with 1 affected relative, and those with ≥2 affected first-degree relatives (56.6, 48.6 and 41.8 years, respectively) as well as those with affected first- and second-degree relatives (56.5, 50.7 and 47.0 years, respectively). Conclusions. A younger age of patients with myocardial infarction is associated with a higher number of relatives with a history of premature MI/ischaemic stroke. Thus, the family history of premature atherosclerosis involving not only first- but also second-degree relatives seems to be a valuable factor in CVD risk evaluation in young people.
Molecular epidemiology and risk factors of Stenotrophomonas maltophilia infections in a Chinese teaching hospital
Authors: Duan Zhongliang , Qin Juanxiu , Liu Yao , Li Cui , Ying Chunmei 
Published: August 2020

Abstract
Background: Stenotrophomonas maltophilia (S. maltophilia) is an important opportunistic pathogen that can be isolated in hospitals. With the abuse of broad spectrum antibiotics and invasive surgical devices, the rate of S. maltophilia infection is increasing every year. This study is an epidemiological analysis of the clinical and molecular characteristics of S. maltophilia infection in a Chinese teaching hospital. The goal is to obtain a comprehensive understanding of the status of S. maltophilia infection in order to provide strong epidemiological data for the prevention and treatment of S. maltophilia infection.Results: A total of 93 isolates from Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine were included, in which 62 isolates were from male patients and 81 isolates were isolated from sputum samples. A total of 86 patients had underlying diseases. All of the patients had received antibiotic therapeutics. The multilocus sequence typing (MLST) analysis indicated that 61 different sequence types (STs) were found (including 45 novel STs), and the MLST did not show significantly dominant STs. Pulsed field gel electrophoresis (PFGE) results showed the 93 isolates could be divided into 73 clusters, and they also showed weak genetic linkage between isolates. The resistant rates to Trimethoprim/sulfamethoxazole (TMP/SMX) and levofloxacin were 9.7% and 4.3%, respectively, and all of the isolates were susceptible to minocycline. The positive rates of the four virulence genes Stmpr1, Stmpr2, Smf-1, and Smlt3773 locus were 79.6%, 91.4%, 94.6%, and 52.7%, respectively. The positive rates of the three biofilm genes rmlA, spgM, and rpfF were 82.8%, 92.5%, and 64.5%, respectively. The mean biofilm forming level of OD492 was 0.54 ± 0.49, and there was no significant difference between different genders and different age groups. Data from patients in the intensive care unit (ICU) and the control group were analyzed retrospectively, and the independent risk factors of those who were infected in the ICU included immunosuppression and the increased of the antibiotics usage.Conclusions: Most of the patients had prior medical usage histories and baseline diseases. The positive rate of virulence genes was high, the drug resistance rate of S. maltophilia was low, and the biofilm formation ability was strong. The increased use of antibiotics was an independent risk factor for S. maltophilia infection, which should receive more attention. No obvious clonal transmission was found in the same department.
Neutrophil to Lymphocyte Ratio as a predictor for diagnosis of early Periprosthetic Joint Infection
Authors: Yu BaoZhan , Fu Jun , Chai Wei , Hao LiBo , Chen Jiying 
Published: August 2020

Abstract
Background: Periprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. Thediagnosis of PJI is very difficult, especially in the early postoperative period . The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty. Methods: We retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018.There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR, interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter.The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated. Results: The CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The median of CRP was 66.6 mg/l in the infected group and 8.6mg/l in the uninfected group (p<0.001). The median of ESR was 34.8 mm/hr in the infected group and 17.4mm/hr in the uninfected group (p<0.001). In the infected group and uninfected group, the median of WBC was 8.2X10 9 /L and 6.1 X10 9 /L (p = 0.002), respectively; while the median of NLR was 5.2 and 2.1 (p<0.001). The median of IL-6 was 46pg/ml and 6.4pg/ml (p<0.001),respectively.The best parameter for the diagnosis of early PJI was IL-6 (AUC=0.814) followed by the NLR (AUC =0.802), CRP (AUC =0.793), ESR (AUC =0.744) and WBC (AUC = 0.632). Conclusions: This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.
Intramedullary reaming and irrigation and antibiotic-loaded calcium sulfate implantation for the treatment of infection after intramedullary nailing: a retrospective study of 19 cases
Authors: Zhang Hong-An , Zhou Chun-Hao , Meng Xiang-Qing , Fang Jia , Qin Cheng-He 
Published: August 2020

Abstract
Background: The incidence of intramedullary infection is increasing with increased use of intramedullary fixation for long bone fractures. However, appropriate treatment for infection after intramedullary nailing is unclear. The purpose of this study was to report the results of our treatment protocol for infection after intramedullary nailing: intramedullary nail removal, local debridement, reaming and irrigation, and antibiotic-loaded calcium sulfate implantation with or without segmental bone resection and distraction osteogenesis. Methods: We retrospectively reviewed the records of patients with an infection after intramedullary nailing treated from 2014 to 2017 at our center. Patients with follow-up of less than 24 months, received other treatment methods, or those with serious medical conditions were excluded from the analysis. Patients met the criteria were treated as described above, followed by distraction osteogenesis in 9 cases to repair bone defect. The infection remission rate, infection recurrence rate, and post-operative complication rates were assessed. Results: A total of 19 patients were included in the analysis. All of patients had satisfactory outcomes with an average follow-up of 38.1 ± 9.4 months (range, 24 to 55months). Eighteen patients (94.7%) achieved infection remission; 1 patient (5.3%) developed a reinfection that resolved after repeat debridement. Nine patients with bone defects (average size 4.7 ± 1.3 cm; range, 3.3 to 7.6 cm) were treated with bone transport which successfully restored the length of involved limb. The mean bone transport duration was 10.7 ± 4.0 months (range, 6.7 to 19.5 months). The majority of patients achieved full weight bearing and became pain free during the follow-up period. Postoperative complications mainly included prolonged aseptic drainage (7/19; 36.8%), re-fracture (1/19; 5.3%) and joint stiffness, which were successfully managed by regular dressing changes and re-fixation, respectively. Conclusion: Intramedullary nail removal, canal reaming and irrigation, and antibiotic-loaded calcium sulfate implantation (with or without distraction osteogenesis) is effective for treating infections after intramedullary nailing.