bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Operating Room Size on Orthopaedic Surgical Site Infection Rates
Authors: Tantillo Tyler , Petrone Brandon , Stapleton Erik , Frane Nicholas , Matai Prashant , Lutsky Larry , Schilling Mary , Armellino Donna , Katsigiorgis Gus , Bitterman Adam 
Published: January 2021

Objective:
With many preventable causes of surgical site infections (SSIs) identified, the effect of operating room (OR) size on SSI rates has not been assessed. This study investigated the effect of OR size on incidence of SSIs for orthopaedic procedures.

Background:
SSIs remain a common complication within the perioperative realm. Responsible for increasing length of hospitalization and costs, SSIs result in a decreased quality of life for patients.

Methods:
A retrospective review of 11,163 patients who underwent orthopaedic surgery—including total knee and hip arthroplasties, laminectomies, and spinal fusions—between January 2018 and January 2020 were reviewed. Total net square footage (NSF) of all ORs was recorded, and incidence of SSIs was calculated. Cases were categorized based on the size of the OR (small: 250 to 399 NSF; medium: 400 to 549 NSF; and large: 550 to 699 NSF). Chi-square analysis compared infection rates between the different OR sizes, and a binary logistic regression model identified other predictors of infection.

Results:
Overall, 137 patients (1.2%) developed an SSI. Of these infections, 16 (11.7%) occurred in small ORs, 83 (60.6%) in medium ORs, and 38 (27.7%) in large ORs. The incidence of SSIs was 0.7% in small ORs, 1.3% in medium ORs, and 1.8% in large ORs. Factors found to significantly impact SSI's included medium-sized ORs, younger patients, procedure type (fusions and emergencies/traumas), longer procedures, and higher American Society of Anesthesiologists scores (>3).

Conclusion:
Our study shows that OR size in addition to various other perioperative parameters plays a role in the rate of SSIs for orthopaedic procedures.

Level of Evidence:
Retrospective Cohort Study; Level III Evidence
A Community Orthopaedic Residency Approach to Education and Training During the COVID-19 Pandemic
Authors: Oguayo Chris C. , Chu Jennifer , Jones Alan L. 
Published: January 2021

Background:
The COVID-19 pandemic has rapidly affected all facets of everyday life including the practice of medicine. Hospital systems and medical practices have evolved to protect patients, physicians, and staff and conserve personal protective equipment and resources. Orthopaedic practices have been specifically affected by social distancing and stay at home guidelines, limiting in-office practice and elective surgery restrictions. This, in turn, has had an effect on resident education. Previous literature has been published regarding how academic programs have adjusted to these changes. However, the effects on smaller orthopaedic residencies with nonacademic faculty has not been discussed. The orthopaedic residency at Baylor University Medical Center of Dallas is a fifteen-resident program with a combination of hospital employed and private practice faculty. We adjusted our resident education in mid-March 2020 to keep residents safe while trying to maximize surgical and clinical education and outside research.

Goals:
Our goals were to come up with a plan allowed for continuing high-level patient care and resident education while protecting residents and limiting burnout.

Model:
We devised a four-team system with five-day call periods. Interactions between teams were strictly minimized. We also moved to a web-based academic curriculum and devised a system for safe resident participation in surgical cases. The model has been adjusted based on attending and resident feedback.

Conclusion:
Until we develop effective treatments or vaccination for COVID-19, there is a possibility that it will be an ongoing threat. Resident education must also adapt to the changing environment while continuing to provide residents safe opportunities for patient care, didactic education, and research. We believe we have come up with a sustainable, adaptable model for resident education during this challenging time.
Interobserver Variation of PD-L1 SP142 Immunohistochemistry Interpretation in Breast Carcinoma: A Study of 79 Cases Using Whole Slide Imaging
Authors: Hoda Raza S. , Brogi Edi , D'Alfonso Timothy M. , Grabenstetter Anne , Giri Dilip , Hanna Matthew G , Kuba M. Gabriela , Murray Melissa P. , Vallejo Christina E. , Zhang Hong , Reis-Filho Jorge S. , Wen Hannah Y. 
Published: January 2021

Context.—
The Ventana programmed death ligand-1 (PD-L1) SP142 immunohistochemical assay (IHC) is approved by the US Food and Drug Administration as the companion diagnostic assay to identify patients with locally advanced or metastatic triple-negative breast cancer for immunotherapy with atezolizumab, a monoclonal antibody targeting PD-L1.

Objective.—
To determine interobserver variability in PD-L1 SP142 IHC interpretation in invasive breast carcinoma.

Design.—
The pathology database was interrogated for all patients diagnosed with primary invasive, locally recurrent, or metastatic breast carcinoma on which PD-L1 SP142 IHC was performed from November 2018 to June 2019 at our institution. A subset of cases was selected using a computerized random-number generator. PD-L1 IHC was evaluated in stromal tumor-infiltrating immune cells using the IMpassion130 trial criteria, with positive cases defined as immunoreactivity in immune cells in 1% or more of the tumor area. IHC was interpreted on whole slide images by staff pathologists with breast pathology expertise. Interobserver variability was calculated using unweighted κ.

Results.—
A total of 79 cases were assessed by 8 pathologists. Interobserver agreement was substantial (κ = 0.727). There was complete agreement among all 8 pathologists in 62% (49 of 79) of cases, 7 pathologists or more in 84% (66 of 79) of cases, and 6 pathologists or more in 92% (73 of 79) of cases. In 4% (3 of 79) of cases, all of which were small biopsies, pathologists' interpretations were evenly split between scores of positive and negative.

Conclusions.—
The findings show substantial agreement in PD-L1 SP142 IHC assessment of breast carcinoma cases among 8 pathologists at a single institution. Further study is warranted to define the basis for discrepant results.
Communicating Sustainable Tourism in English and Italian: A Contrastive Analysis
Authors: Lazzeretti Cecilia 
Published: January 2021

Sustainable tourism has become a popular field of research over the last decades; yet, while acknowledging that sustainable tourism requires communication strategies different from those of mainstream tourism, scholars have paid little attention to this area of language. Based on two parallel corpora, this study explores the discursive representation of sustainable tourism in web communication in English and in Italian. The methodological framework adopted is that of Corpus Assisted Discourse Studies. The analysis suggests that the Italian representation of sustainable tourism is characterized by a distant stance towards readers and relies on a strong polarization between ‘good’ tourism and ‘bad’ tourism. Communication in English instead relies on proximal person deixis and on the creation of value around responsible tourism by means of factual information rather than on mere evaluation.
Differential Impact of School Segregation in the Performance of Native and Non-Native Students in Spain
Authors: Murillo F. Javier , Belavi Guillermina 
Published: January 2021

Abstract
There is evidence of the impact of school segregation on students’ academic achievement, but it is debated whether the extent of this impact is dependent on students’ socioeconomic status, or on their native or non-native condition. This research addresses the problem in Spain, seeking to determine how immigrant and socioeconomic segregation affect the academic achievement of native and non-native students. With this aim, the PISA study database was specially exploited by means of two-tier Multilevel Models, estimating school segregation through the Hutchens Square Root Index. Specifically, the study estimates the influence of school segregation on students’ academic achievement in the subjects of Mathematics, Language and Science. The results confirm that school socioeconomical and immigrant segregation affect students’ academic achievement differently. Whereas socioeconomic segregation negatively affects both groups in all three subjects, immigrant segregation affects non-native students more strongly. Thus, data shows school segregation on socioeconomic grounds is always significant, and always has a considerable impact on achievement, regardless of students’ national origin. School segregation reproduces and accentuates conditions of social injustice. To counter its harmful effects, it is necessary to act first and foremost on socioeconomic segregation, as this causes the most devastating effects in education, particularly for non-native students.
The Teacher-Student Relationship in the Use of Social Network Sites for Educational Purposes: A Systematic Review
Authors: Camas Garrido Laura , Valero Moya Aída , Vendrell Morancho Mireia 
Published: January 2021

Abstract
This paper aims at exploring the educational scholarly writing on the teacher-student relationship and performance within the use of Social Network Sites (SNSs) for educational purposes. To that end, a systematic review of 111 journal articles focused on young people, and found in ten relevant databases (ERIC, SCOPUS, WOS, JCR (SSCI), DOAJ, EBSCO, ISOC, REDIB, JSTOR, and PsycARTICLES), has been performed. The results show continuity in the roles of educators and students between physical and virtual spaces. This homogeneous conceptualisation is grounded on student-centred theories. Also, the existence of a theoretical confrontation between the figurative dichotomy of vertical (distance) and horizontal (closeness) teacher-student relationship is revealed and discussed. While most of the reviewed studies focused on requirements for technical training, the need for acquiring digital cultural knowledge is stressed. Finally, some of the educational implications of the ethical dimension of the teacher-student relationship in digital spaces are exposed.
Performativity of Materials in Learning: The Learning-Whole in Action
Authors: Carvalho Lucila , Yeoman Pippa 
Published: January 2021

Abstract
Contemporary educational practices have been calling for pedagogical models that foreground fexibility, agency, ubiquity, and connectedness in learning. Tese models have, in turn, been stimulating redevelopments of educational infrastructure –with physical contours reconfgured into novel complex learning spaces at universities, schools, museums, and libraries. Understanding the complexity of these innovative learning spaces requires an acknowledgement of the material and digital as interconnected. A ‘physical’ learning space is likely to involve a range of technologies and in addition to paying attention to these ‘technologies’ one must understand and account for their physical sites of use as well. Tis paper discusses the infuence of materiality in learning, using an analytical approach that situates learning activity as an emergent process. Drawing on theories that foreground socio-materiality in learning and on the relational perspective ofered by networked learning, we call for a deeper understanding of the interplay between the physical (material and digital), conceptual, and social aspects of learning, and their combined infuence on emergent activity. Te paper argues that in order to successfully design for innovative learning, educators need to develop their capacity to trace the intricate connections between people, ideas, digital and material tools, and tasks –to see the learning-whole in action.
There Is No ‘Virtual Learning’: The Materiality of Digital Education
Authors: Gourlay Lesley 
Published: January 2021

Abstract
The distinction between face-to-face and distant digitally-mediated educational engagement is a complex one, and the two modes are often combined in practice, via ‘blended learning’ or the use of a VLE to support campus-based teaching. The current Covid-19 pandemic has thrown this distinction into relief, in a context where educationalists have been forced to move to fully distant engagement in a very short timeframe. This paper explores how this predicament has brought to the fore the nature of our engagement with digital knowledge practices and screen-based communication, arguing that the notion of ‘virtual learning’ is a flawed one. Instead, adopting a sociomaterial perspective, it argues that all aspects of digital engagement are in fact grounded in material and embodied entanglements with devices and other artefacts.
The Topologies of Data Practices: A Methodological Introduction
Authors: Decuypere Mathias 
Published: January 2021

Abstract
This paper offers a methodological framework to research data practices in education critically. Data practices are understood in the generic sense of the word here, i.e., as the actions, performances, and the resulting consequences, of introducing data-producing technologies in everyday educational situations. The paper first distinguishes between data infrastructures, datafication and data points as three distinct, yet interrelated, phenomena. In order to investigate their concrete doings and specificities, the paper proposes a topological methodology that allows disentangling the relational nature and interwovenness of data practices. Based on this methodology, the paper proceeds with outlining a methodical toolbox that can be employed in studying data practices. Starting from nascent work on digital education platforms as a worked example, the toolbox allows researchers to investigate data practices as consisting of four unique topological dimensions: the Interface of a data practice, its actual Usage, its concrete Design, and its Ecological embeddedness - IUDE.
Wiener Index of Fuzzy Graph by Using Strong Domination
Authors: Emrany Saqr H. AL- , Shubatah Mahiuob M. Q. 
Published: January 2021

Aims/ Objectives: This paper presents a new method to calculate the Wiener index of a fuzzy graph by using strong domination number s of a fuzzy graph G. This method is more useful than other methods because it saves time and eorts and doesn't require more calculations, if the edges number is very larg (n). The Wiener index of some standard fuzzy graphs are investigated. At last, we nd the relationship between strong domination number s and the average (G) of a fuzzy graph G was studied with suitable examples.
Assessment of the Efficacy of Nebulized 3% Hypertonic Saline versus Nebulized Adrenaline in Infants with Acute Bronchiolitis
Authors: Elkhateeb Nancy Elsayed Abdel Gawad , Hamza Mohamed Bassiony , Shafiey Rasha Mohamed Gamal El , Razik Ahmed Mohamed Abdel- 
Published: January 2021

Aims: The aim of the work was to assess the efficacy of nebulized 3% hypertonic saline versus nebulized adrenaline in treatment of acute bronchiolitis in infants as supportive therapy with conventional therapy.
Place and Duration of Study: Pediatric Pulmonology Unit (PPU), Tanta University Hospital (TUH), was applied during the period from April 2019 to April 2020.
Methodology: We included ninety infants with moderate to severe acute bronchiolitis were selected, enrolled in the study and randomized into 3 groups: Group A: thirty patients were received nebulized 3% hypertonic saline plus conventional therapy. Was started from first day of admission till RADI score became 4. Group B: thirty patients were received nebulized adrenaline plus conventional therapy. Was started from first day of admission till RADI score became 4. Group C: thirty patients were received conventional therapy. Was started from first day of admission till RADI score became 4. They were subjected to history taking, clinical assessment and investigations (CXR, ECHO, CBC and CRP). Follow up done in Chest Clinic four day after discharge.
Results: There was statistically significant difference between studied groups as mean duration of O2 supplementation was significantly shorter in group B than in group A than in group C (p-value<0.05). On admission, mean RR in group B was significantly higher than those in groups A and C (p-value=0.05), On 5th day, mean RR in group B was significantly lower than those in groups A and C (p-value= 0.05). On admission, mean HR in group B was significantly higher than those in groups A and c (p-value =0.05) On 5th days, mean HR in group B was significantly lower than those in groups A and C (p-value= 0.05), with no statistically significant difference between groups A and C. length of hospitalization in studied groups group B showed significantly shorter need for hospital stay than that in groups A and C, with no statistically significant difference between group A and C.
Conclusion: When comparing between inhalation of adrenaline and hypertonic saline 3% in acute bronchiolitis adrenaline improve RD, oxygenation and decrease length of hospitalization.
Rifampin-divalproex drug-drug interaction in an adult patient: A case report
Authors: Doran Christine , Moro Michael , Green Jennifer , Gardner Kristen N. 
Published: January 2021

Abstract
The divalproex (DVP) package insert states that rifampin may increase the oral clearance of valproate by 40% and that valproic acid derivative dose adjustments may be required when starting or stopping rifampin. However, the overall clinical significance of this drug-drug interaction remains unclear given that limited clinical outcome data has been published. This case describes a 52-year-old female with bipolar disorder, borderline personality disorder, and PTSD who was previously stable on a medication regimen consisting of DVP delayed-release 500 mg every morning and 1500 mg every evening (baseline steady-state trough 99.8 mcg/mL). Throughout rifampin therapy for latent tuberculosis treatment, she required an increase in both the frequency of DVP administration, from 2 to 3 times daily, and DVP dose by 75% to maintain clinical stability. Valproic acid trough concentrations ranged from 56.4 to 75.9 mcg/mL during the 4-month course of rifampin. This report supports that the DVP-rifampin interaction may be clinically significant and of a greater magnitude than suggested by the package insert.
Formation of branched polyethylenes by ethylene homopolymerization using LNiBr2 homo‐ and heterogeneous precatalysts: Interpretation of the polymer structures in comparison with commercial LLDPE
Authors: Matsko Mikhail A. , Semikolenova Nina V. , Zakharov Vladimir A. , Soshnikov Igor E. , Shundrina Inna K. , Sun Wen‐Hua 
Published: January 2021

AbstractComparative data on the micro‐structures and properties of branched polyethylenes (BPE) produced via ethylene homopolymerization over homogeneous N,N‐α‐diimine LNiBr2 complexes with different ligand composition (AlEt2Cl as a cocatalyst) and corresponding supported catalysts LNiBr2/SiO2(Al) (Al[iso‐Bu]3 as a cocatalyst) are presented. Noticeable differences were observed between micro‐structures of BPEs obtained using homo‐ and heterogeneous LNiBr2 complexes as catalysts. Supported catalysts produce BPEs with the majority of methyl branches (17–18 CH3(1000 C)−1 characterized by different molecular masses (1800–210 kg mol−1) and molecular weight distributions (Mw[Mn]−1 = 5.9 and 2.6). Thermal and mechanical properties of these BPE samples obtained over supported Ni catalysts are similar to those of commercial LLDPE samples prepared with metallocene and Ziegler‐Natta catalysts.
Preoperative undernutrition predicts postoperative complications of acute empyema
Authors: Sakai Takashi , Sano Atsushi , Azuma Yoko , Koezuka Satoshi , Otsuka Hajime , Shimizu Hiroshige , Kishi Kazuma , Iyoda Akira 
Published: January 2021

AbstractIntroductionSurgery for acute empyema is associated with postoperative complications and relapse. Establishing a predictor for postoperative complications may improve prognosis.ObjectivesTo demonstrate undernutrition as a predictor of complications after surgery for acute empyema.MethodsWe retrospectively analyzed 52 consecutive patients who underwent surgery for acute empyema from 2004 to 2019 and validated the correlation of undernutrition with serum albumin level, patient characteristics, hospital stay, and postoperative complications.ResultsThe median preoperative serum albumin level was 2.4 g/dL (range: 1.1‐3.4). The levels in all patients were lower than the standard value (3.5 g/dL). Patients were divided into two groups based on the median serum albumin levels: the low serum albumin level group (group L, n = 28) and the high serum albumin level group (group H, n = 24). Group L patients were significantly older (64.5 vs 52.9 years, P = .002), had lower median body mass index (21.0 vs 24.2, P = .008), and significantly had Streptococcus anginosus group as the causative bacteria (50% vs 21%, P = .044). Their hospitalization duration was significantly longer (28.1 vs 14.8 days, P < .001), and postoperative complications were significant or tended to be more frequent (all incidence; 11 (39%) vs 2 (8%), P = .012, respiratory‐related; 7 (25%) vs 1 (4%), P = .056) in group L. Further analyses revealed that other undernutrition indicators also correlated with postoperative complications.ConclusionsPreoperative serum albumin level is a valid predictor of complications after surgery for acute empyema. Preoperative nutrition management for empyema patients may reduce the occurrence of postoperative complications.
Factors influencing the ability to honour debt repayment obligations by Governments in Africa
Authors: Abotsi Anselm K. 
Published: January 2021

AbstractThe debt overhang in the 1990s among African countries significantly constrained fiscal space and had a devastating effect on economic development. With the current rising levels of public debt, this study seeks to explore the factors that influence the ability of governments to honour their debt repayment obligations. The study used secondary data from the World Development Indicators and World Economic Outlook. The frequency of the data is annual from 1980 to 2019. The fixed and random effects panel data estimation technique was deployed. Deploying fixed and random panel data estimation techniques while controlling for other variables, the study shows that government gross debt and total investment have a positive influence on the ability to honour debt repayment obligations while government expenditure and current account balance have a negative influence. Prudent government expenditure, financing of productive public investment, and implementation of export‐oriented policies are recommended.
Building youth leadership skills and community awareness: Engagement of rural youth with a community‐based leadership program
Authors: T. Puxley Shane , Chapin Laurie A. 
Published: January 2021

AbstractAimsCommunity leadership programs have the potential to positively impact many aspects of young people's development, as well as the community. This study, therefore, aims to understand the experiences of the young people, particularly rural youth, involved with the Western Bulldogs Youth Leadership Project (WBYLP), a 7‐month program for Year‐9 and Year‐10 students, and if the developmental assets are a good framework to inform future program development.MethodA transformative mixed‐methods design was used and included surveys with 96 participants at two time points, and semistructured interviews with eight participants.ResultsQuantitatively leadership significantly increased, particularly due to increases in the domains of understanding self and decision‐making skills. Social competencies increased, though total developmental assets did not. Interviews identified four primary themes: Perspective taking, self‐efficacy, community awareness, and decreased isolation.ConclusionsThese results indicate that participants developed both individual skills relating to leadership and social skills. The participants also developed their awareness of the issues in their community.