bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Same-Day Discharge Total Joint Arthroplasty and Risk of 90-Day Adverse Events in Patients with ASA Classification of ≥3
Authors: Reddy Nithin C. , Prentice Heather A. , Paxton Elizabeth W. , Hinman Adrian D. , Lin Abraham G. , Navarro Ronald A. 
Published: September 2021

Background:
Although safety in same-day discharge total joint arthroplasty (TJA) has been reported, findings are limited to healthier patients, specific surgeons, and/or specific institutions. Indications for same-day discharge TJA have expanded to include patients with multiple comorbidities; however, safety in this specific patient population remains unknown. Therefore, we sought to compare the risk of 90-day adverse events in higher-risk patients undergoing same-day discharge versus inpatient TJA.

Methods:
The Kaiser Permanente Total Joint Replacement Registry was utilized to conduct a cohort study. All patients with an American Society of Anesthesiologists (ASA) classification of ≥3 who underwent primary elective TJA for osteoarthritis from 2017 through 2018 were identified. The risk of 90-day adverse events (i.e., emergency department visits, unplanned readmissions, complications, and mortality) was evaluated with use of propensity score-weighted Cox proportional hazard regression including noninferiority testing with a margin of 1.10.

Results:
The cohort included a total of 5,250 patients who underwent total hip arthroplasty and 9,752 patients who underwent total knee arthroplasty, of whom 1,742 (33.2%) and 3,283 (33.7%) had same-day discharge, respectively. Same-day discharge hip arthroplasty was noninferior to an inpatient stay in terms of emergency department visits (hazard ratio [HR], 0.73; 1-sided HR 95% upper bound [UB], 0.84), readmissions (HR, 0.47; 95% UB, 0.61), and complications (HR, 0.63; 95% UB, 0.75); we did not have evidence of noninferiority for mortality (HR, 0.84; 95% UB, 1.97). Same-day discharge knee arthroplasty was noninferior to an inpatient stay in terms of emergency department visits (HR, 0.79; 95% UB, 0.87), readmission (HR, 0.80; 95% UB, 0.95), complications (HR, 0.72; 95% UB, 0.82), and mortality (HR, 0.53; 95% UB, 1.03).

Conclusions:
We found that same-day discharge TJA did not increase the risk of emergency department visits, unplanned readmissions, and complications compared with an inpatient stay for higher-risk patients, suggesting that it is possible to expand indications for same-day discharge TJA in the hospital setting while maintaining safety.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Applying The Principle of Insurance on The Credit Life Insurance in The Consumer Lending
Authors: Kurniawan Faizal , Thalib Prawitra , Sabrie Hilda Yunita 
Published: September 2021

The specific task of the commercial banks are as follows: the bank must distribute most of the credit for developing the activities of the cooperatives and entrepreneurs economically weak or small entrepreneurs, the public banking that provides credit in foreign currency required to distribute some the foreign currency credit to finance the activities of non-oil exports and required to perform an assessment of the fulfillment the terms of the feasibility of the debtor's business. In carrying out its functions, the bank must still run banking principles contained in the articles contained in the Banking Act. It is often in distribute the credit, the bank requires the third party, such as the insurance companies. The purpose of insurance companies is to minimize the risks that may be experienced by the bank as debtors failed to pay. The bank is very concerned with their insurance company. There are various types of loans that cannot be separated by the insurance, this study focuses on consumer credit in PT. Bank Jatim. In practice, especially consumer credit lending cannot be separated from the role of the insurance companies. But in operating the bussiness, the insurance companies should also continue to apply the principles of general insurance. The application of the insurance principle is intended that no aggrieved parties. Generally speaking, there will be a conflict of interest between the application of the principles of insurance carried by the insurance company as an insurer with the business aspect of the field of insurance and banking.
Geological and Geochemical Characteristics of the Geothermal Resources in Rucheng, China
Authors: Long Xiting , Xie Heping , Deng Xinping , Wen Xiangyue , Ou Jian , Ou Renwen , Wang Jun , Liu Fei 
Published: September 2021

Abstract
The development of geothermal energy promotes the changing of energy consumption structure in China. A series of experiments were performed to evaluate the geothermal resources of Rucheng County, which is the largest geothermal field in Central South China. The experiments include geothermal exploration, apparent resistivity, and determining the geochemical characteristics of the geothermal water. The experimental results show that the F3 fault zone and F1 hanging wall secondary fault are the main thermal control, heat conduction, water diversion, and thermal storage structures. The pH, EC, and Eh of the river water, shallow groundwater, and geothermal water exhibit seasonal changes. The pH and EC of the geothermal water are higher than those of the river water and shallow groundwater, while the Eh is lower. In addition, the corrosivity coefficient Kk and the Ryznar index are used to evaluate the corrosivity and calcium carbonate scaling of the geothermal water, and it is found that the geothermal water has no corrosiveness or calcium carbonate scaling, which indicates that the geothermal energy in Rucheng County has wide application prospects.
Elucidating the Pollution Sources and Groundwater Evolution in Typical Seawater Intrusion Areas Using Hydrochemical and Environmental Stable Isotope Technique: A Case Study for Shandong Province, China
Authors: Chen Guangquan , Xiong Guiyao , Lin Jin , Xu Xingyong , Yu Hongjun , Liu Wenquan , Fu Tengfei , Su Qiao , Wang Yancheng , Dai Yunfeng , Ali Imran , Zheng Xilai , Peng Changsheng 
Published: September 2021

Abstract
Seawater intrusion has a serious impact on industry, agriculture, and people’s daily life. Thus, the present study was designed to elucidate the pollution sources and groundwater evolution in typical intrusion areas of Shandong Province by hydrochemistry and environmental isotope techniques. The water samples were collected to analyze the groundwater evolution under different intrusion, and groundwater evolution in the south of Laizhou Bay from 2005 to 2019. The findings indicated that the groundwater level dropping funnel caused by overexploitation was the direct causation of seawater intrusion in the three typical intruded areas. The groundwater evolution paths demonstrated that the groundwater in the south of Laizhou Bay had the fastest evolution rate and the highest degree of evolution, followed by the Dagu River Basin. The groundwater evolution extent and fitting of mixing lines indicated that the groundwater in the south of Laizhou Bay, Longkou, and Dagu River Basin was dominated by palaeosaltwater intrusion, modern seawater intrusion, and sea-saltwater mixed intrusion, respectively. Palaeosaltwater mixing produces a more severe salinization effect compared to seawater mixing. Meanwhile, the isotopes are gradually enriched with the deepening of intrusion, while the decrease of isotopes is delayed compared with the saltwater retreat. This is caused by that the stable isotopes enriched in the aquiclude due to the chemical permeation effect will be released into the aquifer after the salinity attenuates in the aquifer. The palaeosaltwater intrusion caused by anthropogenic activities has promoted serious fluorine pollution in the south of Laizhou Bay, while the groundwater nitrate pollution in Longkou was the most serious, followed by the Dagu River Basin due to high-density agricultural and domestic activity.
Charged Domain Wall and Polar Vortex Topologies in a Room Temperature Magnetoelectric Multiferroic Thin Film
Authors: Moore Kalani , O'Connell Eoghan , Griffin Sinéad M. , Downing Clive , Colfer Louise , Schmidt Michael , Nicolosi Valeria , Bangert Ursel , Keeney Lynette , Conroy Michele 
Published: September 2021

Abstract
Multiferroic topologies are an emerging solution for future low-power magnetic nanoelectronics due to their combined tuneable functionality and mobility. Here, we show that in addition to being magnetoelectric multiferroic at room temperature, thin film Aurivillius phase Bi6TixFeyMnzO18 is an ideal material platform for both domain wall and vortex topology based nanoelectronic devices. Utilising atomic resolution electron microscopy, we reveal the presence and structure of 180˚ type charged head-to-head and tail-to-tail domain walls passing throughout the thin film. Theoretical calculations confirm the sub-unit cell cation site preference and charged domain wall energetics for Bi6TixFeyMnzO18. Finally, we show that polar vortex type topologies also form at out-of-phase boundaries of stacking faults when internal strain and electrostatic energy gradients are altered. This study could pave the way for controlled polar vortex topology formation via strain engineering in other multiferroic thin films. Moreover, these results confirm the sub-unit-cell topological features play an important role in controlling the charge and spin state of Aurivillius phase films and other multiferroic heterostructures.
Preoperative Ultrasound to Map the Three-dimensional Anatomical Distribution of the Lateral Femoral Cutaneous Nerve in Direct Anterior Approach for Total Hip Arthroplasty
Authors: Zhang Yu , Yao Yao , Wang Yexian , Zhuang Zaikai , Shen Ying , Jiang Qing , Chen Dongyang 
Published: September 2021

Abstract
Background：The postoperative complaints of hypoaesthesia or a burning sensation due to lateral femoral cutaneous nerve (LFCN) injury in patients is not yet solved. The present study aimed to identify the three-dimensional (3D) distribution of LFCN using preoperative ultrasound and evaluate the rate of injury in direct anterior approach for total hip arthroplasty. Methods： A total of 59 patients ( 28 males and 31 females, age 69.0 ± 4.6 years，BMI 24.7 ± 3.0 kg/m2) were randomly allocated to the ultrasound group and 58 patients ( 28 males and 30 females, age 68.5 ± 4.5 years, BMI 24.8 ± 2.8 kg/m2) were in the control group. Surgeons received the data of 3D distribution of LFCN only in the ultrasound group before surgery with respect to the direction, the depth on the skin, and the length to tensor fasciae latae (TFL). The anatomical characteristics of LFCN in the surgical region were summarized. At 1 and 3 months post-surgery, the rate of LFCN injury and abnormal sensitive area were evaluated in both groups. Results： There was a significant consistency in gender, age and BMI of these two groups (P>0.05). Based on the data from the ultrasound group, over 90% of patients had one or two branches of LFCN. LFCN always courses in the fascia layer, the depth ranged from 6.8±2.6 (3.0 ~12.0) mm to 11.1±3.4 (4.0 ~17.0) mm and depended on the thickness of the subcutaneous fat, and length was 3.3±4.6 (-5.0 ~10.0) mm at proximal part and -2.7±4.7 (-10.0 ~8.0) at distal end to the medial edge of TFL. Both the rate of LFCN injury and abnormal sensory area in the ultrasound group were significantly lower than those in the control group (3.4% VS 25.9%, P=0.001, at 1 month; 3.4% VS 22.4%, P=0.005, at 3 months).Conclusions： LFCN mostly courses along the medial border of TFL in the fascia layer. The 3D distribution of LFCN using preoperative ultrasound mapping could help the surgeons to evaluate the risk of injury preoperatively and decrease the rate of injury during the operation. However, some branch injuries, especially for the fan type LFCN, could not be avoided.
Expression of Slit and Robo During Remodeling of Corticospinal Tract in Cervical Spinal Cord in Middle Cerebral Artery Occlusion Rats
Authors: Ying Zhenhao , Wu Junxuan , Jiang Wenjun , Zhang Guoli , Zhu Weiming , Li Xin , Pang Xueyun , Liu Wei 
Published: September 2021

Abstract
Background: Slits and Robos were associated with the generation of axons of corticospinal tract during the corticospinal tract (CST) remodeling after the cerebral ischemic stroke (CIS). However, little is known about the mechanism of CST remodeling. In this study, we detected the expression of Slits and Robos in middle cerebral artery occlusion (MCAO) rats to investigate the roles of Slits and Robos in the CIS. Methods: MCAO model was established using modified Zea Longa method. Beam walking test (BWT) was conducted to evaluate the motor function. The images of the track of cortical spinal cord beam on day 7, 14 and 21 were observed by anterograde CST tracing. Biopinylated dextan amine (BDA) was used to mark CST anterogradely. Expression of GAP-43 mRNA and GAP-43 protein in cervical spinal cord was detected by Real-Time PCR and Western blot analysis, respectively. The expression of Slit1, Slit2 and Robo1 in cervical spinal cord was detected by immunofluorescence staining.Results: The scores in the model group were significantly reduced compared to sham-operation group on day 7 (P<0.001), 14 (P<0.001) and 21 (P<0.001), respectively. There was no significant difference in the score on day 7, 14 and 21 of the sham-operation groups (P>0.05). In contrast, significant increase was noticed in the scores in model group, presenting a time-dependent manner. More CST staining fibers could be observed at the degenerative side in the model group compared with that of the sham-operation group on day 21. GAP-43 mRNA expression in the model group showed significant increase compared to that of sham-operation group on day 14 (P=0.015) and 21 days (P=0.002). The expression of GAP-43 protein in model group showed significant increase compared to that of sham-operation group on day 14 (P=0.022) and day 21 (P=0.008), respectively. The expression of Slit1 and Slit2 showed increase on day 14 and day 21, while the expression of Robo1 showed significant decrease in MCAO rats.Conclusion: Up-regulation of Slit1 and Slit2 and the downregulation of Robo1 may be related to the axons of CST midline crossing in spinal cord of MCAO rat during the spontaneous recovery of impaired motor function.
Cultural Competence and Its Associated Factors Among Nurses Working in Tertiary Hospitals: A Cross-Sectional Study
Authors: Geleta Bonsa Amsalu , Radie Yosief Tsige , Areri Habtamu Abera 
Published: September 2021

Abstract
Background
Ethiopian nurses are facing a culturally diverse population predominantly due to the coexistence of multicultural and diverse ethnics in the country. This study aimed to assess the level of cultural competency and its associated factors among nurses working in tertiary hospitals of Addis Ababa, Ethiopia.
Methods
A cross-sectional study was conducted on nurses working in tertiary hospitals of Addis Ababa city from March 1 to April 30, 2018. A systematic random sampling technique was used to select 352 nurses. Data were collected using an English version self-administered cultural competence questionnaire for nurses scale. Data was entered into Epi data manager version 4.2.2 and exported to SPSS software version 20.0 and analyzed using descriptive statistics and inferential statistics.
Results
A total of 343 participants were involved in the study with a response rate of 97.4%. The overall cultural competence level of participants was low to moderate (1.94 ± 0.65) with the highest mean was scored for cultural sensitivity (2.54 ± 0.69) and the lowest mean was scored for cultural skill (1.62 ± 0.98). Participants’ age, religion, level of education, work experience, current role, spoken languages beside Amharic and English, previous cultural care education, work experience beside the current hospital, the experience of caring for diverse patients and availability of interpreter service were the factors significantly associated with cultural competence at p < 0.05.
Conclusion
The overall cultural competence of nurses was low to moderate and influenced by several factors. Therefore, nurses and other responsible bodies should struggle to improve the cultural competence of nurses. Furthermore, a national large-scale study with patient’s perspectives was recommended.
Impact of Web-Based Health Education on HPV Vaccination Uptake Among College Girl Students in Western and Northern China: A Follow-Up Study
Authors: Zhang Xi , Chen Hui , Zhou Jing , Li Jing , Huang Qian , Feng Xiao-yu 
Published: September 2021

Abstract
Objective: To investigate the knowledge of human papillomavirus (HPV) and HPV vaccines, HPV vaccination uptake, and vaccination willingness among female college students, and to explore the effect of a web-based educational intervention, immediately and at one month later, on HPV knowledge, vaccine acceptability and uptake among female college students in Western and Northern China. Methods: A web-based interventional follow-up study was conducted at two universities in Western and Northern China between February and April 2020. Female freshmen were required to complete an online questionnaire, and then eligible students were randomized into intervention and control group. Students in the intervention group received 7-days of web-based health education regarding HPV and HPV vaccines, while the control group received educational materials unrelated to HPV prevention. All students were asked to complete post-intervention questionnaire to assess their awareness, uptake, and willingness regarding HPV vaccination at a 7 days and 30 days interval, respectively. Differences between intervention and control groups were compared using the Chi-square test. Multivariable logistic regression was used to analyze the influencing factors of vaccination intentions. Results: A total of 967 participants were included in this study. Prior to the intervention, 63.8%, 66.3%, and 60.8% of students had heard of HPV, HPV-related diseases, and HPV vaccines, respectively. However, only 2.2% of students had reported to have been vaccinated, and 33.0% were willing to be vaccinated against HPV. After 7-days education, students in the intervention group had higher awareness and willingness of HPV vaccines than those in the control group. Major reasons that college female students do not accept HPV vaccines were the high cost (57.7%) and concerns about the adverse events (56.0%). School location, education background of parents, history of counseling about HPV vaccines, history of sexual behavior, and having heard of HPV vaccines are influencing factors on willingness to be vaccinated. Conclusion: The female college students’ HPV vaccination uptake is insufficient, and they have minimal detailed knowledge about HPV and its vaccines. Web-based health education on HPV vaccines is an easy, feasible, and effective way to improve the awareness and acceptance of HPV vaccination among female college students, but it has limited effect on improving HPV vaccination uptake.
Soil Loss and Erosion Potential Estimation of Jhimruk Watershed, Nepal
Authors: Pandey Parbati , Gurung Anup 
Published: September 2021

Abstract
The Revised Universal Soil Loss Equation (RUSLE) model was used in a Geographic Information System (GIS) to estimate the soil loss of the Jhimruk Watershed, Lumbini Province, Nepal. This research also aimed to calculate the erosional soil loss status of the local governments lying inside the watershed. For this, remote sensing data obtained from various sources were used to generate the factor maps to calculate the soil loss through RUSLE. A 13 year mean annual precipitation data from the 8 meteorological stations in and around the watershed was used to calculate the rainfall erosivity (R) factor. For the soil erodibility factor (K), the soil map of the watershed was clipped from the digital soil map of the world provided by FAO. Aster Digital Elevation Model of 30m resolution was used for the generation of LS factor map. For the computation of C-factor, the landcover map of the watershed produced in Arc GIS 10.2.1 through supervised classification of the Sentinal imagery of 10m resolution was used. The values were assigned based on the literatures in the case of C and P factors.The mean annual soil loss of the watershed was found to be 13.4 tons per hectare per year (t/ha/yr.). However, the soil loss was calculated to be as high as 182 t/ha/yr. 68.82% of the total area of the watershed lie under very low erosion class and thus have low conservation priority whereas 7.73 % of the total area lie under extremely high erosion class and thus have a conservation priority class of 1.The mean erosion rate from the barren land was found to be highest (23.179 t/ha/yr.) followed by agricultural (21.40 t/ha/yr.) and forest area had the lowest erosion rate i.e. 7.90 t/ha/yr.
Intravenous Ibuprofen 400 Versus 800 mg Every 6 Hours in Abdominal and Orthopedic Surgery: A Multicenter, Randomized Controlled Trial
Authors: Zhang Hong , Huang Ji-Han , Xu Hong-Meng , Chen Li , Zheng Hong , Hong Zheng-Hua , Chen Lei , Zhang Xi-Zhe , Liu Huai-Ping , Li Chao-Yu , Lu Qiu-Ye , Bai Yu-Jiang , Hu Zu-Rong , Zhang Ya-Kui , Ma Yong-Sheng , Zhou Xu-Yan , Feng Yi 
Published: September 2021

Abstract
Background: Multimodal postoperative analgesia with intravenous ibuprofen can reduce the consumption of opioids and reduce the postoperative pain intensity. Recommended dose in the USA and Europe is 800 mg every 6 hours for the management of moderate to severe postoperative pain. The purpose of this study was to investigate whether 800 mg is needed in the Chinese population.Methods: This is a multicenter, randomized, controlled multi-center trial. Adult patients (18-65 years of age) scheduled for abdominal or orthopedic surgery under general anesthesia with endotracheal intubation were eligible. Subjects were randomized at a ratio of 1:1:1 to receive ibuprofen at 400 or 800 mg or saline every 6 hours for 48 hours after the operation. All subjects received morphine access through patient-controlled intravenous analgesia (PCIA) device, which was set as background infusion rate 0.5 mg/h, bolus 1 mg, 5-minute lock interval and 20-mg 4-hour limit. The primary endpoint was morphine consumption within the first 24 hours after surgery. Results: A total of 396 patients were enrolled (180 men, 216 women; 46±12.4 years of age; 106 patients receiving abdominal surgery, and 290 patients receiving orthopedic surgery). The number of patients was 131 in the placebo group, 132 in the 400-mg group, and 133 in the 800-mg group. The 3 groups did not differ in age, sex, BMI and the type of surgery. Median 24-hour morphine consumption was 39.1 mg (IQR: 29.7, 61.7) mg in the placebo control, 29.8 mg (IQR: 24.3, 43.7) mg in the 400-mg group, and 28.0 mg (IQR: 24.1, 35.9) in the 800-mg group (P<0.001 for comparisons between placebo versus 400 and 800 mg ibuprofen). There was no significant difference between the two ibuprofen groups (P=0.125). Analgesia-related adverse events did not differ among the 3 groups.Conclusions: Intravenous ibuprofen at either 400 or 800 mg every 6 hours could reduce postoperative morphine consumption, with apparently equal efficacy in Chinese population.