bluuebunny/crossref_metadata_2025_split huggingface dataset:
PLAN and AM-PAC “6-Clicks” Scores to Predict Discharge Disposition After Primary Total Hip and Knee Arthroplasty
Authors: Hadad Matthew J. , Orr Melissa N. , Emara Ahmed K. , Klika Alison K. , Johnson Joshua K. , Piuzzi Nicolas S. 
Published: December 2021

Background:
Determination of the appropriate post-discharge disposition after total hip (THA) and knee (TKA) arthroplasty is a challenging multidisciplinary decision. Algorithms used to guide this decision have been administered both preoperatively and postoperatively. The purpose of this study was to simultaneously evaluate the predictive ability of 2 such tools—the preoperatively administered Predicting Location after Arthroplasty Nomogram (PLAN) and the postoperatively administered Activity Measure for Post-Acute Care (AM-PAC) “6-Clicks” basic mobility tools—in accurately determining discharge disposition after elective THA and TKA.

Methods:
The study included 11,672 patients who underwent THA (n = 4,923) or TKA (n = 6,749) at a single large hospital system from December 2016 through March 2020. PLAN and “6-Clicks” basic mobility scores were recorded for all patients. Regression models and receiver operator characteristic curves were constructed to evaluate the tools' prediction concordance with the actual discharge disposition (home compared with a facility).

Results:
PLAN scores had a concordance index of 0.723 for the THA cohort and 0.738 for the TKA cohort. The first “6-Clicks” mobility score (recorded within the first 48 hours postoperatively) had a concordance index of 0.813 for the THA cohort and 0.790 for the TKA cohort. When PLAN and first “6-Clicks” mobility scores were used together, a concordance index of 0.836 was observed for the THA cohort and 0.836 for the TKA cohort. When the PLAN and “6-Clicks” agreed on home discharge, higher rates of discharge to home (98.0% for THA and 97.7% for TKA) and lower readmission rates (5.1% for THA and 7.0% for TKA) were observed, compared with when the tools disagreed.

Conclusions:
PLAN and “6-Clicks” basic mobility scores were good-to-excellent predictors of discharge disposition after primary total joint arthroplasty, suggesting that both preoperative and postoperative variables influence discharge disposition. We recommend that preoperative variables be collected and used to generate a tentative plan for discharge, and the final decision on discharge disposition be augmented by early postoperative evaluation.

Clinical Relevance:
The determination of post-discharge needs after THA and TKA remains a complex clinical decision. This study shows how simultaneously exploring the predictive ability of preoperative and postoperative assessment tools on discharge disposition after total joint arthroplasty may be a useful aid in a value-driven health-care model.
Analisis Keterampilan Berpikir Analitis Siswa pada Tema Pewarisan Sifat
Authors: Fitriani Fitriani , Wirawan Fadly  , Ulinnuha Nur Faizah  
Published: December 2021

Ketrampilan berpikir analitis, sebagai kemampuan berpikir tingkat tingi dengan menerapkan penalaran yang begitu kompleks sehingga menjadi sangat penting untuk dimilki oleh peserta didik dalam menghadapi persoalan dan permasalahan di abad 21 yang mana peserta didik akan dihadapkan pada permasalahan global yang semakin meningkat. Penelitian ini merupakan penelitian kuantitatif menggunakan desain eksperiment kuantitatif-kualitatif dengan analisis data melalui pendekatan deskriptif. Tujuan penenlitian ini adalah untuk mengukur taraf ketrampilan berpikir peserta didik pada pembelajaran IPA kelas IX-E SMP Ma'arif 1 Ponorogo. Berdasarkan hasil analisis data yang telah diperoleh dengan mengukur 6 indikator ketrampilan berpikir analitis (Memahami konsep, Mengidentifikasi, Membedakan, Mengorganisasikan, Menghubungkan dan Aplikatif) uji kemampuan melalui pemberian tes soal uraian dan tabel, dan dari hasl rata-rata yang diperoleh dapat diketahui bahwa tingkat ketrampilan berpikir analitis peserta didik sebesar dan berada pada level yang rendah
Efektivitas Penerapan Model Pembelajaran Discovery-Inquiry Berbantuan Mind Mapping Terhadap Kemampuan Berpikir Rasional Peserta Didik
Authors: Isnain Anita Septariani , Irawan Edi , Ekapti Rahmi Faradisya , Faizah Ulinnuha Nur 
Published: December 2021

Penelitian ini bertujuan untuk mengetahui 1) keterlaksanaan model pembelajaran discovery-inquiry berbantuan mind mapping di MTs Ma’arif Al-Ishlah Bungkal, 2) apakah kemampuan berpikir rasional peserta didik kelas VII menggunakan model pembelajaran discovery-inquiry berbantuan mind mapping lebih baik daripada model pembelajaran konvensional pada materi pencemaran lingkungan di MTs Ma’arif Al-Ishlah Bungkal. Penelitian ini termasuk penelitian kuantitatif. Populasi penelitian ini adalah siswa kelas VII di MTs Ma’arif Al-Ishlah Bungkal. Sampel yang digunakan dalam penelitian ini yaitu peserta didik kelas VII C (kelas kontrol) dan VII D (kelas eksperimen) yang dipilih dengan menggunakan teknik cluster random sampling. Teknik pengumpulan data menggunakan tes tulis (pre test dan posttest). Hasil penelitian menunjukkan bahwa proses pembelajaran menggunakan model pembelajaran discovery-inquiry berbantuan mind mapping dapat terlaksana secara baik serta model pembelajaran discovery inquiry berbantuan mind mapping mampu meningkatkan kemampuan berpikir rasional peserta didik. Hal ini menunjukkan bahwa kemampuan berpikir rasional peserta pada kelas eksperimen lebih baik daripada peserta didik pada kelas kontrol.
Comorbidities Associated with Complicated Hospital Course and Death in COVID-19 Patients: A Retrospective Study from Iran
Authors: Tavakoli Nader , Hashemi-Madani Nahid , Malek Mojtaba , Emami Zahra , Khajavi Alireza , Aghili Rokhsareh , Honardoost Maryam , Abdolmaleki Fereshteh , Khamseh Mohammad Ebrahim 
Published: December 2021

Abstract
Objective There are limited data regarding the impact of comorbidities on hospitalized patients with coronavirus disease 2019 (COVID-19) in Iran. Methods We evaluated the risk of serious adverse outcomes in 1368 Iranian COVID-19 patients, admitted to five academic hospitals in Tehran between February-June 2020. The composite end-points were defined as admission to an intensive care unit, invasive ventilation, or death. The Cox proportional survival model determined the potential comorbidities associated with death. Results Overall, 576 patients (42.3%) reached the composite end-point (280 death). Adjusted for age, sex, duration of hospitalization, and the presence of the other comorbidities, patients with diabetes (RR=1.25, 95%CI; 1.08-1.44), heart failure (RR=1.45, 95%CI; 1.10-1.91), chronic kidney disease (RR=1.32, 95%CI; 1.04-1.67), malignancy (RR=1.79, 95%CI; 1.41-2.28), and lung diseases (RR=1.53, 95%CI; 1.27-1.84) were more likely to reach the composite end-point than those without the very comorbidity. Moreover, patients aged less than 65 years had a greater risk of death in the presence of two (HR=2.68, 95%CI; 1.46-4.95, p=0.002) or more (HR=3.47, 95%CI; 1.69-7.12, p=0.001) comorbidities, compared to those without any comorbidity. Conclusion To conclude, having two or more comorbidities in patients less than 65 years is associated with a greater risk of death during hospitalization.
Fourteen-Day Sequential Therapy Containing Rabeprazole Versus 10 And 14-Day Concomitant Therapy in The First Line Treatment of Helicobacter Pylori Infection: A Randomized, Open-Label Clinical Trial
Authors: Seddik Hassan , Boutallaka Hanae , Berrag Sanaa , Mrabti Samir , Loubaris Khaoula , Sair Asmae , Addajou Tarik , Benhamdane Ahlame , Elkoti Ilham , Berraida Reda , Sentissi Sara , Bulajic Milutin , Benkirane Ahmed 
Published: December 2021

Abstract
Aims:To compare an optimized sequential therapy to 10 and 14-day non-Bismuth quadruple therapies currently recommended, in terms of efficacy, incidence of adverse effects and cost.Patients and methods:This open-label prospective study randomized patients with confirmed Helicobacter pylori (H.Pylori) infection to 3 groups (1:1:1): The first group received quadruple therapy of twice-daily (bid) Omeprazole 20mg, Amoxicillin 1g, Clarithromycin 500mg and Metronidazole 500mg for 10days (QT-10), the second group received a 14 day quadruple therapy following the same regimen (QT-14), and the third received an optimized sequential therapy consisting on a bid Rabeprazole 20 mg plus amoxicillin 1g for 7 days, followed by bid Rabeprazole 20 mg, clarithromycin 500 mg and metronidazole 500mg for the next 7 days (OST-14). Adverse events (AEs) were recorded throughout the study, and the H.Pylori eradication rate was determined 4 to 6 weeks after treatment using the 13C urea breath test.Results:In intention to treat analysis, eradication rate was 85,5%, 91,8% and 95,4% respectively in QT-10, QT-14 and OST-14 groups (p=0,03). In the per protocol analysis, the eradication rate was significantly higher in the OST- 14 group compared to the QT-14 and QT-10 groups (98,1%, 94,4% and 89,5% respectively, p=0,02).The overall incidence of AEs was significantly lower in the OST-14 group (p=0,01). Furthermore, the OST-14 was the most cost-effective among the three groups.Conclusion:14-day optimized sequential therapy is a safe and effective alternative that allows a higher eradication rate compared to 10 and 14-days quadruple therapies while causing less adverse effects and allowing a gain in term of cost.
Primary Health Care Case Management Through the Lens of Complexity: an Exploratory Study of Naturopathic Practice Using Complexity Science Principles
Authors: Graham Kim D , Steel Amie , Wardle Jon 
Published: December 2021

Abstract
BackgroundAdvances in systems science creates an opportunity to bring a complexity perspective to health care practices and research. While medical knowledge has greatly progressed using a reductionist and mechanistic philosophy, this approach may be limited in its capacity to manage chronic and complex illness. With its holistic foundation, naturopathy is a primary health profession with a purported alignment with a complexity perspective. As such this pilot study aimed to investigate the application of complexity science principles, strategies, and tools to primary health care using naturopathy as a case study.MethodsA network mapping and analysis of the naturopathic case management process was conducted. Mind maps were created by naturopathic practitioners to reflect their clinical conceptualisation of a common paper clinical case. These mind maps were inputed into Gephi, a network mapping, exploration, and analysis software. Various layouts of the data were produced, and these were analysed using exploratory data analysis and computational network analysis.ResultsSeven naturopathic practitioners participated in the study. In the combined network mapping, 133 unique elements and 399 links were identified. Obesity, the presenting issue in the case, was centrally located. Along with obesity, other keystone elements included: systemic inflammation, dysbiosis, diet, the liver, and mood. Each element was connected on average to 3.05 other elements, with a degree variation between one and 36. Six communities within the dataset were identified, comprising: the nervous system and mood, gastroinstetinal and dietary factors, systemic inflammation and obesity, the endocrine system and metabolism.ConclusionsThis pilot study demonstrates that it is feasible to apply a complexity science perspective to investigating primary health care case management. This supports a shift to viewing the human organism as a complex adaptive system within primary health care settings, with implications for health care practices that are more cognisant with the treatment of chronic and complex conditions and research opportunities to capture the complex clinical reasoning processes of practitioners.
Quantification and Trend Analysis of Multidecadal Global Dissolved Oxygen Changes
Authors: Agrawal Ayush , Swift James 
Published: December 2021

Abstract
Previous studies have found there to be measurable deoxygenation in regions of the world’s oceans, with changes linked to biogeochemical cycles, changes in ocean productivity, and climate fluctuations. Here, we investigated multidecadal large-scale dissolved oxygen trends in the principal basins of the Atlantic, Pacific, and Indian Oceans using data from WOCE, CLIVAR, and GO-SHIP cruises, representing some of the highest quality available water column data. We differenced spatially coincident older and more recent data, averaged differences in geographic subregions, and integrated results on 500-dbar thick layers from 500 dbar to 3500 dbar, with bottom levels extending to 6000 dbar. Overall, we found a deoxygenation below 500 dbar across all major basins at a global average rate of -0.06 µmol kg−1 year−1, with important variations between regions and layers. Our research demonstrates a deoxygenation trend coincident with the global ocean warming and increased stratification trends documented in other studies.
Removal of Zn(II) By Magnetic Composite Adsorbent: Synthesis, Performance, And Mechanism
Authors: Yi Shuang , Bao Binqin , Song Weifeng , Liu MuDdan 
Published: December 2021

Abstract
In this study, L-methionine and nano-Fe3O4 were encapsulated and cured on sodium alginate by the ionic cross-linking method to form magnetic composite gel spheres (SML). The influence of adsorbent dosages, pH, reaction time, and initial ion concentration on the ability of the gel spheres to adsorb Zn(II) was investigated. The experimental results indicated that under the optimum conditions, the maximum amount of Zn(II) adsorbed by the adsorbent gel spheres reached 86.84 mgˑg-1. The experimental results of adsorption indicate that the reaction process of this adsorbent fits well with the Langmuir and pseudo-second-order kinetic models and is a heat absorption reaction. The results of the adsorption investigation of the coexistence system showed that the adsorbent would preferentially adsorb Pb(II), and the adsorption efficiency of Zn(II) decreased when the concentration of interfering ions increased. The structure of this adsorbent and the adsorption mechanism were investigated by Fourier transform infrared spectrometer, thermal gravimetric analyzer, vibrating sample magnetometer, scanning electron microscope, Brunner-Emmet-Teller measurements, and X-ray photoelectron spectroscopy. The results show that this magnetic composite adsorbent is a mesoporous material with superior adsorption performance, and the amino and carboxyl groups on it react with Zn(II) via ligand chelation; the ion exchange effect of Ca(II) also plays a role. The desorption-adsorption experiments of the adsorbent indicated that the adsorption amount of Zn(II) was maintained at a higher level after several cycles, and the loss of Fe was approximately 0.2%. In summary, SML is an ideal adsorbent for environmental protection.
The Influence of Abdominal Obesity on Hip Pain, Function, and Walking Ability after Three Years of THA: A Prospective Cohort Study
Authors: Wang Xiang , Yang Ze , Zhang Yang , Tian Yuan , Shen Jing , Ji Weifeng 
Published: December 2021

Abstract
Background: There are many clinical studies about the impact of obesity on postoperative function following THA, but their conclusions are different and even contradictory. Abdominal obesity is closely related to obesity, while its impact on postoperative function following THA remains to be elucidated.Methods: Four hundred and thirteen patients were included in this study. They were divided into an AO group (waist circumference ≥ 90 cm for men and ≥ 85 cm for women) and a non-AO group (waist circumference ≤ 90 cm for men and ≤ 85 cm for women). Preoperative assessments including numerical pain rating, the Oxford Hip Score, and 6-minute walk test were repeated at 1,2, and 3 years postoperatively. Postoperative assessments included the anteversion and inclination of the acetabular prosthesis and satisfaction survey.Results：At a mean follow-up of 48±1.3 months, there was a significant difference in the improvement of the 6-minute walk test (251.22 to 387.46, 410.34, 410.07 vs 207.79 to 362.17, 395.82, 403.36; p < 0.001) at 1, 2 and 3 years and the numerical pain rating scale (6.00 to 0.39 vs 5.76 to 0.80; p < 0.001) at 1 year between the non-AO group and AO group. There was no difference between both groups in inclination, anteversion, OHS, and satisfaction. Conclusion: AO does not increase the complications after THA, nor does it have a significant impact on the function after THA, but it seems to have a negative effect on the improvement of walking ability and the relief of hip pain.
Autophagy Induction by Cyclic Stretch and Its Effect on Cytokines in Retinal Pigment Epithelial Cells
Authors: Wang Zengyi , Liang Xida , Wu Shen , Zhang Jingxue , Liu Qian , Yu Yanping , Qi Bingying , Yang Xiaohan , Liu Lingzi , Zhang Ke , Liu Wu 
Published: December 2021

Abstract
Background: Strong evidence of the correlation between age-related macular degeneration (AMD) and vitreomacular interface abnormality (VMIA). Meanwhile, as a crucial mechanism of retinal pigment epithelial (RPE) cells’ homeostasis, autophagy induction by cyclic stretch appears to be particularly significant.Methods: Cultured ARPE-19 cells were subjected to cyclic stretch (20% elongation, 1HZ) for 1h, 2h, 6h, 12h,24h and 48h by FX-5000 Tension System. Then, we observed the expression levels of LC3I, LC3II, Beclin-1, SQSTM1/p62, LAMP-1, mTOR and phosphorylated mTOR(pmTOR), AMPK and pAMPK, NADPH oxidase 4 (NOX4), and vascular endothelial growth factor (VEGF) in RPE cells under stretch by western blot and immunofluorescence.Results: We found autophagic proteins mostly induced by cyclic stretch in a time-dependent fashion via mTOR suppression and AMPK activation, except for SQSTM1/p62. 3-Methyladenine(3-MA), an inhibitor for autophagy, could reduce the up-regulation of autophagy due to cyclic stretch, leading to higher level of VEGF release after 24h cyclic stretch. Rapamycin could narrow the increase degree of VEGF and NOX4 by cyclic stretch by raise autophagic level in RPE cells.Conclusion: Stretch might induce autophagy in RPE cells by mTOR or AMPK pathway. Autophagy might play the protective function for RPE cells away from mechanical stress derived from VMIA-related AMD.
The Diversity and Evolutionary Relationships of Ticks and Tick-borne Bacteria in China
Authors: Tian Junhua , Hou Xin , Ge Mihong , Xu Hongbin , Yu Bin , Liu Jing , Shao Renfu , Holmes Edward C. , Lei Chaoliang , Shi Mang 
Published: December 2021

Abstract
Background

Ticks (order Ixodida) are ectoparasites of vertebrates that transmit diverse pathogens to humans and domestic animals. However, information on the genomic diversity of ticks in China is currently limited to a small number of common species, leaving substantial knowledge gap in the evolution of both ticks and their associated bacterial.
Results

We collected more than 20,000 contemporary and historical (up to 60 years of preservation) tick samples representing a wide range of tick biodiversity across diverse geographic regions in China, including 18 common species, nine rare species, and two undetermined species. Metagenomic sequencing was performed on individual ticks to obtain the complete or near-complete mitochondrial (mt) genome sequences from 46 tick species, among which 30 species were revealed for the first time. These new mt genomes data greatly expanded the diversity of many tick groups and revealed five cryptic species. Utilizing the same metagenomic sequence data we identified divergent and abundant bacteria in Haemaphysalis, Ixodes, Dermacentor and Carios ticks, including nine species of pathogenetic bacteria and potentially new species within the genus Borrelia. We also used these data to explore the evolutionary relationship between ticks and their associated bacteria, revealing a pattern of long-term co-divergence relationship between ticks and Rickettsia and Coxiella bacteria.
Conclusions

In sum, our study provides important new information on the prevalence of tick-borne pathogens in China and sheds new light on the long-term evolutionary and ecological relationships between ticks and their associated bacteria.
First Report On The Occurrence of Pharmaceuticals And Cocaine In The Coastal Waters of Santa Catarina, Brazil, And Its Related Ecological Risk Assessment
Authors: Pisetta Ane-Mery , Roveri Vinicius , Guimarães Luciana Lopes , de Oliveira Therezinha Maria Novais , Correia Alberto Teodorico 
Published: December 2021

Abstract
The worldwide occurrence of pharmaceuticals and personal care products (PPCPs) in aquatic ecosystems is reason for concern, since these emerging micro pollutants, includes a large and diverse group of organic compounds, with continuous input, high environmental persistence and potential threat to biota and human health. The aim of this study was to evaluate, for the first time, the occurrence of twenty-seven PPCPs of various therapeutic classes (including cocaine and its primary metabolite, benzoylecgonine), in the coastal waters of Santa Catarina, southern Brazil. Water samples were taken in November 2020, during the low tide periods, at eight sampling points located along the coast of Santa Catarina, covering its entire geographical extension. Sampling was carried out in triplicate and at different depths of the water column. Nine compounds were detected through liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS): caffeine (12.58-119.80 ng/L), diclofenac (1.398-7.920 ng/L), losartan (0.432-3.200 ng/L), cocaine (0.0248-0.1686 ng/L) and benzoylecgonine (0.0146-1.094 ng/L) were quantified in 100% of the samples; carbamazepine (0.0242-0.2720 ng/L) was quantified in 75% of the samples; acetaminophen (0.212-10.040 ng/L) was quantified in 60% of the samples; and both atenolol (1.13-2.50 ng/L) and orphenadrine (0.073-0.0886 ng/L) were quantified in 25% of the samples. The other PPCPs were below the limit of detection (LOD). The highest occurrence of these compounds was detected in the northern and central coastal region of Santa Catarina, namely in Penha and Palhoça cities. The sources of these compounds may be associated with areas with high population density, awaited by tourism, with consequent production of sanitary sewage and solid waste. The ecological risk assessment of these substances in the aquatic ecosystems showed that 67% and 77% of the compounds respectively presented no ecological risk, acute and chronic, but 44% presented low to moderate risks for acute and chronic effects in the three trophic levels evaluated. The occurrence of these chemical compounds can imply deleterious effects on the environmental health of Santa Catarina coastal zone, and therefore deserve more acute and directed attention.