bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reasons for Litigation in Arthroplasty Infections and Lessons Learned
Authors: Senard Olivia , Houselstein Thierry , Crémieux Anne-Claude 
Published: October 2019

Background:
Infections complicate a minority of orthopaedic arthroplasties but are the leading cause of malpractice claims. The basis for the claims is unclear. The objective of this study was to identify the main deviations from current recommendations by reviewing patient files recorded by a major French medical liability-specialized insurance company for private practitioners (MACSF [Mutuelle d’Assurance du Corps de Santé Français]) and to analyze legal claims and outcomes of litigation.

Methods:
All claims data for periprosthetic joint infections were analyzed retrospectively from 2010 to 2014. Treatment strategies were compared with therapeutic guidelines published by medical societies.

Results:
Forty-five claims for periprosthetic joint infection were recorded; 82% of patients were men and the mean patient age was 63 years. Twenty-one patients (47%) had a knee arthroplasty, 21 had a hip arthroplasty, 2 had a shoulder arthroplasty, and 1 had an ankle arthroplasty. Twenty-three infections (51%) occurred within 1 month postoperatively. Staphylococcus aureus was isolated from intraoperative samples in 36% of the cases (including 25% of these with methicillin-resistant strains), and coagulase-negative staphylococci were isolated in 51% (44% methicillin-resistant strains) of the cases. Treatment lasted for a median of 9.5 months (range, 1.5 to 96 months), with a median of 6 months (range, 1.5 to 20 months) of antibiotics and 3 surgical procedures (range, 0 to 7 surgical procedures). A total of 18% of patients had antibiotic-related side effects, 2% of patients died, and 76% of patients had persistent sequelae. An infectious disease specialist’s advice was required for 56% of the patients. Discordances with therapeutic guidelines were found in 76% of the patient files, including delay in diagnosis (44%) and inadequate medical treatment (18%) or medico-surgical treatment (13%).

Conclusions:
Late diagnosis of early postoperative infections appears to be the major cause of inappropriate management and malpractice litigation. Discordance with current guidelines was identified. Early consultation with an infectious disease specialist may help to reduce malpractice claims.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Musculoskeletal Infection in Orthopaedic Oncology
Authors: Strony John , Brown Scot , Choong Peter , Ghert Michelle , Jeys Lee , O’Donnell Richard J. 
Published: October 2019

Background:
The first International Consensus Meeting (ICM) on Musculoskeletal Infection convened in 2013 in order to provide agreement on the prevention, the diagnosis, and the treatment of surgical site infection (SSI) and periprosthetic joint infection (PJI). Recognizing the added susceptibility of orthopaedic oncology patients to SSI and PJI, the second ICM in 2018 included questions and corresponding recommendations from this subspecialty of orthopaedics.

Methods:
The 13 steps of the Delphi method were followed over the course of 26 months, starting in June 2016. From July 25 to 27, 2018, delegates from 93 countries convened at Thomas Jefferson University in Philadelphia, Pennsylvania. Delegates were divided into their subspecialty workgroups, where questions and recommendations were discussed, modified, and subsequently voted upon. The level of consensus measured the agreement among the delegates on the basis of the voting results. The level of evidence that accompanied each question and recommendation was dependent on the types of studies that were reviewed for each question and the number of flaws that were present in those studies.

Results:
There were 30 orthopaedic oncology questions and recommendations that were voted on by 14 delegates with expertise in either orthopaedic oncology or infectious disease. Twenty-six (87%) of the questions were unanimous among the delegates. The remaining 13% (n = 4) were agreed upon by 93% of the delegates, with 7% of the delegates abstaining from the vote.

Conclusions:
The inclusion of orthopaedic oncology in the 2018 ICM on Musculoskeletal Infection was particularly important because of the high rate of SSI and PJI following these procedures. Despite there being strong consensus among voting delegates, these recommendations are based on limited levels of evidence and tend to reflect the recommendations from hip and knee arthroplasty. We hope that high-quality prospective studies in the field of orthopaedic oncology are available for the third ICM.
O PROCESSO DE ENSINO E APRENDIZAGEM DA MATEMÁTICA ESCOLAR NA EDUCAÇÃO ESPECIAL: ABORDAGENS E PERSPECTIVAS
Authors: Medeiros Margarete Farias , Oliveira Helen Savi Mondo de , Silveira Katia Elizete , Ribeiro Elizete Maria Possamai , Helfenstein Mara Juliane Woiciechoski , Moraes Ana Maria de , Medeiros Alessandra Olisia , Raimundo Augusto Kurtz 
Published: October 2019

O presente artigo tem por finalidade apresentar um relato de experiência sobre a realização do projeto de extensão direcionado a alunos com necessidades específicas da rede pública do município de Sombrio (SC). Foram envolvidos alunos das séries finais do Ensino Fundamental de duas escolas, uma estadual e outra municipal, com metodologias alternativas de ensino, utilizando materiais manipulativos e softwares, procurando atender as dificuldades de aprendizagem da Matemática escolar. O projeto em questão teve como objetivo apresentar possibilidades metodológicas para o ensino da Matemática escolar a alunos com necessidades específicas, bem como propiciar às acadêmicas do Curso Superior de Licenciatura em Matemática uma formação baseada na constante busca por novas metodologias de ensino, no sentido de desafiá-las a rever constantemente suas práticas pedagógicas, dentro de uma postura reflexiva diante das mais diversas realidades em que possam se deparar. Na realização desta experiência, apontamos como pontos positivos a experiência para as acadêmicas bolsistas, a participação dos alunos, seu interesse e a disponibilidade das escolas envolvidas. Destacamos, ainda, que os alunos envolvidos apresentavam dificuldades de aprendizagem na Matemática escolar, mas com a utilização de materiais manipulativos estes superavam suas dificuldades e conseguiam participar na sala de aula apresentando atenção e concentração nas atividades.
GESTÃO DE RESÍDUOS SÓLIDOS EM UMA EMPRESA SEM FINS LUCRATIVOS
Authors: Vieira Merielin Cristina , Passos Tiago Germano , Maidel Simone 
Published: October 2019

O presente artigo aborda de maneira simples e direta a implantação de um sistema de gestão dos resíduos sólidos em uma empresa de pequeno porte, sem fins lucrativos. O projeto teve como objetivo geral a redução, reutilização e reciclagem de Resíduos Sólidos, bem como a implantação da coleta seletiva, em conformidade com a legislação ambiental e foram utilizados como apoio três objetivos específicos: 1) Evidenciar a necessidade de implantação da Gestão de Resíduos Sólidos na empresa Capri Iate Clube; 2) Definir formas de armazenagem de cada categoria de resíduos e 3) Conscientizar colaboradores e sócios sobre a importância da Gestão de Resíduos Sólidos. Como referência, para o planejamento das ações foram utilizadas as diretrizes da Lei nº 12.305/10, que institui a Política Nacional de Resíduos Sólidos (PNRS). Embora ainda não finalizado, o projeto já alcançou resultados positivos e a simpatia dos sócios e frequentadores da empresa, contribuindo para a conscientização das consequências decorrentes do manejo inadequado dos resíduos sólidos na comunidade e encorajando esforços futuros para completa implantação do projeto na empresa.Palavras chaves: resíduos sólidos; coleta seletiva; responsabilidade ambiental.
Comparison of the metabolites profiles between a Graft Chimera ‘Hongrou Huyou’ ( Citrus changshan-huyou + C. unshiu Marc.) and Two Donors
Authors: Zhang Min , Jing Luyang , Wu Qun , Zhu Kaijie , Ke Fuzhi , Xu Jianguo , Zhao Siqing , Wang Gang , Zhang Chi 
Published: October 2019

Abstract
Background: Chimeras synthesized artificially by grafting are crucial to breeding of perennial woody plants. ‘Hongrou Huyou’ ( Citrus changshan-huyou + C . unshiu Marc.) was a new grafting chimera originated from the junction where a scion Citrus changshan-huyou (“C”) was top-grafted onto a stock Satsuma mandarin ‘Owari’ ( C . unshiu Marc., “O”). The chimera was simplified as OCC because the cell layer constitutions were O for L1 and C for L2 & L3, respectively. In this study, profiles of primary metabolites, volatiles and carotenoids derived from different tissues were investigated between OCC and two donors, aiming to figure out the relationship between layer donor and metabolites.
Results: Comparison of the metabolite profiles showed that the amount and composition of metabolites were different between the peels and the juice sacs, as well as between OCC and two donors. Metabolites (such as violaxanthin and β -cryptoxanthin in carotenoids, germacrene D in volatiles, citric acid and sorbose in primary metabolites) specifically present or absent in the certain tissue were identified in three phenotypes. According to the principal component analysis (PCA), the total metabolites of chimeric peel properties were derived from the donor C, whereas those of chimeric juice sac properties came from the donor O.
Conclusion: Profiles of primary metabolites, volatiles and carotenoids derived from the peels and the juice sacs were systematically compared between OCC and two donors. The content and composition of metabolites differed in tissues as well as between OCC and two donors. Donor dominant metabolite inheritance was dramatic in the different tissues of OCC and basically consistent with the layer origin that the chimeric peels were derived from C and the chimeric juice sacs came from O. These profiles provide potentially chemical markers for genotype differentiation and citrus breeding assessment, more than that, for donor selection during chimera synthesis artificially.
Cloning and Functional Analysis of the FAD2 Gene Family from Desert Shrub Artemisia sphaerocephala
Authors: Miao Xiumei , zhang lijing , Hu Xiaowei , Nan Shuzhen , Chen Xiaolong , Fu Hua 
Published: October 2019

Abstract
Background: Linoleic acid is an important polyunsaturated fatty acid, required for all eukaryotes. Microsomal delta-12 (Δ12) oleate desaturase (FAD2) is a key enzyme for linoleic acid biosynthesis. Desert shrub Artemisia sphaerocephala is rich in linoleic acid, it has a large FAD2 gene family with twenty-six members. The aim of this work is to unveil the difference and potentially functionality of AsFAD2 family members.
Results: Full-length cDNAs of twenty-one AsFAD2 genes were obtained from A. sphaerocephala. The putative polypeptides encoded by AsFAD2 family genes showed a high level of sequence similarity and were relatively conserved during evolution. The motif composition was also relatively conservative. Quantitative real-time PCR analysis revealed that the AsFAD2-1 gene was strongly expressed in developing seeds, which may be closely associated with the high accumulating ability of linoleic acid in A. sphaerocephala seeds. Although different AsFAD2 family members showed diverse response to salt stress, the overall mRNA levels of the AsFAD2 family genes was stable. Transient expression of AsFAD2 genes in the Nicotiana benthamiana leaves revealed that the encoded proteins were all located in the endoplasmic reticulum. Heterologous expression in Saccharomyces cerevisiae suggested that only three AsFAD2 enzymes, AsFAD2-1, -10, and -23, were Δ12 oleate desaturases, which could convert oleic acid to linoleic acid, whereas AsFAD2-1 and AsFAD2-10 could also produce palmitolinoleic acid.
Conclusions: This research reported the cloning, expression studies, subcellular localization and functional identification of the large AsFAD2 gene family. These results should be helpful in understanding fatty acid biosynthesis in A. sphaerocephala, and has the potential to be applied in the study of plant fatty acids traits.
Clinical practice competency and associated factors among graduating nursing students attending at Universities in Amhara region, Ethiopia: Institution based cross-sectional study, 2018
Authors: Getie ፟Addisu , Tsige Yosief , Birhanie Emebet , Getaneh Kenean , Demis Asmamaw 
Published: October 2019

Abstract
Objective To assess clinical practice competency and associated factors among graduating nursing students in universities of Amhara region, Northern Ethiopia. Result This study showed that, 33.6% of the participants were clinically competent and there is slight variation in the clinical competency of participants at different Universities found in Amhara region. Clinical practice competency of students was affected by clinical instructor factors. Students who had got orientation about objective of clinical practice were 2.387 times more likely to be clinically competent [AOR: 2.387; 95% CI (1.011-5.635)]. Students who had clinical instructor who spent enough time for mentoring them during clinical practice had 2.247 times more likely to be clinical competent [AOR: 2.247; 95% CI (1.100-4.593)]. Students who had instructors that follow them while they conduct a procedure were 2.655 times more likely clinically competent [AOR: 2.655; 95% CI (1.294-5.449)]. This study also revealed that clinical practice competency of students was affected by assessment methods factors. Students with clinical practice assessment checklist had 2.663 times higher clinical practice competency [AOR: 2.663; 95% CI (1.324-5.358)]. Regarding staff-student factors, students who were allowed to perform tasks by clinical staffs were 5.858 times more likely to be clinical competent task [AOR: 5.858; 95% CI (2.657-12.916)]
Outbreak of KPC-2 Carbapenem-Resistant Klebsiella pneumoniae ST76 and Carbapenem-Resistant K2 Hypervirulent Klebsiella pneumoniae ST375 Strains in Northeast China: Molecular and Virulent Characteristics
Authors: Su Shanshan , Zhao Yongxin , Yu Lan , Li Chunjiang , Wang Yong , Wang Yuchao , Bao Mingjia , Fu Yu , Zhang Jisheng , Zhang Xiaoli 
Published: October 2019

Abstract
Background Carbapenem-resistant hypervirulent Klebsiella pneumoniae strains have recently come into existence worldwide; however, researchers in northeast China are not aware of their clinical features and molecular characteristics. Methods Here, the molecular and virulent characteristics of 44 carbapenem-resistant K. pneumoniae (CRKP) isolates collected from January 2015 to December 2017 were studied. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were carried out to define the clonal relatedness among the isolates. PCR and capsular serotyping of the virulence-associated genes, as well as biofilm formation and serum complement-mediated killing assays, were employed to determine the virulent potential. The genomic features and associated mobile genetic elements of JmsCRE57 were detected by whole genome sequencing. Results The only positive isolate was JmsCRE57, which belonged to the ST375 serotype K2 that expressed uge, mrkD, fimH, kpn, aerobactin and rmpA virulence-associated genes and showed strong biofilm formation and serum sensitivity. Sequencing results showed that the JmsCRE57 genome mainly consisted of a circular chromosome, three antibiotic resistance plasmids and a virulent plasmid. The antibiotic resistance plasmid expressing blaKPC-2, blaCTX-M-15, aph(3'')-Ib, aph(6)-Id, qnrB1, aac(3)-IIa, aac(6')-Ib-cr, blaOXA-1, blaTEM-1B, catB4, sul2, dfrA14 and blaSHV-99. The virulent plasmid belonged to the IncHI1B group, which is mainly composed of mucoid phenotype genes and siderophore-associated genes. The remaining CRKP strains that expressed uge, fimH, mrkD and kpn virulence-associated genes were not successfully typed. Conclusion Our results provide new insights on the epidemiology of carbapenem-resistant K2 hypervirulent K. pneumoniae ST375 and CRKP ST76 strains in northeast China, which may help control their future outbreaks.
Later Onset of Hypertension Is Associated with Higher Risk of Dementia in Mild Cognitive Impairment
Authors: qin hongyun , Hu chengping , Wang ling , Guo yi , Cao Zhicheng , Zhao xudong , Zhu binggen 
Published: October 2019

Abstract
Objective

To investigate the correlation between hypertension development and the progression of MCI for middle aged and elderly people.

Methods

A population-based longitudinal cognition survey of people aged 55+ was conducted. The hypertension onset age was estimated by self-reported information and medical insurance card records. In order to study the effect of later onset of hypertension on dementia, the incidence of dementia was compared between the two groups.

Results

A total of 277 hypertensive mild cognitive impairment (MCI) participants without dementia were followed for 6 years. Overall, 56 MCI participants (20.22%) progressed to dementia (MCIp). The proportion of MCIp participants in the old-age onset hypertension group (≥ 65 years) was higher than that of middle-age onset one (27.0% vs 15.4%; X2 = 5.538, P = 0.019). And in the old-age onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7% vs 12.6%; X2 = 5.321, P = 0.021), and the proportion of MCIp with increased pulse pressure was higher than those without increased pulse pressure (33.3% vs 15.4%; X2 = 3.902, P = 0.048). However, the multivariate logistic regression analysis showed that older age was the only risk for MCIp (OR=0.732, p=0.029).

Conclusions

These results suggest that, individuals with later onset hypertension may have greater cognition decline, even in cases with blood pressure maintained at 130/80 mmHg with antihypertensive management.
Familial autosomal recessive bestrophinopathy: identification of a novel variant in BEST1 gene and the specific metabolomic profile
Authors: Ye Panpan , Xu Jia , Luo Yueqiu , Su Zhitao , yao ke 
Published: October 2019

Abstract
BackgroundAutosomal recessive bestrophinopathy (ARB) is a retinal degenerative disorder caused by BEST1 mutations with autosomal recessive inheritance. We aim to map a comprehensive genomic and metabolic profile of a consanguineous Chinese family with ARB.MethodsOphthalmic examinations were performed on affected patients with ARB. Target capture sequencing was performed to screen causative mutations in 256 known retinal disease genes and Sanger sequencing were used for verification. A UHPLC-MS/MS metabolomic analysis was performed to explore the disease-associated metabolic feature.ResultsAffected patients from this family were characterized by low vision, the presence of subretinal fluid, macular edema, and hyperopia with coincidental angle closure. DNA sequencing identified a novel missense mutation in BEST1 gene (chr11:61725867G>A) of the proband. Sanger sequencing further confirmed the mutation. The blood metabolic profiles were highly similar among all family members probably due to the same life style, habitats and genomic background. However, ARB patients presented significant deregulation of metabolites such as Citric acid, L-Threonic acid, Eicosapentaenoic acid.Conclusions
We identified a novel disease-associated variant in BEST1 gene as well as a disease-specific metabolic feature in familial ARB. The findings improved the understanding of mechanisms of ARB and provided a potential therapeutic strategy with application of metabolomics.
Spontaneous malignant transformation of ovarian surface epithelial cells correlates with EMT alteration and stemness acquisition
Authors: Li Bingyan , Zhang Hemei , Guo Yi , Liu Lizhi , Hou Yongfeng , Wang Ping , Jiang Fei , Zhang Zengli , Hei Tom K 
Published: October 2019

Abstract
Background

In order to complete the physiological function of postovulatory repair during repeated ovulation, the ovarian surface epithelium (OSE) not only has to undergo epithelial-mesenchymal transition (EMT), but also possess the properties of somatic stem-like cells. However, there is no evidence to indicate that both EMT alteration and stemness acquisition are linked to epithelial ovarian carcinomas.Methods

In this study, we established a cell model of spontaneous oncogenic transformation of mouse OSE (MOSE). The cell proliferation was assessed using clonogenic survival and soft agar. The self-renewal of cancer stem-like cells (CSCs) was determined by spheroid culture. CD44 + /CD117 + cells were analyzed using flow cytometer. The PCR array was used to determine the EMT-related mRNA level. Expression of pan-keratin, vimentin, E-cadherin, Snail1 and Slug were detected using western-blotting and immunofluorescences, respectively. The tumorigenesis were monitored by limiting dilution assay in vitro and in vivo .Results

Based on morphological change, chromosomal number and proliferating ability, we defined three sequential stages of transformed cells as early, intermediate and late MOSE cells, respectively. We found that MOSE cells had dual characteristics of not only epithelial but mesenchymal nature as well. Over time, MOSE cells spontaneously developed characteristics of malignant cells and generated tumor nodules expressing both Pan-keratin and Vimentin. Furthermore, we found that the neoplastic transformation of MOSE was accompanied by continuous EMT-inducing signals including Snail1 and Slug. Concurrently, the increase of CD44 + /CD117 + cells and their self-renewal ability were associated with the progression of spontaneous neoplastic transformation of MOSE cells in vitro. Conclusion

These results indicated that both EMT alteration and stemness acquisition were closely correlated with the spontaneous malignant progression of MOSE cells. Our findings provide new insights into the future to combat epithelial ovarian carcinomas.
WITHDRAWN: Successful implementation of an Enhanced Recovery After Surgery (ERAS) protocol reduces nausea and vomiting in patients after infratentorial craniotomy: a randomized controlled trial
Authors: Lu Dan , Wang Yuan , Zhao Tianzhi , Liu Bolin , Ye Lin , Zhao Lanfu , Zhao Binfang , Li Mingjuan , Ma Lin , Li Zhengmin , Niu Jiangtao , Lv Wenhai , Zhang Yufu , Zheng Tao , Xue Yafei , Chen Lei , Chen Long , Sun Xude , Gao Guodong , Chen Bo , He Shiming 
Published: October 2019

Abstract

Objectives: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV.Methods: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications.Results: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group.Conclusion: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications.