bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work Relative Value Units Do Not Adequately Support the Burden of Infection Management in Revision Knee Arthroplasty
Authors: Samuel Linsen T. , Grits Daniel , Acuña Alexander J. , Piuzzi Nicolas S. , Higuera-Rueda Carlos A. , Kamath Atul F. 
Published: October 2019

Background:
Revision total knee arthroplasty for infection is challenging. Septic revisions, whether 1-stage or 2-stage, may require more time and effort than comparable aseptic revisions. However, the burden of infection may not be reflected by the relative value units (RVUs) assigned to septic revision compared with aseptic revision. The purposes of this study were to compare the RVUs of aseptic and septic revision total knee arthroplasties and to calculate the RVU per minute for work effort.

Methods:
The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was analyzed for the years 2006 to 2017. The Current Procedural Terminology (CPT) code 27487 and the International Classification of Diseases, Ninth Revision (ICD-9) code 996.XX, excluding 996.6X, were used to identify all aseptic revision total knee arthroplasties (n = 12,907). The CPT code 27487 and the ICD-9 code 996.6X were used to determine all 1-stage septic revision total knee arthroplasties (n = 891). The CPT codes 27488 and 11981 were used to identify the first stage of a 2-stage revision (n = 293). The CPT codes 27447 and 11982 were used to identify the second stage of a 2-stage revision (n = 279). After 4:1 propensity score matching, 274 cases were identified per septic cohort (aseptic single-stage: n = 1,096). The RVU-to-dollar conversion factor was provided by the U.S. Centers for Medicare & Medicaid Services (CMS), and RVU dollar valuations were calculated.

Results:
The septic second-stage revision was used as the control group for comparisons. The RVU per minute for the aseptic 2-component revision was 0.215, from a mean operative time of 148.95 minutes. The RVU per minute for the septic, 2-component, 1-stage revision was 0.199, from a mean operative time of 160.6 minutes. For septic, 2-stage revisions, the first-stage RVU per minute was 0.157, from a mean operative time of 138.1 minutes. The second-stage RVU per minute was 0.144, from a mean operative time of 170.0 minutes. Two-component aseptic revision total knee arthroplasty was valued the highest.

Conclusions:
Despite the increased complexity and worse postoperative outcomes associated with revision total knee arthroplasties for infection, the current physician reimbursement does not account for these challenges. This inadequate compensation may discourage providers from performing these operations and, in turn, make it more difficult for patients with periprosthetic joint infection to receive the necessary treatment. Therefore, the CPT code revaluation may be warranted for these procedures.
Novel Treatment for Recurrent Posttraumatic Hip Instability
Authors: Christian Robert A. , Butler Bennet A. , Weber Timothy G. , Stover Michael D. 
Published: October 2019

Case:
A 26-year-old woman sustained a traumatic right hip dislocation with posterior wall component in a motor vehicle collision. Initial treatment consisted of open reduction internal fixation of her posterior wall fracture. Six years later, she developed low-energy recurrent hip instability. Imaging demonstrated posterior capsular insufficiency and femoral retrotorsion. The patient underwent intertrochanteric femoral rotational osteotomy. Nine years postoperatively, the patient has returned to activity without restriction or subsequent dislocations.

Conclusions:
Recurrent posttraumatic hip instability requires careful identification of the etiology of instability. This case provides long-term follow-up after successful treatment with intertrochanteric femoral rotational osteotomy.
A Feasible Method for the Trajectory Measurement of Radial Jet Drilling Laterals
Authors: Huang Zhe , Huang Zhongwei , Su Yinao , Bi Gang , Li Weichang , Liu Xin , Jiang Tianwen 
Published: October 2019

Summary
Radial jet drilling (RJD) is an unconventional drilling technology that uses high-pressure liquid jet to drill multiple radial laterals. It is a cost-effective alternative for bypassing damage zones near the wellbore, restimulating the production of old wells, and developing unconventional reservoirs. However, because of the structure of the deflector and the diameter of the radial laterals, traditional well-trajectory measuring tools cannot be applied in RJD wells, which hinders the conduct of some significant operations. The unknown trajectory is a crucial limitation to further development and field application of RJD technology.
In this paper, along with an introduction to RJD technology, a measuring system and a mini-tool are proposed for attitude measurement and motion-state recognition. With an extra tripping stage, the tool is tripped down to the bottom of the RJD laterals after the jet drilling is completed, and then tripped out at a constant speed. The measured data stored in memory media could be downloaded after the measurement. On the basis of navigation theory, a reckoning method was proposed to obtain the trajectory parameters by using the recorded data of the tool and the operational data of the coiled tubing (CT). After that, an experimental study was carried out to test the performance of the measuring tool and the reckoning method. As results of the experiments demonstrate, the average errors of the measured length, inclination, and azimuth are 3.94, 2.62, and 4.54%, respectively.
Association between NMD3 and symptoms of Parkinson’s disease in Chinese
Authors: Wu Hui , Li Hui , Shi Zhiqiang , Tang Jiajia , Mei Shuya , Ai Tianyi , He Zhenzhou 
Published: October 2019

Abstract
Bcakground Parkinson's disease (PD) is a progressive degenerative disorder of the basal ganglia that not only affects the initiation and execution of voluntary movements, but also nonmotor features. The aim was to investigate the association between NMD3 and symptoms of PD patients in Chinese. Methods 217 PD patients were recruited in this study. All patients were evaluated by Sniffin’ Sticks 16 (SS-16), Hamilton anxiety rating scale and Hamilton depression rating scale, 39-item Parkinson's disease Questionnaire (PDQ-39) and MDS - Unified PD Rating Scale (MDS-UPDRS). Symptoms were also recorded. Results NMD3 carriers had worse cognitive function (MMSE: p 0.042, NMD3 wildtype: 27.44 ± 2.89, NMD3 carriers: 26.31 ± 3.79; MoCA: p 0.005, NMD3 wildtype: 23.15 ± 4.20, NMD3 carriers: 20.75 ± 6.68). Conclusions The recessive and overdominant model of GALC rs8001572 was associated with the presence of sensitive to light.
Using poster presentation to assess large classes: A case study for first year undergraduate module in a South African University
Authors: Ross Andrew , Dlungwane Thembelihle , Wyk Jacqueline Van 
Published: October 2019

Abstract
Background
The massification of higher education is often associated with poor student engagement, poor development of their critical thinking, inadequate feedback and poor student throughput. These factors necessitate the need to devise novel, innovative methods to teach, assess and provide feedback to learners to counter the restrictions imposed due to the large class learning environments. This study was conducted to ascertain the perceptions of 1st year medical students and staff at the Nelson Mandela School of Medicine regarding the value of poster presentations as a strategy to enhance learning, assessment and feedback.

Methods
This was an exploratory observational, descriptive cross-sectional, case study. Data was collected through separate student and staff questionnaires that required participant responses on a five-point Likert scale. The data was extracted into Excel spreadsheets for quantitative analysis.

Results
Two-hundred- and-thirty (92%) student questionnaires were returned (N=250). Most students indicated that the design and presentation of the poster had helped them to select important material (92%), understand and describe disadvantage (86%) and to make a difference in the community (92%). The students agreed that the poster assessment was an efficient (81%) and fair method (75%) that provided opportunities for meaningful feedback. Ten staff members responded to the questionnaire. Most staff members (90%) indicated that the poster presentation had allowed students to demonstrate their engagement in a meaningful and appropriate way around issues of disadvantage and HIV and agreed that the poster presentations allowed for immediate and effective feedback.

Discussion and conclusions
Students’ interactions in the tasks promoted active engagement with others and course material; the development of higher order thinking and skills which added to students’ accounts of transformative learning experiences. They could describe and illustrate the difference that they had made in their chosen community. The poster presentations allowed for quick and efficient marking, immediate feedback and an opportunity to validate the students’ participation.
Poster presentations offered an innovative way to encourage deep meaningful engagement and learning amongst peers and facilitators. Poster presentations should be more widely considered as an innovative way of encouraging deeper engagement and learning in a large class setting.
Linguistic Analysis of Pediatric Residency Personal Statements: Gender Differences
Authors: Babal Jessica , Gower Aubrey , Frohna John , Moreno Megan 
Published: October 2019

Abstract
Background: All US residency programs require applicants to submit personal statements. Prior studies showed gender differences in personal statement writing, which has implications for gender bias in the application process, but previous studies have not considered the dual influence of specialty-specific values on personal statement writing by applicants of each gender.
Objective: To understand gender differences in pediatric residency personal statements
Methods: From 2017-2018, we performed linguistic analysis of personal statements written by interviewees at a mid-size US pediatrics residency during two prior academic years. We assessed writing tone, communal language, and agentic language. We performed t-tests to evaluate for gender differences, p<0.05.
Results: We analyzed personal statements from 85 male and 85 female interviewees. Average word count was 676 words. Personal statements demonstrated analytic writing style with authentic and positive emotional tone. We found no gender differences in communal language for social affiliation (p=0.31), adjectives (p=0.49), or orientation (p=0.48), which deviates from typical gender norms for male language use. Males used agentic language of reward more frequently (p=0.02).
Conclusions: Findings suggest that social language is valued in pediatrics, a predominantly female specialty, regardless of applicant gender. Use of reward language by males is consistent with previous findings. Future studies should evaluate gender differences in residency applications across specialties to advance understanding of the role gender plays in the application process.
Genetic diversity and population structure of black cottonwood (Populus deltoides) revealed using simple sequence repeat markers
Authors: Chen Cun , Chu Yanguang , Ding Changjun , Su Xiaohua , Huang Qinjun 
Published: October 2019

Abstract
Background: Black cottonwood (Populus deltoides) is one of the keystone forest tree species, and has become the main breeding parents in poplar hybrid breeding. However, the genetic diversity and population structure of the introduced resources are not fully understood. Results: In the present study, five loci containing null alleles were excluded and 15 pairs of SSR (simple sequence repeat) primers were used to analyze the genetic diversity and population structure of 384 individuals from six provenances of P. deltoides. Ultimately, 108 alleles (Na) were detected; the expected heterozygosity (He) ranged from 0.070 to 0.905, and the average locus polymorphic information content (PIC) was 0.5354. The provenance ‘Was’ had the lowest genetic diversity, while ‘Que’, ‘Lou’, and ‘Ten’ provenances had high genetic diversity, with Shannon's information index (I) above 1.0. The mean coefficient of genetic differentiation (Fst) and gene flow (Nm) were 0.129 and 1.931 respectively. Analysis of molecular variance (AMOVA) showed that 84.88% of the genetic variation originated from individuals. Based on principal coordinate analysis (PCoA) and STRUCTURE cluster analysis, clones distributed in Mississippi River Basin were roughly classified as one group, while those distributed in the St. Lawrence River Basin and Columbia River Basin were classified as another group. The cluster analysis based on the population level showed that provenance ‘Iow’ had a smaller gene flow and higher degree of genetic differentiation compared with the other provenances, and was classified into one group. There was no significant relationship between genetic distance and geographical distance. Conclusions: P. deltoides resources have high genetic diversity and there is a moderate level of genetic differentiation among provenances. Geographical isolation and natural conditions may be the main factors causing genetic differences among individuals; however, the genetic variation among provenances has no clear correlation with their geographical locations. Clones reflecting population genetic information can be selected to build a core resource bank, which could provide effective protection and promote the scientific utilization of the P. deltoids resource, laying a solid foundation for poplar breeding.
Heterogeneous Neurodevelopmental Disorders in Children with Kawasaki Disease: What is New Today?
Authors: Lin Chien-Heng , Lin Wei-De , Chou I-Ching , Lee Inn-Chi , Hong Syuan-Yu 
Published: October 2019

Abstract
Background: Kawasaki disease (KD) is a common vasculitis of childhood in East Asia. The complications of KD ascribed to long-term cardiovascular sequelae are considerably diverse. Although studies have investigated neurodevelopmental problems following KD in the past few decades, they have reported inconsistent conclusions. This study investigated potential epilepsy and associated neurodevelopmental disorders (NDDs) following KD in Taiwanese children.
Methods: We retrospectively analyzed the data of children aged <18 years with clinically diagnosed KD from January 1, 2005, to December 31, 2015. These patients were followed up to estimate the prevalence of epilepsy and associated NDDs in comparison with the prevalence in general pediatric population in Taiwan and worldwide.
Results: A total of 612 patients with an average age of 1.6 years were included. The prevalence of associated NDDs was 16.8% (n = 103/612) in the study group, which consisted of epilepsy, intellectual disability (ID), autism spectrum disorders , Tourette syndrome (TS), attention deficit hyperactivity disorder, (ADHD), and others. Moreover, children with KD had a higher prevalence of epilepsy and TS in both Taiwan and worldwide (epilepsy: 2.61% in the KD group vs 0.33% in Taiwan and 0.05%–0.8% in worldwide, p < 0.05; TS: 2.77% in the KD group vs 0.56% in Taiwan and 0.3%–1% in worldwide, p < 0.05). The prevalence of ID, ADHD, and developmental language disorders was not significantly different between our study patients and those in Taiwan or worldwide.
Conclusions: Results revealed a higher prevalence rate of NDDs, especially epilepsy and TS, in Taiwanese children with KD than in the general pediatric population in Taiwan. However, these NDDs could be heterogeneous. Children diagnosed with KD were followed up because they had a higher risk of heterogeneous NDDs.
Keywords: Kawasaki disease, Neurodevelopmental Disorders, Children, Epilepsy, Tourette syndrome
Nursing students’ knowledge, attitude, self-efficacy in blended learning of cardiopulmonary resuscitation: a randomized controlled trial
Authors: Moon Hyunjung , Hyun Hye Sun 
Published: October 2019

Abstract
Background: Although various forms of online education are on the rise worldwide, effects of such innovative approach are yet to be validated. This study analyzes whether blended learning cardiopulmonary resuscitation (CPR) education that integrates e-learning and face-to-face education is effective in improving nursing students’ knowledge, attitude, and self-efficacy.Methods: A randomized controlled design was used. The participants of this study were 120 nursing students randomly assigned to the intervention group (n = 60) or the control (n = 60). The intervention group was trained using a blended learning CPR education program. Self report questionnaires with knoweldge, attitude, and self-efficacy were all used in the pre and post intervention. Differences before and after the education of each group were analyzed with a paired t-test, and the differences between the two groups were analyzed with ANCOVA with knowledge as the covariate.Results: The findings indicated that the intervention group had significantly higher knowledge scores (intervention: 16.40±1.56, control: 6.46±2, p <.001), and emotional attitude (intervention: 40.85±8.01, control: 36.05±6.87, p = .002) about CPR than the control group, but other outcomes did not differ between groups.Conclusions: In this monocentric study, a blended learning CPR program that integrated videos and face to face lecture was found effective in improving nursing students' knowledge and attitudes regarding CPR.
Screening differentially expressed genes of pancreatic cancer between Mongolian and Han people using bioinformatics technology
Authors: Xu Jiasheng , Liao Kaili , FU ZHONGHUA , XIONG ZHENFANG 
Published: October 2019

Abstract
Objective: To screen and analyze differentially expressed genes in pancreatic carcinoma tissues taken from Mongolian and Han patients by Affymetrix Genechip. Methods: Pancreatic ductal cell carcinoma tissues were collected from the Mongolian and Han patients undergoing resection in the Second Affiliated Hospital of Nanchang University from March 2015 to May 2018 and the total RNA was extracted. Differentially expressed genes were selected from the total RNA qualified by Nanodrop 2000 and Agilent 2100 using Affymetrix and a cartogram was drawn; The gene ontology (GO) analysis and Pathway analysis were used for the collection and analysis of biological information of these differentially expressed genes. Finally, some differentially expressed genes were verified by real-time PCR.
Results: Through the microarray analysis of gene expression, 970 differentially expressed genes were detected by comparing pancreatic cancer tissue samples between Mongolian and Han patients. A total of 257 genes were significantly up-regulated in pancreatic cancer tissue samples in Mongolian patients; while a total of 713 genes were down-regulated. In the Gene Ontology database, 815 differentially expressed genes were identified with clear GO classification, and CPB1 gene showed the highest increase in expression level (multiple difference: 31.76). The pathway analysis detected 28 signaling pathways that included these differentially expressed genes, involving a total of 178 genes. Among these pathways, the enrichment of differentially expressed genes in the FAK signaling pathway was the strongest and COL11A1 gene showed the highest multiple difference (multiple difference: 5.02). The expression of differentially expressed genes CPB1, COL11A1、ITGA4、BIRC3、PAK4、CPA1、CLPS、PIK3CG and HLA-DPA1 determined by real-time PCR were consistent with the results of gene microarray analysis.
Conclusions: The results of microarray analysis of gene expression profiles showed that there are a large number of differentially expressed genes in pancreatic cancer tissue samples comparing Mongolian and Han population. These genes are closely related to the cell proliferation, differentiation, invasion, metastasis and multi-drug resistance in pancreatic cancer. They are also involved in the regulation of multiple important signaling pathways in organisms.
A preliminary assessment of vital-signs-integrated patient-assisted intravenous opioid analgesia (VPIA) for postsurgical pain: a case series
Authors: SNG Ban Leong , Tan Daryl Jian'an , TAN Chin Wen , HAN Nian-Lin Reena , SULTANA Rehena , SIA Alex Tiong Heng 
Published: October 2019

Abstract
Background

We developed a Vital-signs-integrated Patient-assisted Intravenous opioid Analgesia (VPIA) analgesic infusion pump, a closed-loop vital signs monitoring and drug delivery system which embodies in a novel algorithm that takes into account patients’ vital signs (oxygen saturation, heart rate). The system aims to allow responsive titration of personalized pain relief to optimise pain relief and reduce the risk of respiratory depression. Moreover, the system will be important to enable continuous monitoring of patients during delivery of opioid analgesia.Methods

Nineteen patients who underwent elective gynecological surgery with postoperative patient controlled analgesia (PCA) with morphine were recruited. The subjects were followed up from their admission to the recovery room/ ward for up to 24 hours until assessment of patient satisfaction on the VPIA analgesic infusion pump.Results

The primary outcome measure of incidence of oxygen desaturation showed all patients had at least one episode of oxygen desaturation (<95%) during the study period. Only 6 (31.6%) patients had oxygen desaturation that persisted for more than 5 minutes. The average percentage time during treatment that oxygen saturation fell below 95% was 4.6%. Fourteen (73.7%) out of 19 patients encountered safety pause, due to transient oxygen desaturation or bradycardia. The patients’ median [IQR] pain scores at rest and at movement after post-op 24 hours were 0.0 [2.0] and 3.0 [2.0] respectively. The average ± SD morphine consumption in the first 24 hours was 12.5 ± 7.1mg. All patients were satisfied with their experience with the VPIA analgesic infusion pump.Conclusions

We have demonstrated the potential of VPIA analgesic infusion pump to increase the safety and patient satisfaction by incorporating vital signs monitoring to intravenous opioid analgesia.