bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Knee Arthroplasty After High Tibial Osteotomy Results in Excellent Long-Term Survivorship and Clinical Outcomes
Authors: Chalmers Brian P. , Limberg Afton K. , Tibbo Meagan E. , Perry Kevin I. , Pagnano Mark W. , Abdel Matthew P. 
Published: June 2019

Background:
Some prior reports of total knee arthroplasty after high tibial osteotomy have shown high rates of aseptic loosening. As such, the goal of this study was to analyze the outcomes of contemporary total knee arthroplasty after high tibial osteotomy, with particular emphasis on survivorship free from aseptic loosening, any revision, and any reoperation; complications; radiographic results; and clinical outcomes.

Methods:
We retrospectively reviewed 207 patients who underwent 231 total knee arthroplasties using cemented prostheses after high tibial osteotomy from 2000 to 2012 through our total joint registry: 87% were after a closing-wedge osteotomy and 13% were after an opening-wedge osteotomy. The mean follow-up from total knee arthroplasty was 8 years. At the time of the total knee arthroplasty, the mean age was 64 years and the mean body mass index was 31 kg/m2. The majority of total knee arthroplasties had a posterior-stabilized design (93%), and 4% had a varus-valgus constraint design. Tibial stems were utilized in 8% of cases. Bivariate and multivariate Cox regression analyses were utilized to analyze risk factors for poorer survival.

Results:
At 10 years, survivorship free from aseptic loosening was 97%, survivorship free from any revision was 90%, and survivorship free from any reoperation was 85%. Fifteen patients (15 total knee arthroplasties [6%]) underwent aseptic revision, most commonly for instability (3%), aseptic loosening (2%), and periprosthetic fracture (1%). On bivariate analysis, patient age of <60 years was a significant risk factor for poorer revision-free survival (hazard ratio, 2.9; p = 0.02); on multivariate analysis, younger age was the only significant risk factor for revision (p = 0.04). There were 14 complications (6%), the most common being a manipulation under anesthesia in 9 cases (4%). No unrevised total knee arthroplasties had definitive radiographic evidence of loosening. Knee Society scores improved from a mean preoperative score of 59 points to a mean postoperative score of 93 points (p < 0.001).

Conclusions:
Contemporary total knee arthroplasty with a cemented prosthesis after high tibial osteotomy demonstrated excellent long-term durability, with 10-year survivorship free from aseptic loosening of 97%. There was reliable improvement in clinical outcomes, but perfect knee balance was sometimes challenging, as reflected by a 4% prevalence of manipulation under anesthesia and a 3% prevalence of revision for instability.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Episódios relacionados à língua em interações de teletandem: implicações para a formação de professores de PLE.
Authors: Franco Gabriela Rossatto 
Published: June 2019

O projeto “Teletandem e transculturalidade na interação on-line em línguas estrangeiras por webcam” (TELLES, 2011) possibilita que estudantes de universidades brasileiras interajam via Skype com alunos de universidades estrangeiras fornecendo explicações sobre a língua materna ou aquela em que são fluentes a seus parceiros. Desse modo, o presente artigo observa os episódios relacionados à língua (SWAIN; LAPKIN, 1998) emergentes nessas sessões, analisando a forma como os alunos brasileiros (professores de línguas em formação) esclarecem dúvidas sobre a língua portuguesa a seus parceiros. Metodologicamente, os dados foram analisados de acordo com a pesquisa qualitativa de caráter interpretativista. Como fundamentação teórica, este artigo se baseia nas teorias do Foco na Forma (LONG, 1991) e da Conscientização da Linguagem (HAWKINS, 1984), pois destaca a importância de que os praticantes de teletandem, futuros professores de língua estrangeira, desenvolvam uma atitude reflexiva sobre as práticas de linguagem. Os resultados mostram que o teletandem pode favorecer um contexto de discussão e reflexão a partir dos episódios relacionados à língua e, portanto, contribuir para a formação de professores de línguas, especialmente de português como língua estrangeira (PLE).
Borehole-Breathing/Kick Discriminator: Diagnostic Tool and Potential Resource for In-Situ Formation Characterization
Authors: Baldino S.. , Miska S. Z. , Ozbayoglu E. M. , Zhang J.. 
Published: June 2019

SummaryIn most drilling environments, wellbore pressure exceeding the fracture–opening/initiation gradient often results in major fluid losses when drilling ahead and fluid returns when circulation is stopped. The phenomenon is generally referred to as wellbore breathing. Because no flow is expected when circulation is stopped, the mudflow return is more noticeable and could lead to kick misdiagnosis. To rapidly identify whether a possible influx is caused by formation breathing (or otherwise), correct interpretation and modeling of this phenomenon are paramount. The latter can be used to generate a reliable diagnostic tool for breathing discrimination, and it can also be turned into a valuable resource. Potentially, several in–situ properties of the fractured formation can be inferred with static flowback signatures and pressure–while–drilling (PWD) data. This paper shows how to use the proposed geomechanical model to generate diagnostic flowback type curves. A step–by–step procedure is then presented to discriminate the nature of the influx and to infer the fracture–network properties (damaged radius, generalized hydraulic diffusivity, average borehole breathability, and generalized total compressibility) through a type–curve matching protocol. Several field data have been analyzed to show the applicability of the proposed diagnostic tool and to validate its ability to rapidly differentiate borehole breathing from a kick.
Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal
Authors: Gautam Rajendra , Parajuli Keshab , Tshokey Tshokey , Stenos John , Sherchand Jeevan Bahadur 
Published: June 2019

Abstract
Introduction

Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium,Orientia tsutsugamushi. Given their affordability and ease of use, antibody based diagnostic assays can be important diagnostic tools for early detection of scrub typhus fever in resource poor countries like Nepal. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated the InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission.

Methodology

Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal from April 2017 to March 2018. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit (In Bios International, USA) and an in-house IgM IFA (Australian Rickettsial Reference Laboratory, Geelong, Australia. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol.

Result

Statistical analysis of ELISA IgM results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73%-87.68%), specificity 94.82% (95% CI: 93.43%-95.99%), positive likelihood ratio 16.21% (95% CI: 12.71%-20.67%), negative likelihood ratio 0.17% (95% CI: 0.13-0.21%), disease prevalence 22.08% (95% CI: 20.06%-24.21%), positive predictive value 82.12% (95% CI: 78.28-85.42%) and negative predictive value 95.44% (95% CI: 94.27%-96.38%) respectively.

Conclusion

The study indicated that the IgM ELISA has the sensitivity 84.0% (95% CI: 79.73%-87.68%) and specificity 94.82% (95% CI: 93.43%-95.99%). Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA with appropriate OD cut–off values may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.
Construction of an Arabidopsis/Nicotiana inter-order graft for studies of scion-rootstock interaction
Authors: Deng Zhuying , Jiang Mengting , Wang Mi , Liang Dacheng 
Published: June 2019

Abstract
Background
Scion–rootstock union formation is a critical step towards functional assemblage of heterogeneous plants. However, scion-rootstock interaction often results in graft incompatibility during the process of assemblage. So far, the lack of model heterografts involving both clear genetic backgrounds and taxonomically distant species greatly impedes insights into the mechanisms underlying scion-rootstock interaction.
Results
In this report, we established an Arabidopsis (At)/Nicotiana benthamiana (Nb) heterografting system in which the model plant At and the model plant Nb for plant bioreactor was used as scion and rootstock respectively, to explore the interaction between the two model plants. Regarding to the At scion phenotypes, the At-Nb connection can be characterized into three groups: the mild-stressed, the albino and the dormant grafts. Examination of symplastic and apoplastic flow indicated that a functional inter-order grafting was established in the mild-stressed group, but not in the dormant group. What’s more, the free GFP movement in both At/At homograft and the At/Nb graft implicated that macromolecules moved across the heterograft union of the mild-stressed graft, but congealed at the union of dormant graft. These results accentuated the role of vascular connection in the establishment of compatible heterografts.
Conclusions
The present study established an inter-order model graft involving Arabidopsis and Nicotiana. The interactions from these two species resulted in three distinct grafting groups, which offer us a novel vista to explore many important issues such as grafting compatibility and biomolecule movement.
Genome-wide association mapping for agronomic and quality traits in foxtail millet
Authors: Lou Yanhong , Chen Yun , Liu Zhihao , Sun Mingjie , Han Fei , Wang Tingting , Wang Hui , Zhuge Yuping , Chen Liang 
Published: June 2019

Abstract
Background: Foxtail millet [Setaria italica (L.) P. Beauv.] is a particularly important cereal and fodder crop in arid and semi-arid regions. The genomic variation and alleles underpinning agronomic and quality traits are important for foxtail millet improvement. To better understand the diversity of foxtail millet and facilitate the genetic dissection of its agronomic and quality traits, we used high-quality single nucleotide polymorphisms (SNPs) to perform a genome-wide association study (GWAS). Results: Using genotyping-by-sequencing, 107 foxtail millet accessions were sequenced, and further analysis revealed 72,181 high-quality SNPs, of which 53 were significantly associated with 15 agronomic and quality traits. These SNPs were distributed across the nine chromosomes of foxtail millet; 44 were located in intergenic regions, whereas one and eight SNPs were located in exon and intron regions, respectively. The GWAS revealed that 28 SNPs were associated with a single trait. Conclusions: For some of the significant SNPs, favourable genotypes showed pyramiding effects for several traits. The 53 loci identified in this study will therefore be useful for breeding programs aimed at foxtail millet improvement.
The Relationship between Teaching Quality and Academic Engagement in Medical Students: a descriptive-correlational study
Authors: Bayat Amir-Hossein , Haghgoo Amin , Asady Hadi , Gholamhosseini Elahe , Armoon Bahram 
Published: June 2019

Abstract

Background: One of the essential activities in improving the quality and effectiveness of teaching is to pay attention to the quality of teaching and engagement of students in their academic process. Thus, the aim of this study was to determine the relationship between teaching quality and academic engagement among Iranian nursing students. Methods: This is a descriptive-correlational study. The present study was carried out on 124 anesthesia and operating room nursing students who were selected using simple random sampling in the year 2017. The research tools included standard demographic, course experience, and academic engagement questionnaires. Data analysis was carried out using descriptive tests, independent t-test, and Pearson correlation in SPSS ver. 24. Results: The results of Pearson correlation analysis on the relationship between the subscales of teaching quality, including good teaching, clear goals, appropriate assessment, appropriate workload, independence, and generic skills with academic engagement showed a statistically significant relationship between all remaining subscales, except for the proper workload sub-scale (P=0.234). Conclusion: The results of this study showed a significant positive correlation between the course experience and academic engagement. Therefore, steps can be taken to improve the quality of the educational system using active and student-centered teaching methods.
Young Adult Stroke in Taiwan: etiologies and outcomes
Authors: Chen Chun-Yu , Lin Po-Tso , Syu Ruei-Wun , Hsu Shao-lun , Chang Li-Hsin , Tsai Jui-Yao , Huang Hui-Chi , Liu Tzu-Ching , Wang Yun-Huei , Lin Chun-Jen , Tang Chih-Wei , Hsu Li-Chi , Chung Chih-Ping , Liu Hung-Yu , Chi Nai-Fang , Lee I-Hui 
Published: June 2019

Abstract
Background

Early-onset adult stroke has not been fully characterized in Asians.

Objectives

We investigated the etiologic subtypes, risk factors and 1-year outcomes of early-onset stroke (16 – 55 years of age) in a Taiwanese cohort.

Methods

We retrospectively reviewed consecutive patients with acute stroke admitted to the Taipei Veterans General Hospital in Taiwan between 2009 and 2017. Patients were classified by age of onset (≤ or > 55) and etiologic subtypes and regularly followed for 1 year.

Results

Among all stroke patients (n=8155), 17.6% (n=1310) were early-onset, who had slightly more spontaneous hemorrhagic stroke (50.8%) than ischemic stroke (49.2%). The most common etiologic subtypes of hemorrhagic stroke were hypertensive intracerebral hemorrhage (ICH), subarachnoid hemorrhage and undetermined ICH. The most common subtypes of infarction were large artery atherosclerosis, other determined diseases (52.5% arterial dissection) and embolic stroke of undetermined source. Smoking, alcohol overdrink, obesity, ischemic heart disease and family history of stroke were more in the early-onset than the elderly patients. The early-onset patients with familial stroke (n=87, 6.6%) were more males and more commonly had infarction than those without familial stroke. Monogenic diseases accounted for 5.7% of young familial stroke. At 1-year follow-up, the early-onset patients with infarction displayed greater functional improvements but more stroke recurrence than those with ICH.

Conclusions

Hypertensive hemorrhagic stroke and large artery atherosclerosis or dissection occlusion are characteristically common etiologies of young stroke in Taiwan. Early-onset infarction had higher recurrence yet better 1-year outcomes than early-onset ICH. Patients with familial versus non-familial aggregation had more ischemic infarction and monogenic diseases.
Assessing utility of clinical exome sequencing in diagnosis of rare idiopathic neurodevelopmental disorders in Indian population
Authors: Sheth Harsh , Pancholi Dhairya , Bhavsar Riddhi , Mannan Ashraf U. , Ganapathy Aparna , Chaudhari Mayank , Shah Sudhir , Solanki Dhaval , Sheth Frenny , Sheth Jayesh 
Published: June 2019

Abstract
Background: Neurological diseases are phenotypically and genotypically heterogeneous. Clinical exome sequencing (CES) has been shown to provide a high diagnostic yield for these disorders in the European population but remains to be demonstrated for the Indian population.

Methods: A cohort of 19 idiopathic patients with neurological phenotypes, primarily intellectual disability and developmental delay, were recruited. CES covering 4620 genes was performed on all patients. Candidate variants were validated by Sanger sequencing.

Results: CES in 19 patients provided identified 21 variants across 16 genes which have been associated with different neurological disorders. Fifteen variants were reported previously and 6 variants were novel to our study. Eleven patients were diagnosed with autosomal dominant de novo variants, 7 with autosomal recessive and 1 with X-linked recessive variants. CES provided definitive diagnosis to 10 patients, hence the diagnostic yield was 53%.

Conclusion: Our study suggests that the diagnostic yield of CES in the Indian population is comparable to that reported in the European population. CES together with deep phenotyping could be a cost-effective way of diagnosing rare neurological disorders in the Indian population.
Virulence analysis of 81 of Pseudomonas aeruginosa genomes available in public sequence databases
Authors: Brzozowski Marcin , Jursa-Kulesza Joanna Barbara , Kosik-Bogacka Danuta 
Published: June 2019

Abstract
Background

Pseudomonas aeruginosa is a pathogen capable of causing a wide range of severe opportunistic infections. Its genome contains numerous virulence genes encoding secretion systems of different types, structures responsible for adhesion and motility, toxins, proteases, siderophores, and others. The aim of this study is to analyse virulence, population structure, and distribution of highly divergent genes among 81 P. aeruginosa strains available in whole genome sequence databases.

Results

For this purpose, 260 virulence genes were searched in 81 different P. aeruginosa whole genomes that were available in databases. We identified most of the virulence genes as core and softcore genes. The most of the highly divergent sequences encoding pyoverdines, flagella and pilA were acknowledged as accessory, because of the differences in sequence among different alleles of those genes. Phylogenetic tree revealed the existence of three genetic groups of P. aeruginosa. Strains of the first clade were characterised as ExoS positive, whiles genomes of the second clade were ExoU positive. The member of third clade, PA7 strain was the only strain deprived of all T3SS genes. The analysis of pyoverdine locus facilitated finding a new pyoverdine type similar to pyoverdine type III. This newly described variant was present in 7 different strains. It contained a gene that was probably created by the fusion of pilD and pilI genes. In order to determine the coexistence of genes encoding exoenzymes, flagella and pyoverdines, Pearson correlation coefficients were calculated. There were significant correlations between genes encoding ExoS/ExoU-type strains and genes encoding type-A/type-B flagella. The correlation also occurred between

Conclusion

This study facilitates describing genetic differences of various P. aeruginosa strains based on Pseudomonas aeruginosa whole genome information from online databases. We conclude that most P. aeruginosa virulence genes are present in more than 95% of available genomes of the species. There are correlations of occurrence of different P. aeruginosa accessory virulence genes.
Recurrent Risk of Ischemic Stroke due to Vertebrobasilar Dolichoectasia
Authors: Chen Zhaoyao , Zhang Shuai , Dai Zhengze , Cheng Xi , Wu Minghua , Dai Qiliang , Liu Xinfeng , Xu Gelin 
Published: June 2019

Abstract
Background: Patients with vertebrobasilar dolichoectasia usually have persistent hemodynamic abnormalities, and therefore, may bear an increased risk of stroke. This study aimed to identify risk factors for stroke recurrence in patients with vertebrobasilar dolichoectasia.

Methods: Patients with acute ischemic stroke were screened and evaluated for eligibility. Enrolled patients were followed via scheduled clinical visits or telephone interviews. Ischemic stroke recurrence was proposed with clinical symptoms and confirmed with cranial Magnetic Resonance Imaging or Computerized Tomography scans. Baseline characteristics and vascular geometry were compared between patients with and without stroke recurrence. Significant parameters were introduced into COX proportional hazard model to detect possible predictors of stroke recurrence.

Results: A total of 115 stroke patients with vertebrobasilar dolichoectasia were enrolled, of which 22 (19.1%) had recurrence during 22 ± 6 months follow-up. Basilar artery diameter ≥ 5.3mm (HR = 4.744; 95% CI, 1.718-13.097; P = 0.003), diffuse intracranial dolichoectasia (HR = 3.603; 95% CI, 1.367-9.496; P = 0.010) and ischemic heart disease history (HR = 4.095; 95% CI, 1.221-13.740; P = 0.022) had increased risk of recurrence.

Conclusions: Stroke patients with vertebrobasilar dolichoectasia may have a high risk of recurrence. Larger basilar artery diameter or diffuse intracranial dolichoectasia may increase the risk of recurrence.
Premedication with dexmedetomidine to reduce emergence agitation: a randomized controlled trial
Authors: Kim Jong Chan , Kim Jihee , Kwak Hayeon , Ahn So Woon 
Published: June 2019

Abstract
Background: Nasal bone fracture is the most common type of facial fracture, and the high incidence of severe emergence agitation occurring after closed reduction of the nasal bone fracture can be challenging to manage. The purpose of this trial was to evaluate whether pre-operative administration of dexmedetomidine is effective in reducing the incidence and severity of emergence agitation in adults undergoing closed reduction of nasal bone fractures.
Methods: In this randomized controlled trial, 90 patients who were scheduled to undergo closed reduction of a nasal bone fracture were prospectively included and were randomly assigned to either the control group (n = 45; 0.9% saline infusion) or the dexmedetomidine group (n = 45; 1 mcg/kg over 10 minutes, pre-operatively). The primary endpoint was Aono's four-point scale after anesthesia. The recovery time and numeric rating scale score were assessed as secondary endpoints.
Results: Aono's four-point scale scores were lower in the dexmedetomidine group than in the control group (median: 1 [1-1] vs. 1 [1-2], 95% comfidence interval of difference: 0.01 to 0.02, P = 0.02). The number, severity, and duration of agitation episodes were significantly lower in the dexmedetomidine group than in the control group. Furthermore, the number of patients exhibiting intraoperative movement was lower in the dexmedetomidine group.
Conclusions: Pre-operative administration of dexmedetomidine demonstrated several significant benefits, such as a lower incidence of emergence agitation, reduced agitation severity, and a shorter duration of agitation. Additionally, we observed more stable maintenance of intraoperative anesthesia with less movement during the surgery.