bluuebunny/crossref_metadata_2025_split huggingface dataset:
Refining Risk Adjustment for the Proposed CMS Surgical Hip and Femur Fracture Treatment Bundled Payment Program
Authors: Cairns Mark A. , Ostrum Robert F. , Clement R. Carter 
Published: February 2018

Background:
The U.S. Centers for Medicare & Medicaid Services (CMS) has been considering the implementation of a mandatory bundled payment program, the Surgical Hip and Femur Fracture Treatment (SHFFT) model. However, bundled payments without appropriate risk adjustment may be inequitable to providers and may restrict access to care for certain patients. The SHFFT proposal includes adjustment using the Diagnosis-Related Group (DRG) and geographic location. The goal of the current study was to identify and quantify patient factors that could improve risk adjustment for SHFFT bundled payments.

Methods:
We retrospectively reviewed a 5% random sample of Medicare data from 2008 to 2012. A total of 27,898 patients were identified who met SHFFT inclusion criteria (DRG 480, 481, and 482). Reimbursement was determined for each patient over the bundle period (the surgical hospitalization and 90 days of post-discharge care). Multivariable regression was performed to test demographic factors, comorbidities, geographic location, and specific surgical procedures for associations with reimbursement.

Results:
The average reimbursement was $23,632 ± $17,587. On average, reimbursements for male patients were $1,213 higher than for female patients (p < 0.01). Younger age was also associated with higher payments; e.g., reimbursement for those ≥85 years of age averaged $2,282 ± $389 less than for those aged 65 to 69 (p < 0.01). Most comorbidities were associated with higher reimbursement, but dementia was associated with lower payments, by an average of $2,354 ± $243 (p < 0.01). Twenty-two procedure codes are included in the bundle, and patients with the 3 most common codes accounted for 98% of the cases, with average reimbursement ranging from $22,527 to $24,033. Less common procedures varied by >$20,000 in average reimbursement (p < 0.01). DRGs also showed significant differences in reimbursement (p < 0.01); e.g., DRG 480 was reimbursed by an average of $10,421 ± $543 more than DRG 482. Payments varied significantly by state (p ≤ 0.01). Risk adjustment incorporating specific comorbidities demonstrated better performance than with use of DRG alone (r2 = 0.22 versus 0.15).

Conclusions:
Our results suggest that the proposed SHFFT bundled payment model should use more robust risk-adjustment methods to ensure that providers are reimbursed fairly and that patients retain access to care. At a minimum, payments should be adjusted for age, comorbidities, demographic factors, geographic location, and surgical procedure.
Minimum Two-Year Follow-up of Anterior Cruciate Ligament Reconstruction in Patients with Generalized Joint Laxity
Authors: Kim Sung-Jae , Choi Chong Hyuk , Lee Su-Keon , Lee Wonyong , An Haemosu , Jung Min 
Published: February 2018

Background:
The purposes of this investigation were to compare outcomes of anterior cruciate ligament (ACL) reconstruction between patients with generalized joint laxity and those without it and to investigate the effect of generalized joint laxity on outcomes of ACL reconstruction from 2 to 8 years postoperatively.

Methods:
We retrospectively reviewed 163 patients who had undergone unilateral ACL reconstruction from January 2001 to December 2008. Patients were divided into 2 groups according to presence or absence of generalized joint laxity. The proportions of patients with meniscectomy, graft rupture, and contralateral ACL rupture were compared. Rupture rates were compared with Kaplan-Meier analysis. The Lachman test, pivot-shift test, and anterior translation measured with the KT-2000 arthrometer were evaluated. The Lysholm knee score and International Knee Documentation Committee (IKDC) subjective score were compared. The IKDC objective grade and radiographic grade were also evaluated. Follow-up assessments were performed at 2, 5, and 8 years postoperatively.

Results:
The proportions of meniscectomy, graft rupture, and contralateral ACL rupture in patients with generalized joint laxity were higher than in patients without generalized joint laxity during the whole evaluation period. However, differences in proportions and cumulative rupture rates did not reach significance (p > 0.05). Patients with generalized joint laxity had less stability and poorer functional outcomes at the 8-year follow-up compared with patients without generalized joint laxity. With regard to the Lachman test and anterior translation, poorer results were shown in patients with generalized joint laxity than in patients without generalized joint laxity during the whole evaluation period. The results of pivot-shift testing differed significantly at 5 years (p = 0.002) and 8 years (p = 0.007). Patients with generalized joint laxity also had worse Lysholm knee scores and IKDC subjective scores during the whole evaluation period; these differences may not be clinically important. Comparisons between serial outcomes measured at 2, 5, and 8-year follow-ups within each patient group showed that anterior translation (p = 0.002), Lysholm knee score (p = 0.014), and IKDC subjective score (p = 0.002) deteriorated over time, although the values at 8 years were similar to those at 5 years, in patients with generalized joint laxity.

Conclusions:
Generalized joint laxity as an inherent physiologic characteristic of patients was related to a significant adverse effect on stability and functional outcomes of ACL reconstruction for patients followed for 2 to 8 years. Generalized joint laxity should be considered a risk factor for poor outcomes after ACL reconstruction.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Unified Approach to Yield, Buckling, and Leak in Well Tubulars
Authors: Goodman Malcolm A. 
Published: February 2018

Summary
Yield and buckling are independent of hydrostatic pressure. However, leak in a threaded connection depends on hydrostatic pressure, and hence, leak resistance is a function of connector location in the string. It also means that von Mises stress alone is insufficient to characterize connection leak. Like pipe-body yield and buckling, a simple consistent failure theory derived from principles of mechanics is proposed for leak in threaded connections. In addition, the buckling fictitious force is reformulated as a nonfictitious expression to clearly show independence of hydrostatic pressure. Two leak constants—thread modulus and makeup leak resistance—are introduced and evaluated with simple example cases. To quantify results, a 7-in. long-thread-casing (LTC) connection is modeled with the new leak criterion, and results demonstrate that the connection can withstand differential pressures higher than the published ratings because of hydrostatic pressure. A new connection safety factor is defined, and a leak line and a leak circle are developed for graphical purposes to quickly identify critical loads for leak.
Antifungal Activity of Arginine-Based Surfactants
Authors: Fait Maria E. , da Costa Helen P. S. , Freitas Cleverson D. T. , Bakás Laura , Morcelle Susana R. 
Published: February 2018

Background:Amino acid based surfactants constitute an important class of surface active biomolecules showing remarkable biocompatible properties. Antimicrobial activity is one of the most remarkable biological properties of this kind of surfactants, which have been widely studied against a broad spectrum of microorganisms. However, the antifungal activity of this kind of compound has been less well investigated. The aim of this work is the study of the antifungal activity of two novel argininebased surfactants (Nα-benzoyl-arginine decylamide, Bz-Arg-NHC10 and Nα-benzoyl-arginine dodecylamide, Bz-Arg-NHC12), obtained by an enzymatic strategy, against phytopathogenic filamentous fungi and dermatophyte strains.Methods:Four phytopathogenic fungi (Fusarium oxysporum, Fusarium solani, Colletotrichum gloeosporioides and Colletotrichum lindemuthianum) and two human pathogenic fungi (dermatophytes Trichophyton rubrum and Trichophyton mentagrophytes) were tested. Inhibition of vegetative growth and conidia germination was investigated for the phytopathogenic fungi. In order to elucidate the possible mechanism of biocide action, membrane integrity, as well as the production of reactive oxygen species (ROS) were evaluated. Additionally, the inhibition of germination of dermatophyte microconidia due to both arginine-based surfactants was studied. Minimum inhibitory concentration, as well as the concentration that inhibits 50% of germination were determined for both compounds and both fungal strains.Results:For the vegetative growth of phytopathogenic fungi, the most potent arginine-based compound was Bz-Arg-NHC10. All the tested compounds interfered with the conidia development of the studied species. Investigation of the possible mechanism of toxicity towards phytopathogenic fungi indicated direct damage of the plasma membrane and production of ROS. For the two strains of dermatophyte fungi tested, all the proved compounds showed similar fungistatic efficacy.Conclusion:: Bz-Arg-NHC10 and Bz-Arg-NHC12 were demonstrated to have broad biocidal ability against the proliferative vegetative form and the asexual reproductive conidia. Results suggest that both membrane permeabilization and induction of oxidative stress are part of the antifungal mechanisms involved in the interruption of normal conidia development by Bz-Arg-NHCn, leading to cell death.
Inducing Behavioral Change in Seekers of Pro-Anorexia Content Using Internet Advertisements: Randomized Controlled Trial
Authors: Yom-Tov Elad , Brunstein-Klomek Anat , Mandel Or , Hadas Arie , Fennig Silvana 
Published: February 2018

Background
The influence of pro-anorexia (pro-ana) websites is debated, with studies indicating both negative and positive effects, as well as significant variation in the effects of different websites for those suffering from eating disorders (EDs) and the general population. Online advertising, known to induce behavioral change both online and in the physical world, has not been used so far to modify the search behavior of people seeking pro-ana content.

Objective
The objective of this randomized controlled trial (RCT) was to examine if online advertisements (ads) can change online search behaviors of users who are looking for online pro-ana content.

Methods
Using the Bing Ads system, we conducted an RCT to randomly expose the searchers for pro-ana content to 10 different ads referring people to one of the three websites: the National Eating Disorders Association, the National Institutes of Mental Health, and MyProAna. MyProAna is a pro-ana website that was found in a previous study to be associated with less pathological online behaviors than other pro-ana websites. We followed participants exposed and unexposed to the ads to explore their past and future online searches. The ads were shown 25,554 times and clicked on 217 times.

Results
Exposure to the ads was associated with a decrease in searches for pro-ana and self-harm content. Reductions were greatest among those referred to MyProAna (reduction of 34.0% [73/215] and 37.2% [80/215] for pro-ana and self-harm, respectively) compared with users who were referred elsewhere (reduction of 15.47% [410/2650] and 3.21% [85/2650], respectively), and with users who were not shown the ads, who increased their behaviors (increase of 57.12% [6462/11,314] and 4.07% [461/11,314], respectively). In addition, those referred to MyProAna increased their search for treatment, as did control users, who did so to a lesser extent. However, users referred elsewhere decreased their searches for this content.

Conclusions
We found that referring users interested in ED-related content to specific pro-ana communities might lessen their maladaptive online search behavior. This suggests that those who are preoccupied with EDs can be redirected to less pathological online searches through appropriate pathways.

Trial Registration
ClinicalTrials.gov NCT03439553; https://clinicaltrials.gov/show/NCT03439553 (Archived by WebCite at http://www.webcitation.org/6xNYnxYlw)
An Outcomes-Based Definition of Proteinuria Remission in Focal Segmental Glomerulosclerosis
Authors: Troost Jonathan P. , Trachtman Howard , Nachman Patrick H. , Kretzler Matthias , Spino Cathie , Komers Radko , Tuller Sarah , Perumal Kalyani , Massengill Susan F. , Kamil Elaine S. , Oh Gia , Selewski David T. , Gipson Patrick , Gipson Debbie S. 
Published: February 2018

Background and objectives
Proteinuria is used as an indicator of FSGS disease activity, but its use as a clinical trial end point is not universally accepted. The goal of this study was to refine proteinuria definitions associated with long-term kidney survival.

Design, setting, participants, & measurements
Data on 466 patients with primary FSGS with proteinuria (urine protein-to-creatinine ratio >1 g/g) were analyzed from five independent cohorts. Proteinuria by months 1, 4, and 8 after study baseline was categorized by conventional definitions of complete (<0.3 g/g) and partial remission (<3.5 g/g and 50% reduction in proteinuria). Novel remission definitions were explored using receiver operating curves. Kaplan–Meier methods were used to estimate the associations of proteinuria with progression to ESRD or a 50% loss in kidney function. Propensity score–adjusted Cox proportional hazards models were used to adjust for baseline proteinuria, eGFR, and therapy.

Results
In the initial derivation cohort, conventional partial remission was not associated with kidney survival. A novel definition of partial remission (40% proteinuria reduction and proteinuria<1.5 g/g) on the basis of receiver operating curve analyses of 89 patients was identified (Sensitivity=0.70; Specificity=0.77). In the validation cohort analyses, complete remission was associated with better prognosis (6 out of 41 patients progressed to kidney failure; 6.6 per 100 patient-years) as was the novel partial remission (13 out of 71 progressed; 8.5 per 100 patient-years), compared with those with no response (51 out of 116 progressed; 20.1 per 100 patient-years). Conventional partial remission at month 8, but not month 4, was also associated with better response (19 out of 85 patients progressed; risk=10.4 per 100 patient-years). Propensity score–adjusted analyses showed the novel partial remission was associated with less progression at months 4 and 8 (month 4: hazard ratio, 0.50; P=0.01; month 8: hazard ratio, 0.30; P=0.002).

Conclusions
Reaching either a complete or partial remission using a novel or conventional definition was associated with better long-term outcomes in patients with FSGS.

Podcast
This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_02_20_CJASNPodcast_18_3_T.mp3
INTEGRATION MODEL OF CREATIVE TELEMATICS INDUSTRIES WITH MANUFACTURING INDUSTRY IN WEST JAWA PROVINCE
Authors: Nurhasan Nurhasan 
Published: February 2018

This research is important to integrate the vision and mission of Small and Medium Industries of Creative Telematics with the vision and mission of the Manufacturing Industry especially in West Java province, considering the facts or existing condition that between Small and Medium Industries of Creative Telematics and the Manufacturing Industry still run on their own way and there has not been symbiotic mutualism relations and /or orientation of activities between the two levels of industry has not been integrated. This study was conducted by using empirical juridical approach which is oriented towards holistic study and in the process, legal disciplines receive related disciplines .Analysis of the object of research was conducted through legal analysis The results of this analysis is the drafting of Integration Model Construction of Small and Medium Industries of Creative Telematics in the strengthening of manufacturing industry to increase productivity and competitiveness of industry in west java province, which can be briefly described as follows: a) Intellectual Property Rights produced by Small and Medium Industries of Creative Telematics either Copyrights, Patents, industrial design, or Right to Layout Design of Integrated Circuits is appreciated and is utilized by the specific manufacturing industry, so that both Small and Medium Industries of Creative Telematics and specific manufacturing industry get Added Value to increase the productivity and the competitiveness of local industry and national industry, and periodically Small and Medium Industries of Creative Telematics get the program of technical and management assistance from the specific manufacturing industry in order to meet the standardization of quality of products and quantity of products which is in accordance with standards set by the specific manufacturing industry, and also to gain greater trust from Financial Services to boost the capital; b) the specific manufacturing Industry got efficiency and effectiveness in developing the investments especially related to the fulfillment of the market demands ( design development) and production capacity through symbiotic mutualism and Small and Medium Industries of Creative Telematics; c) The government obtained the holistic study as materials to formulate legislation (Act, government regulations, local regulations) in the field of development of Small and Medium Industries of Creative Telematics in particular, the integrated industrial development and the sustainable industrial development, and the increase of regional revenue in the form of both local taxes and levies. and d) Financial Institutions ( Financial Services ) can reduce or minimize the potency of bad loans from the Small and Medium Industries of Creative Telematics.
Is There a Need for the Re(dis)covery of Teaching?
Authors: Biesta Gert 
Published: February 2018

Earlier this year I published a book with the title The Rediscovery of Teaching (Biesta 2017). In the book I make the case that teaching matters. But unlike a significant part of contemporary discourse, I argue against the idea that the reason why teaching matters is that it has the capacity for driving test scores in the narrow set of curricular subjects that the Global Education Measurement Industry is keen to measure, not just to identify ‘quality,’ but also to ‘name and shame’ countries that are apparently not performing ‘well’ – a naming and shaming where, unfortunately, teachers often find themselves at the receiving end.
Use of a 3-Telsa magnet to perform delayed gadolinium-enhanced magnetic resonance imaging of the distal interphalangeal joint of horses with and without naturally occurring osteoarthritis
Authors: Bischofberger Andrea S. , Fürst Anton E. , Torgerson Paul R. , Carstens Ann , Hilbe Monika , Kircher Patrick 
Published: February 2018

Abstract
OBJECTIVE To characterize delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) features of healthy hyaline cartilage of the distal interphalangeal joint (DIPJ) of horses, to determine whether dGEMRIC can be used to differentiate various stages of naturally occurring osteoarthritis of the DIPJ, and to correlate relaxation times determined by dGEMRIC with the glycosaminoglycan concentration, water content, and macroscopic and histologic findings of hyaline cartilage of DIPJs with and without osteoarthritis.
SAMPLE 1 cadaveric forelimb DIPJ from each of 12 adult warmblood horses.
PROCEDURES T1-weighted cartilage relaxation times were obtained for predetermined sites of the DIPJ before (T1preGd) and after (T1postGd) intra-articular gadolinium administration. Corresponding cartilage sites underwent macroscopic, histologic, and immunohistochemical evaluation, and cartilage glycosaminoglycan concentration and water content were determined. Median T1preGd and T1postGd were correlated with macroscopic, histologic, and biochemical data. Mixed generalized linear models were created to evaluate the effects of cartilage site, articular surface, and macroscopic and histologic scores on relaxation times.
RESULTS 122 cartilage specimens were analyzed. Median T1postGd was lower than the median T1preGd for normal and diseased cartilage. Both T1preGd and T1postGd were correlated with macroscopic and histologic scores, whereby T1preGd increased and T1postGd decreased as osteoarthritis progressed. There was topographic variation of T1preGd and T1postGd within the DIPJ. Cartilage glycosaminoglycan concentration and water content were significantly correlated with T1preGd and macroscopic and histologic scores but were not correlated with T1postGd.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dGEMRIC relaxation times varied for DIPJs with various degrees of osteoarthritis. These findings may help facilitate early detection of osteoarthritis.
Optimized computed tomography protocol for assessment of dentition in alpacas
Authors: Fulkerson Caroline V. , Lim Chee Kin , Baird Aubrey N. , Weil Ann B. , Heng Hock Gan , Gutierrez-Crespo Beatrice , Moore George E. 
Published: February 2018

Abstract
OBJECTIVE To determine the optimal protocol for acquisition of CT images of the dentition in alpacas.
ANIMALS 3 healthy adult male alpacas.
PROCEDURES Each alpaca was anesthetized with an IM injection of a combination of ketamine, xylazine, and butorphanol and positioned in sternal recumbency on the CT couch with its legs folded in a natural cush position and its head positioned within the isocenter of the gantry of a 64-slice CT scanner. Images were acquired by means of 6 protocols (sequential and helical modes at slice thicknesses of 1.25, 2.5, and 5 mm). Five images (2 molar, 2 premolar, and mandibular incisor teeth) were selected from each protocol for evaluation by 3 veterinary radiologists. For each image, tooth root visibility and sharpness and image noise artifact were subjectively evaluated on a 3-point scoring system.
RESULTS Slice thickness significantly affected tooth root visibility and tooth root sharpness but did not affect image noise artifact. Acquisition mode significantly affected tooth root visibility and tooth root sharpness as well as image noise artifact. Tooth root visibility and sharpness did not differ significantly between the helical and sequential images when the slice thickness was 1.25 mm. Image noise artifact was greater for helical images than sequential images but did not differ by slice thickness within either acquisition mode.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that for a 64-slice CT scanner, the optimal protocol for the acquisition of CT images of the dentition in alpacas was a sequential scan with a slice thickness of 1.25 mm.