bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative Adverse Events in Women Undergoing Concurrent Hemorrhoidectomy at the Time of Urogynecologic Surgery
Authors: Casas-Puig Viviana , Bretschneider C. Emi , Ferrando Cecile A. 
Published: February 2019

Objective
The aim of this study was to describe the incidence and trends of outcomes after concurrent surgeries for symptomatic hemorrhoids and pelvic floor disorders.

Methods
This was a retrospective matched cohort study. Women who underwent concurrent vaginal urogynecologic and hemorrhoid surgery between 2007 and 2017 were identified by their surgical codes and matched to a cohort of women who underwent vaginal urogynecologic surgery only. The medical record was queried for demographic and perioperative data.

Results
Thirty-three subjects met the inclusion criteria; 198 subjects were matched accordingly (N = 231). Mean age and body mass index were 57 ± 12 years and 28.9 ± 5.6 kg/m2, respectively. Subjects who underwent concurrent hemorrhoidectomy were more likely to have had previous prolapse surgery (27.3% vs 15.2%, P = 0.09) and preoperative fecal incontinence (27.3% vs 13.6%, P = 0.05). Concurrent cases were more likely to have unplanned office visits (27.2% vs 12.6%, P = 0.03) and phone calls (range, 1–7 vs 0–10; P = 0.001), mostly for pain complaints. Reoperation was higher in combined cases (3% vs 0%, P = 0.01); however, the overall rate of serious perioperative adverse events was low and not different between groups. Concurrent cases were more likely to be discharged home with a Foley (42.4% vs 18.2%, P = 0.002) and to have a postoperative urinary tract infection (33.3% vs 10.6%, P = 0.005). In the concurrent group, 33.3% of the patients experienced severe rectal pain.

Conclusions
Patients undergoing concurrent hemorrhoidectomy at the time of vaginal urogynecologic surgery are at higher risk of minor events such as postoperative urinary tract infection and need for discharge home with a Foley, as well as risk of pain that may be greater than urogynecologic surgery alone.
Utility of Preoperative Laboratory Testing in Women Undergoing Suburethral Sling
Authors: Pandya Lopa K. , McLaughlin Eric M. , Hudson Catherine O. , Nekkanti Silpa , Smith Pamela E. , Hade Erinn M. , Hundley Andrew F. 
Published: February 2019

Objective
The aim of the study was to examine current patterns and factors associated with preoperative testing in patients undergoing midurethral sling and to compare 30-day outcomes in subjects.

Methods
This retrospective cohort study was performed using the National Surgery Quality Improvement Program database from 2005 to 2014. All women undergoing midurethral slings were identified by Current Procedural Terminology code. Clinical variables were abstracted and the incidence of preoperative serum labs was determined. Multivariable logistic regression was used to estimate associations between clinical factors and collection of preoperative serum labs and between 30-day outcomes and collection of labs.

Results
A total of 12,368 women underwent midurethral sling in the National Surgery Quality Improvement Program database during the study period. Preoperative serum testing within 30 days before surgery was observed in 9172 (74.2%) women. Age, American Society of Anesthesiologists class, diabetes, and hypertension were strongly associated with preoperative testing when modeling together in multivariable regression. Of the 543 women who had any complication, 410 (75.5%) received preoperative testing. Urinary tract infection was the most frequent complication (66.1%). Age, American Society of Anesthesiologists class, body mass index, and presence of any comorbidity were associated with the presence of any complication at 30 days. Adjusting for these factors, the odds of complications were not significantly different between those who did and did not have preoperative testing (adjusted odds ratio = 0.98, 95% confidence interval = 0.78–1.24).

Conclusions
Most women who underwent midurethral sling procedures had preoperative testing. Major postoperative complications were uncommon, and there was no substantial difference in outcomes between women who underwent preoperative testing and those who did not. In the future, surgeons may consider eliminating preoperative testing in low-risk patients.
All Levels of Providers Can Effectively and Efficiently Teach Pelvic Floor Strength Assessment at Time of Pelvic Examination
Authors: Armstrong Abigail A. , Nguyen My-Linh M. , Wieslander Cecilia K. , Tarnay Christopher M. 
Published: February 2019

Objective
In women who undergo provider-guided vaginal biofeedback of pelvic floor muscle strength, we sought to determine whether the level of the provider correlates with the patient’s ability to achieve adequate pelvic floor muscle contractions (PFMCs).

Methods
From August 2017 to April 2018, patients from 2 urogynecology clinics were recruited to participate in an institutional review board–approved, prospective study examining PFMCs. Pelvic examination and teaching session were done by providers who had specific training on how to assess pelvic floor muscle strength using the validated, modified Oxford scale. Patients were asked to perform a baseline PFMC during a 2-digit pelvic examination. Thereafter, patients were counseled to relax their muscles, identify the levator ani muscles during provider teaching, and perform 3 consecutive provider-guided PFMCs. The strength of each PFMC was measured, and the time-to-teach (TTT) was recorded. The level of provider and TTT were correlated with PFMC1 to PFMC3 using Spearman correlation coefficient.

Results
One hundred women participated. Obstetrics/gynecology (OB/GYN) residents (post-graduate years 1–4) evaluated 20 patients; female pelvic medicine and reconstructive surgery fellowship trainees (post-graduate years 5–7), 38 patients; OB/GYN nurse practitioners, 18 patients; generalist OB/GYN faculty, 9 patients; and female pelvic medicine and reconstructive surgery faculty, 15 patients. There was no correlation between level of provider and TTT or between level of provider and strength of PFMC1, PFMC2, or PFMC3.

Conclusions
At the time of pelvic floor muscle assessment, the level of provider does not impact teaching time or PFMC1 to PFMC3. Teaching pelvic floor muscle exercise is a cost-effective, low-resource tool to improve patient care, and providers of any level should be encouraged to teach pelvic floor muscle exercise to patients at the time of office examination.
Understanding Your Online Ratings: A Methodological Analysis Using Urogynecologists in the United States
Authors: Huber Sarah A. , Priestley Jennifer , Kasabwala Khushabu , Gadidov Bogdan , Culligan Patrick 
Published: February 2019

Objective
The influence of online physician ratings is growing, yet their interpretation remains difficult. Our aim was to analyze the online content of urogynecologists on 1 website to transform these ratings into practical tools for care improvement.

Methods
This cross-sectional analysis studied the ratings and reviews of every board-certified urogynecologist listed on Healthgrades.com. The ratio of 5:1 ratings was compared between various physician characteristics and practice qualities. Four investigators classified narrative reviews into one or more of the following themes: about the (1) physician, (2) clinical outcomes, (3) and/or staff. The content of the narrative reviews was analyzed, and word clouds were created to understand the primary motivators behind ratings.

Results
In February 2018, the Healthgrades pages for 689 urogynecologists were evaluated, and 523 physicians were included in the study. Higher 5:1 ratios were found among men versus women (4.0 vs 3.0; P < 0.01), and OB-GYN–trained versus urology-trained (4.0 vs 2.2; P < 0.01) physicians. A benchmarking rubric was developed to illustrate the 5:1 ratio distribution for all physicians stratified by number of ratings. A total of 3300 narrative reviews were assigned themes with strong inter- and intrarater reliability (Table 3). Physician qualities most influenced extreme scores (1 or 5 stars), whereas average reviews were more influenced by staff. Commonly discussed physician qualities included professionalism, time with patient, and counseling.

Conclusions
Using the 5:1 rating ratio and simplified review themes as tools, physicians can understand what their ratings signify both as an indicator of their online reputation compared with their peers and as a means for improving the patient experience.
Validation and Testing of an E-Learning Module Teaching Core Urinary Incontinence Objectives in a Randomized Controlled Trial
Authors: Parker-Autry Candace Y. , Shen E. , Nance Andrea , Butler Timberly , Covarrubias Julie B. , Varner Robert E. , Richter Holly E. 
Published: February 2019

Objectives
To evaluate the efficacy of a urinary incontinence (UI) e-learning module (ELM) in undergraduate medical education.

Methods
An ELM was developed and validated to teach on UI learning objectives. A 21-item assessment was developed to test knowledge gained. A randomized-controlled trial and parallel nested-cohort study were performed to test the effectiveness of the validated UI-ELM compared with standard methods of UI learning. Students were recruited and enrolled at the onset of their obstetrics and gynecology clerkship. Assignments to either a week-long rotation of gynecologic (GYN) or urogynecologic (UroGyn) surgery were made independent of the study protocol. On the GYN rotation, students were randomly assigned to the UI-ELM intervention or no intervention (control group). The nested-cohort comprised students assigned to the UroGyn rotation. Parametric statistics were applied assessing score changes between the UI-ELM versus control/UroGyn groups.

Results
Eighty-three students rotated between June 2015 and February 2016. Fifty-five were assigned to GYN and randomized: 35 UI-ELM versus 20 no intervention; 28 were assigned to UroGyn. Students randomized to the UI-ELM had greater score improvement compared with controls (between group difference of +2.73; 95% confidence interval, 0.53–4.93; P = 0.02). Knowledge improvement was similar between students exposed to the UI-ELM compared with those with UroGyn exposure (between group difference, +0.91; 95% confidence interval, −1.05 to 2.88; P = 0.35).

Conclusions
The UI-ELM resulted in greater improvement in UI knowledge among third year medical students compared with traditional methods of learning and similar to those exposed to a UroGyn rotation.
Determining the Health State Utility Value of Urinary Tract Infection in Women
Authors: Kalyanaraman Rajeshwari , Demtchouk Veronica , Iyer Vidya , Patterson Danielle 
Published: February 2019

Objectives
Health state utility values are a unique representation of an individual’s valuation for being in a particular health state. Depending on the method of evaluation, group of patients, and setting, these values vary significantly. To date, majority of the available estimates for the health-related state utility values for urinary tract infection (UTI) has been in men with comorbid conditions such as benign prostatic hyperplasia and bladder cancer or with spinal cord abnormalities. The utility values in these studies ranged between 0.3 and 0.9. The purpose of this study was to determine and compare the health state utility value for UTI in women derived from EuroQol 5 dimensions (EQ-5D) questionnaire and visual analog scale (VAS) with the Standard Gamble (SG) interview in a tertiary medical center.

Methods
Healthy volunteers at least 18 years of age with no history of UTI were approached for study participation. Twenty-five subjects were given a standard sheet describing UTI and its symptoms and were asked to complete the EQ-5D and VAS followed by SG conversation.

Results
The median utility (interquartile range) for UTI varied based on the methods: EQ-5D, 1.00 (0.124); VAS, 0.98 (0.10); and SG, 0.90 (0.15). Spearman correlation showed that these values were weakly correlated.

Conclusions
Our data suggest a value of 0.90 to represent the health state utility value of UTI in women older than 18 years. The EQ-5D is not sensitive to impact of UTI in women, and we would not recommend using it for that purpose based on our findings.
Bacterial genome architecture shapes global transcriptional regulation by DNA supercoiling
Authors: Houdaigui Bilal El , Forquet Raphaël , Hindré Thomas , Schneider Dominique , Nasser William , Reverchon Sylvie , Meyer Sam 
Published: February 2019

AbstractDNA supercoiling acts as a global transcriptional regulator in bacteria, that plays an important role in adapting their expression programme to environmental changes, but for which no quantitative or even qualitative regulatory model is available. Here, we focus on spatial supercoiling heterogeneities caused by the transcription process itself, which strongly contribute to this regulation mode. We propose a new mechanistic modeling of the transcription-supercoiling dynamical coupling along a genome, which allows simulating and quantitatively reproducing in vitro and in vivo transcription assays, and highlights the role of genes’ local orientation in their supercoiling sensitivity. Consistently with predictions, we show that chromosomal relaxation artificially induced by gyrase inhibitors selectively activates convergent genes in several enterobacteria, while conversely, an increase in DNA supercoiling naturally selected in a long-term evolution experiment with Escherichia coli favours divergent genes. Simulations show that these global expression responses to changes in DNA supercoiling result from fundamental mechanical constraints imposed by transcription, independently from more specific regulation of each promoter. These constraints underpin a significant and predictable contribution to the complex rules by which bacteria use DNA supercoiling as a global but fine-tuned transcriptional regulator.
Investigation of Goodreads’ reviews: Kakutanied, deceived or simply honest?
Authors: Hajibayova Lala 
Published: February 2019

PurposeThe purpose of this paper is to present an analysis of Goodreads’ user-generated book reviews from a linguistic perspective for insights into the psychological aspects of reviewers’ perceptions and behaviors. This examination of users’ language and perspectives may shed light on the role and value of user-generated reviews in complementing the traditional representation of resources and facilitating the discoverability of cultural objects.Design/methodology/approachThis study involved a textual analysis of 474,803 unique reviews of Goodreads’ 2015 top-rated books generated by 9,335 Goodreads’ reviewers. In order to better understand the nuances of user-generated reviews, a content analysis was applied to 2,500 reviews of each of the five top-ranked titles in Goodreads’ Fiction Literature genre category.FindingsThe analysis of user-generated reviews demonstrates that language is a quite stable and reliable dimension across Goodreads’ users. The high rate of function words utilized, in particular I-words, coupled with positive emotion words, suggests that reviewers tended to convey their opinions in order to influence other individuals’ reading choices, or in Bourdieu’s (1985) terms, influence cultural production. In line with previous studies of user-generated reviews, the prevalence of positive reviews may also imply their unreliable nature. This study supports the importance of transparency regarding inclusion of user-generated reviews in traditional systems of knowledge representation, organization and discovery, such as WorldCat.Originality/valueThis study contributes to better understanding of linguistic characteristics of Goodreads’ reviews, including the role and value of user-generated reviews in complementing traditional representation of resources and facilitating discoverability of cultural objects.
Patterns of citations for the growth of knowledge: a Foucauldian perspective
Authors: Hassan Nik Rushdi , Serenko Alexander 
Published: February 2019

PurposeThe purpose of this paper is to sensitize researchers to qualitative citation patterns that characterize original research, contribute toward the growth of knowledge and, ultimately, promote scientific progress.Design/methodology/approachThis study describes how ideas are intertextually inserted into citing works to create new concepts and theories, thereby contributing to the growth of knowledge. By combining existing perspectives and dimensions of citations with Foucauldian theory, this study develops a typology of qualitative citation patterns for the growth of knowledge and uses examples from two classic works to illustrate how these citation patterns can be identified and applied.FindingsA clearer understanding of the motivations behind citations becomes possible by focusing on the qualitative patterns of citations rather than on their quantitative features. The proposed typology includes the following patterns: original, conceptual, organic, juxtapositional, peripheral, persuasive, acknowledgment, perfunctory, inconsistent and plagiaristic.Originality/valueIn contrast to quantitative evaluations of the role and value of citations, this study focuses on the qualitative characteristics of citations, in the form of specific patterns of citations that engender original and novel research and those that may not. By integrating Foucauldian analysis of discourse with existing theories of citations, this study offers a more nuanced and refined typology of citations that can be used by researchers to gain a deeper semantic understanding of citations.
Property valuation in the UK: market value and net of costs
Authors: French Nick 
Published: February 2019

Purpose
The purpose of this paper is to comment upon the relatively straightforward but often contentious practice of allowing for costs on the capital value derived by the investment model of property valuation.

Design/methodology/approach
This education briefing is an explanation of the discounting process to allow for costs used in practice.

Findings
Although, the deduction of cost is a simple use of algebra, often valuers (and, in particular, students) fail to make the allowance correctly.

Practical implications
The process of allowing for cost is a simple heuristic based on market averages for various individual costs such as agents’ fees and legal fees (including VAT) and property taxation (stamp duty).

Originality/value
This is a review of existing models.
The Stability of Tax Elasticities over the Business Cycle in European Countries
Authors: Boschi Melisso , d'Addona Stefano 
Published: February 2019

AbstractWe estimate short‐ and long‐run tax elasticities that capture the relationship between changes in national income and tax revenue. We show that the short‐run tax elasticity changes according to the business cycle. We estimate a two‐state Markov‐switching regression on a novel data set of tax policy reforms in 15 European countries from 1980 to 2013, showing that the elasticities during booms and recessions are statistically (and often economically) different. The elasticities of personal income taxes, corporate income taxes, indirect taxes and social contributions tend to be larger during recessions. Estimates of long‐run elasticities are in line with existing literature.
Description and cost‐analysis of emergency department attendances for hand and wrist injuries
Authors: Robinson Luke S , O'Brien Lisa 
Published: February 2019

AbstractBackgroundInjuries to the hand and wrist are estimated to account for between 10% and 30% of all ED presentations. The economic burden placed on the healthcare system can be extensive and rise sharply with increase in injury severity.ObjectivesThis cost‐analysis was performed with the aim of estimating the economic implications of ED attendances for hand and wrist injuries from the perspective of one Australian public health network.MethodsData from two EDs were retrieved from the electronic billing records of one large health network across two financial year periods (2014–2015 and 2015–2016) using ICD‐10 codes. All costs that resulted from the treatment of any acute hand or wrist injury across the 2 year period were calculated and are presented by age, sex, injury type and mechanism of injury.ResultsA total of 10 024 individuals presented to the two EDs in the 2 year period, accounting for approximately 5.4% of all presentations. The most common presentations were males (62.2%), people aged 25–34 years (26.9%) and lacerations (31.2%). The total cost in the 2 year study period was $3 959 535.38 ($1 923 852.38 in 2014–2015; $2 035 683.00 in 2015–2016). The mean cost per presentation was $383 (95% CI [$373, $393]) in 2014–2015 and $407 (95% CI [$394, $421]) in 2015–2016.ConclusionsAcute hand and wrist injuries contribute to a significant volume of ED presentations each year in one Australian public health network leading to significant expenditure and health resources. Further research into how to best utilise resources and reduce avoidable injuries should be priority areas to reduce the cost of these injuries to the healthcare system and society.
2018 update of the APLAR recommendations for treatment of rheumatoid arthritis
Authors: Lau Chak Sing , Chia Faith , Dans Leonila , Harrison Andrew , Hsieh Tsu Yi , Jain Rahul , Jung Seung Min , Kishimoto Mitsumasa , Kumar Ashok , Leong Khai Pang , Li Zhanguo , Lichauco Juan Javier , Louthrenoo Worawit , Luo Shue Fen , Mu Rong , Nash Peter , Ng Chin Teck , Suryana Bagus , Wijaya Linda Kurniaty , Yeap Swan Sim 
Published: February 2019

AbstractAimTo update recommendations based on current best evidence concerning the treatment of rheumatoid arthritis (RA), focusing particularly on the role of targeted therapies, to inform clinicians on new developments that will impact their current practice.Materials and methodsA search of relevant literature from 2014 to 2016 concerning targeted therapies in RA was conducted. The RA Update Working Group evaluated the evidence and proposed updated recommendations using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach, to describe the quality of evidence and strength of recommendations. Recommendations were finalized through consensus using the Delphi technique.ResultsThis update provides 16 RA treatment recommendations based on current best evidence and expert clinical opinion. Recommendations 1‐3 deal with the use of conventional synthetic disease‐modifying antirheumatic drugs. The next three recommendations (4‐6) cover the need for screening and management of infections and comorbid conditions prior to starting targeted therapy, while the following seven recommendations focus on use of these agents. We address choice of targeted therapy, switch, tapering and discontinuation. The last three recommendations elaborate on targeted therapy for RA in special situations such as pregnancy, cancer, and major surgery.ConclusionRheumatoid arthritis remains a significant health problem in the Asia‐Pacific region. Patients with RA can benefit from the availability of effective targeted therapies, and these updated recommendations provide clinicians with guidance on their use.