bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Usefulness of Main Prayer Hall of Masjid Agung Islamic Center of Lhokseumawe, Aceh - Indonesia
Authors: Karsono Bambang , Gregory Zayn Al-Abideen , Amer Koesmeri Dona Rose , Awang Sulong Awang Hashim bin , Zaini Atta Idrawani 
Published: October 2018

Abstract
Spatial design of masjids is typically the result of duplicating or replicating typology considered appropriate by the Muslim community. Often, this approach results in a massive centralized main prayer space that is underutilized and may contradict fundamental Islamic principles derived from the Quran and Hadith (canonical sayings of Prophet Muhammad

) This article attempts to reveal the utilization of the main praying hall at Masjid Agung Islamic Center (MAIC) of Lhokseumawe. Further, this study challenges the MAIC in light of the Islamic principle of ‘avoiding exaggeration’. Observation was conducted over 30 days alongside an exploration of values and principles guiding Islamic Architecture according to Quran and Hadith. Findings show the utilization of the main prayer hall of MAIC averaged 3.24% on a daily basis and 3.26% for Shalah (ritual prostration performed five times a day); clearly, a sign of wasted space. Results of this study are expected to stimulate discussion in the area of design and planning of Islamic Architecture toward a wiser design, particularly in Aceh Province of Indonesia.
MetaPGN: a pipeline for construction and graphical visualization of annotated pangenome networks
Authors: Peng Ye , Tang Shanmei , Wang Dan , Zhong Huanzi , Jia Huijue , Cai Xianghang , Zhang Zhaoxi , Xiao Minfeng , Yang Huanming , Wang Jian , Kristiansen Karsten , Xu Xun , Li Junhua 
Published: October 2018

Abstract
Pangenome analyses facilitate the interpretation of genetic diversity and evolutionary history of a taxon. However, there is an urgent and unmet need to develop new tools for advanced pangenome construction and visualization, especially for metagenomic data. Here, we present an integrated pipeline, named MetaPGN, for construction and graphical visualization of pangenome networks from either microbial genomes or metagenomes. Given either isolated genomes or metagenomic assemblies coupled with a reference genome of the targeted taxon, MetaPGN generates a pangenome in a topological network, consisting of genes (nodes) and gene-gene genomic adjacencies (edges) of which biological information can be easily updated and retrieved. MetaPGN also includes a self-developed Cytoscape plugin for layout of and interaction with the resulting pangenome network, providing an intuitive and interactive interface for full exploration of genetic diversity. We demonstrate the utility of MetaPGN by constructing Escherichia coli pangenome networks from five E. coli pathogenic strains and 760 human gut microbiomes,revealing extensive genetic diversity of E. coli within both isolates and gut microbial populations. With the ability to extract and visualize gene contents and gene-gene physical adjacencies of a specific taxon from large-scale metagenomic data, MetaPGN provides advantages in expanding pangenome analysis to uncultured microbial taxa.
A randomized controlled trial to improve engagement of hospitalized patients with their patient portals
Authors: Greysen S Ryan , Harrison James D , Rareshide Charles , Magan Yimdriuska , Seghal Neil , Rosenthal Jaime , Jacolbia Ronald , Auerbach Andrew D 
Published: October 2018

AbstractObjectivesTo test a patient-centered, tablet-based bedside educational intervention in the hospital and to evaluate the efficacy of this intervention to increase patient engagement with their patient portals during hospitalization and after discharge.Materials and MethodsWe conducted a randomized controlled trial of adult patients admitted to the hospitalist service in one large, academic medical center. All participants were supplied with a tablet computer for 1 day during their inpatient stay and assistance with portal registration and initial login as needed. Additionally, intervention group patients received a focused bedside education to demonstrate key functions of the portal and explain the importance of these functions to their upcoming transition to post-discharge care. Our primary outcomes were proportion of patients who logged into the portal and completed specific tasks after discharge. Secondary outcomes were observed ability to navigate the portal before discharge and self-reported patient satisfaction with bedside tablet use to access the portal.ResultsWe enrolled 97 participants (50 intervention; 47 control); overall 57% logged into their portals ≥1 time within 7 days of discharge (58% intervention vs. 55% control). Mean number of logins was higher for the intervention group (3.48 vs. 2.94 control), and mean number of specific portal tasks performed was higher in the intervention group; however, no individual comparison reached statistical significance. Observed ability to login and navigate the portal in the hospital was higher for the intervention group (64% vs. 60% control), but only 1 specific portal task was significant (view provider messaging tab: 92% vs. 77% control, P = .04). Time needed to deliver the intervention was brief (&lt;15 min for 80%), and satisfaction with the bedside tablet to access the portal was high in the intervention group (88% satisfied/very satisfied).ConclusionOur intervention was highly feasible and acceptable to patients, and we found a highly consistent, but statistically non-significant, trend towards higher inpatient engagement and post-discharge use of key portal functions among patients in the intervention group.
AMIA Board White Paper: AMIA 2017 core competencies for applied health informatics education at the master’s degree level
Authors: Valenta Annette L , Berner Eta S , Boren Suzanne A , Deckard Gloria J , Eldredge Christina , Fridsma Douglas B , Gadd Cynthia , Gong Yang , Johnson Todd , Jones Josette , Manos E LaVerne , Phillips Kirk T , Roderer Nancy K , Rosendale Douglas , Turner Anne M , Tusch Guenter , Williamson Jeffrey J , Johnson Stephen B 
Published: October 2018

AbstractThis White Paper presents the foundational domains with examples of key aspects of competencies (knowledge, skills, and attitudes) that are intended for curriculum development and accreditation quality assessment for graduate (master’s level) education in applied health informatics. Through a deliberative process, the AMIA Accreditation Committee refined the work of a task force of the Health Informatics Accreditation Council, establishing 10 foundational domains with accompanying example statements of knowledge, skills, and attitudes that are components of competencies by which graduates from applied health informatics programs can be assessed for competence at the time of graduation. The AMIA Accreditation Committee developed the domains for application across all the subdisciplines represented by AMIA, ranging from translational bioinformatics to clinical and public health informatics, spanning the spectrum from molecular to population levels of health and biomedicine. This document will be periodically updated, as part of the responsibility of the AMIA Accreditation Committee, through continued study, education, and surveys of market trends.
Equal North: how can we reduce health inequalities in the North of England? A prioritization exercise with researchers, policymakers and practitioners
Authors: Addison M , Kaner E , Johnstone P , Hillier-Brown F , Moffatt S , Russell S , Barr B , Holland P , Salway S , Whitehead M , Bambra C 
Published: October 2018

Abstract

Background
The Equal North network was developed to take forward the implications of the Due North report of the Independent Inquiry into Health Equity. The aim of this exercise was to identify how to reduce health inequalities in the north of England.

Methods
Workshops (15 groups) and a Delphi survey (3 rounds, 368 members) were used to consult expert opinion and achieve consensus. Round 1 answered open questions around priorities for action; Round 2 used a 5-point Likert scale to rate items; Round 3 responses were re-rated alongside a median response to each item. In total, 10 workshops were conducted after the Delphi survey to triangulate the data.

Results
In Round 1, responses from 253 participants generated 39 items used in Round 2 (rated by 144 participants). Results from Round 3 (76 participants) indicate that poverty/implications of austerity (4.87 m, IQR 0) remained the priority issue, with long-term unemployment (4.8 m, IQR 0) and mental health (4.7 m, IQR 1) second and third priorities. Workshop 3 did not diverge from findings in Round 1.

Conclusions
Practice professionals and academics agreed that reducing health inequalities in the North of England requires prioritizing research that tackles structural determinants concerning poverty, the implications of austerity measures and unemployment.
Sentinel Emotional Events: The Nature, Triggers, and Effects of Shame Experiences in Medical Residents
Authors: Bynum William E. , Artino Anthony R. , Uijtdehaage Sebastian , Webb Allison M.B. , Varpio Lara 
Published: October 2018

Purpose
This study explores an under-investigated topic, how medical residents experience shame within clinical learning environments, by asking residents to reflect on (1) the nature of their shame experiences; (2) the events that triggered, and factors that contributed to, those shame experiences; and (3) the perceived effects of those shame experiences.

Method
In this hermeneutic phenomenology study, the authors recruited 12 (self-nominated) residents from an internal medicine residency at a large teaching hospital in the United States. Data collection from each participant in 2016–2017 included (1) a written reflection about an experience during medical training in which the participant felt “flawed, deficient, or unworthy,” and (2) a semi-structured interview that explored the participant’s shame experience(s) in depth. The data were analyzed according to hermeneutic traditions, producing rich descriptions about participants’ shame experiences.

Results
Participants’ shame experiences ranged from debilitating emotional and physical reactions to more insidious, fleeting reactions. Participants reported shame triggers relating to patient care, learning processes, and personal goals; numerous factors contributed to their shame experiences. The effects of shame reactions included social isolation, disengagement from learning, impaired wellness, unprofessional behavior, and impaired empathy. Positive effects of shame reactions included enhanced learning, increased willingness to reach out for help, and improved relationships.

Conclusions
Shame reactions can be sentinel emotional events with significant physical and/or psychological effects in medical learners. This study has implications for learners, educators, and patients, and it may pave the way toward open, honest conversations about the role shame plays in medical education.
Knee Stiffness After Tibial Plateau Fractures: Predictors and Outcomes (OTA-41)
Authors: Kugelman David N. , Qatu Abdullah M. , Strauss Eric J. , Konda Sanjit R. , Egol Kenneth A. 
Published: October 2018

Objectives:What patient characteristics and injury factors predict decreased knee range of motion (ROM) after operative management of tibial plateau fractures?Design:Prospective cohort study.Setting:Academic medical center.Patients:Over 11 years, tibial plateau fractures at a single academic institution were prospectively followed. A total of 266 patients were included in this study.Intervention:Surgical repair of tibial plateau fractures and secondary interventions due to arthrofibrosis.Main outcome measure:Clinical outcomes were evaluated using the Short Musculoskeletal Function Assessment and ROM at 3-month, 6-month, and long-term follow-up. Secondary outcomes were considered as the need for a subsequent procedure due to arthrofibrosis.Results:At 3-month follow-up, the mean ROM was 113 degrees. By long-term follow-up (mean = 17 months), the mean ROM improved to 125 degrees. Independent predictors of decreased knee ROM were the following: at 3-month follow-up, open fractures (P= 0.047), application of a knee-spanning external fixator (P= 0.026), orthopaedic polytrauma (P= 0.003), and tibial spine involvement (P= 0.043); and at long-term follow-up, nonwhite ethnicity (P= 0.003), increasing age (P= 0.003), and a deep infection (P= 0.002). Ten patients (3.7%) required a secondary procedure for arthrofibrosis. There was a significant improvement in the knee ROM (P< 0.001) and functional outcomes (P= 0.004) following the intervention.Conclusions:At long-term follow-up, independent predictors of decreased knee ROM were nonwhite ethnicity, increasing age, and sustaining a postoperative complication of a deep infection. Secondary interventions were reliable treatments for arthrofibrosis.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Variations in the Organisms Causing Deep Surgical Site Infections in Fracture Patients at a Level I Trauma Center (2006–2015)
Authors: Montalvo Ryan N. , Natoli Roman M. , O'Hara Nathan N. , Schoonover Carrie , Berger Peter Z. , Reahl G. Bradley , Shirtliff Mark E. , Manson Theodore T. , Torbert Jesse T. , O'Toole Robert V. , Joshi Manjari 
Published: October 2018

Objectives:
To quantify the current bacteriology of deep surgical site infections (SSIs) after fracture surgery at 1 institution and to compare those data with historical controls at the same institution, assessing variations in infecting organisms over the past decade.

Design:
Retrospective review.

Setting:
Level I trauma center.

Patients/Participants:
Two hundred forty-three patients requiring surgical intervention for deep SSI between January 2011 and December 2015 were compared with 211 patients requiring surgical intervention for deep SSI between December 2006 and December 2010.

Intervention:
None.

Main Outcome Measurements:
Bacteria were categorized as Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus, Enterococcus, gram-negative rods (GNR), gram-positive rods, anaerobes, or negative cultures. The proportion of each bacterial type was determined and compared with previously published data from the same trauma center (December 2006 to December 2010).

Results:
Patients most commonly had S. aureus infections (48%), followed by GNR (40%) and CoNS (19%). The proportion of CoNS species (26% vs. 12%, P < 0.01) in infected patients was significantly higher during the current study period compared with historical controls. The proportion of S. aureus species in infected patients was significantly less during the current study period (39% vs. 56%, P < 0.01). The reduction in the proportion of S. aureus species in infected patients was driven by a decrease in the proportion of methicillin-resistant S. aureus (MRSA) in the overall sample.

Conclusions:
Bacteriology of deep SSI of fractures has changed substantially over the past decade at our center, specifically the proportions of GNR, CoNS, and MRSA.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Comparison of the Open Semi-extended Parapatellar Versus Standard Entry Tibial Nailing Techniques and Knee Pain: A Randomized Controlled Trial
Authors: Rothberg David L. , Stuart Ami R. , Presson Angela P. , Haller Justin M. , Higgins Thomas F. , Kubiak Erik N. 
Published: October 2018

Objective:
To determine if an open, semi-extended, parapatellar tibial nailing technique (SEK) imparts any undue knee symptoms/pain compared with the traditional infrapatellar tibial nailing technique (FK).

Design:
Randomized controlled trial.

Setting:
Level 1 trauma center.

Patients:
Forty-seven patients with OTA/AO 42A-C tibial shaft fractures were included in the study.

Intervention:
Patients were randomized to treatment with either a SEK or an FK technique.

Main Outcome:
The main outcome was a symptoms subset of the International Knee Documentation Committee (SS-IKDC) pertaining to knee symptoms/pain.

Results:
Final follow-up was collected at 1 year for 24 SEK and 23 FK patients. No significant differences were found between the groups in regards to demographics, injury, or surgery-related variables. The 2 techniques did have equivalent symptoms scores [mean for the difference (SEK − FK): 0.29, 90% confidence interval: −4.16 to 4.75] but did not have equivalent pain scores [mean for the difference (SEK − FK): 0.2, 90% confidence interval: −3.18 to 3.59]. When comparing demographic and injury-related variables to the SS-IKDC, only Kellgren–Lawrence classification was statistically significant (P = 0.026), where increasing presence of osteoarthritis was associated with lower scores.

Conclusions:
The results of this single-center randomized controlled trial show that SEK and FK techniques for tibial nailing are equivalent in regards to knee symptoms (defined as ±5 points on the SS-IKDC) but not specifically pain that showed trends toward decreasing knee pain with the open SEK technique. This randomized controlled trial demonstrates that the use of the open semi-extended, parapatellar technique for tibial nailing should not be associated with any higher likelihood of knee pain/symptoms than the traditional flexed knee, infrapatellar technique.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Operative Setup to Improve Sagittal Syndesmotic Reduction: Technical Tip
Authors: Boszczyk Andrzej , Kordasiewicz Bartłomiej , Kiciński Maciej , Fudalej Marcin , Rammelt Stefan 
Published: October 2018

Summary:
We analyzed the operative measures that may be used to reduce the likelihood of sagittal syndesmotic malreduction. Hence, we propose a simple technical tip to avoid sagittal plane malreduction of the fibula within the syndesmosis in ankle fractures. Supporting the leg under the heel should be avoided when performing syndesmotic reduction for unstable malleolar fractures, and support under the calf should be used instead. Our observations have been confirmed in 6 cadaver specimens. We observed that there was a significant anterior subluxation of the fibula when the leg was supported under the heel. No significant difference between the intact and unstable state was present when the leg was supported under the calf. In conclusion, during syndesmotic reduction and fixation in supine position, supporting the foot under the heel should be avoided.
Use of Inherent Anteversion of an Intramedullary Nail to Avoid Malrotation in Comminuted Femur Fractures: A Prospective Case– Control Study
Authors: Vaidya Rahul , Dimovski Radomir , Cizmic Zlatan , Vaidya Anshul , Gheraibeh Petra , Hudson Ian 
Published: October 2018

Objectives:
To (1) evaluate using the inherent anteversion of a second or third generation femoral nail to set the version of the femur during locked intramedullary nailing of comminuted femoral shaft fractures (Espinosa Technique [ET]) and compare it with our traditional method (traditional group [TG]) and (2) assess the variation of anteversion because of the inherent play in the nail itself.

Design:
A prospective IRB-approved study.

Setting:
Academic US Level 1 Trauma Center.

Patients:
Fifty-two consecutive patients with comminuted femur fractures all completed the study.

Intervention:
The first 27 patients had the anteversion determined using the patellar shadow and lesser trochanter (TG), and the next 25 patients were treated by ET.

Main Outcome Measure:
Computed tomography scanogram for femoral anteversion and length in the normal versus operated femur.

Results:
A >15 degree difference from native to operated legs was found in 8/27 TG (29%, 95% CI 15.3%–54.2%), with a mean difference of 11.6 ± 10.2 degrees (95% CI 8.8–16.17) verses 1/25 in the ET group (2.5%, 95% CI 0%–15.3%), with a mean difference of 4.8 ± 6.2 degrees (95% CI 1.38–8.9) (P = 0.0068). There was a 5 degree variability in our ability to center the proximal locking screw in the femoral head and 5 degrees variation in distal locking.

Conclusions:
The inherent anteversion of a second generation nail can be used to minimize malrotation of the femur after comminuted fractures during locked intramedullary nailing in patients with normal anteversion and is superior to our present fluoroscopic technique.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Foot Function After Surgically Treated Intraarticular Calcaneal Fractures: Correlation of Clinical and Pedobarographic Results of 65 Patients Followed for 8 Years
Authors: Dürr Constanze , Apinun Jirun , Mittlmeier Thomas , Rammelt Stefan 
Published: October 2018

Objectives:
To correlate functional deficits after surgical treatment of displaced intraarticular calcaneal fractures (DIACFs) as measured through dynamic pedobarography with clinical and radiographic long-term results.

Design:
Retrospective single-center study.

Setting:
Level 1 trauma center.

Patients:
Sixty-five patients with unilateral DIACFs, reexamined at an average of 8.1 years after surgery.

Intervention:
Internal fixation of DIACF with lateral plate or percutaneous screws.

Main Outcome Measurements:
Dynamic pedobarography, AOFAS, Zwipp, SF-36 scores, Foot Function Index, Böhler angle, and articular congruity.

Results:
When compared with the uninjured side, pedobarography of the operated foot revealed a significantly increased contact area of the hindfoot and midfoot, with a decreased contact area under first/second metatarsal (MT) and first/second toe after DIACF. Maximum pressure and pressure time integral were significantly increased at the midfoot and lateral MT with a decrease under the hindfoot and first to second MT/toe. Midfoot pressure time integral correlated with the range of plantarflexion. Fracture classification correlated with MT 1 contact time. Hindfoot and MT contact times were negatively correlated with Böhler angle. Patients with the smallest side-to-side differences in pedobarogaphy had overall highest scores and significantly greater ankle/hindfoot range of motion at follow-up.

Conclusions:
Significant correlations were found between clinical and pedobarographic results. Increased contact areas and time at the midfoot indicating a lateral load shift correlated with inferior outcome and decreased subtalar motion. These results support the importance of reconstruction of the subtalar joint and overall bony morphology of the calcaneus with preservation of subtalar motion as necessary for global foot function.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.