bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial and Ethnic Minority Patients Have Increased Complication Risks When Undergoing Surgery While Not Meeting Clinical Guidelines
Authors: Liimakka Adriana P. , Amen Troy B. , Weaver Michael J. , Shah Vivek M. , Lange Jeffrey K. , Chen Antonia F. 
Published: March 2024

Background:
Clinical guidelines for performing total joint arthroplasty (TJA) have not been uniformly adopted in practice because research has suggested that they may foster inequities in surgical access, potentially disadvantaging minority sociodemographic groups. The aim of this study was to assess whether undergoing TJA without meeting clinical guidelines affects complication risk and leads to disparities in postoperative outcomes.

Methods:
This retrospective cohort study evaluated the records of 11,611 adult patients who underwent primary TJA from January 1, 2010, to December 31, 2020, at an academic hospital network. Based on self-reported race and ethnicity, 89.5% of patients were White, 3.5% were Black, 2.9% were Hispanic, 1.3% were Asian, and 2.8% were classified as other. Patients met institutional guidelines for undergoing TJA if they had a hemoglobin A1c of <8.0% and a body mass index of <40 kg/m2 and were not currently smoking. A logistic regression model was utilized to identify factors associated with complications, and a mixed-effects model was utilized to identify factors associated with not meeting guidelines for undergoing TJA.

Results:
During the study period, 11% (1,274) of the 11,611 adults who underwent primary TJA did not meet clinical guidelines. Compared with the group who met guidelines, the group who did not had higher proportions of Black patients (3.2% versus 6.0%; p < 0.001) and Hispanic patients (2.7% versus 4.6%; p < 0.001). An increased risk of not meeting guidelines at the time of surgery was demonstrated among Black patients (odds ratio [OR], 1.60 [95% confidence interval (CI), 1.22 to 2.10]; p = 0.001) and patients insured by Medicaid (OR, 1.75 [95% CI, 1.26 to 2.44]; p = 0.001) or Medicare (OR, 1.22 [95% CI, 1.06 to 1.41]; p = 0.007). Patients who did not meet guidelines had a higher risk of reoperation than those who met guidelines (7.7% [98] versus 5.9% [615]; p = 0.017), including a higher risk of infection-related reoperation (3.1% [40] versus 1.4% [147]; p < 0.001).

Conclusions:
We found that patients who underwent TJA despite not meeting institutional preoperative criteria had a higher risk of postoperative complications. These patients were more likely to be from racial and ethnic minority groups, to have a lower socioeconomic status, and to have Medicare or Medicaid insurance. These findings underscore the need for surgery-related shared decision-making that is informed by evidence-based guidelines in order to reduce complication burden.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Implementing a Hospitalist Comanagement Service in Orthopaedic Surgery
Authors: Ghanem Diane , Kagabo Whitney , Engels Rebecca , Srikumaran Uma , Shafiq Babar 
Published: March 2024

➤ Hospitalist comanagement of patients undergoing orthopaedic surgery is a growing trend across the United States, yet its implementation in an academic tertiary care hospital can be complex and even contentious.➤ Hospitalist comanagement services lead to better identification of at-risk patients, optimization of patient care to prevent adverse events, and streamlining of the admission process, thereby enhancing the overall service efficiency.➤ A successful hospitalist comanagement service includes the identification of service stakeholders and leaders; frequent consensus meetings; a well-defined standardized framework, with goals, program metrics, and unified commands; and an occasional satisfaction assessment to update and improve the program.➤ In this article, we establish a step-by-step protocol for the implementation of a comanagement structure between orthopaedic and hospitalist services at a tertiary care center, outlining specific protocols and workflows for patient care and transfer procedures among various departments, particularly in emergency and postoperative situations.
The History of Academic Leadership Education in Orthopaedic Surgery
Authors: Simon Michael A. , Light Terry R. 
Published: March 2024

Background:
The growth of the American academic orthopaedic community over the last 53 years has been accompanied by an expanding need for academic leadership education.

Methods:
The transition of the Association of Orthopaedic Chairmen, to the Academic Orthopaedic Society, to the American Orthopaedic Association through its Academic Leadership Committee and American Orthopaedic Association Council of Residency Directors is reviewed.

Results:
Academic orthopaedic community members recognized that the evolving leadership needs of the academic community could be better addressed by transitioning to a new organization, the Academic Orthopaedic Society and eventually by creating a new structure within a well aligned and well-resourced existing organization, the American Orthopaedic Association.

Conclusion:
Organizational and leadership flexibility has been vital to serving the evolving need of the American academic orthopaedic community for leadership education.
Analysis of Hybrid Management Indicators and Their Effectiveness in the Project Control Process
Authors: Farnam Seyed Mohammad , Alaeddini Ozma 
Published: March 2024

Abstract

This research deals with the analysis of hybrid management indicators and their role in project control methods in Asian countries. By considering a wide set of factors and micro-factors, it has gone beyond the traditional criteria of the golden triangle in the discussion of project control and has been identified and analyzed through literature reviews. These cases were distributed among civil engineering experts by conducting a semi-structured oral interview and presented in the form of a conceptual model. The validity of the model is also through a survey and with Structural equation modeling along with the structural least squares approach with the help of Smart PLS software. This research is an attempt to apply new technologies in parallel with providing solutions that can challenge managers to benefit from special methods in the process of controlling Construction projects in developing countries instead of inefficient management design. This study shows the very important role of key factors in the control of construction projects, which led to the identification of effective factors that can be very important in the management discussion. This article guides researchers and industrialists to achieve more efficient and effective system goals.
Multimodal ENSO Forecast
Authors: Naisipour Mohammad , Saeedpanah Iraj , Adib Arash 
Published: March 2024

Abstract

Predicting the onset of the El Niño Southern Oscillation (ENSO) in the current rapidly changing climate could help save thousands of lives annually. Since the variability of this phenomenon is increasing, its prediction is becoming more challenging in the post-2000 era. Hence, we present a novel Multimodal ENSO Forecast (MEF) method for predicting ENSO up to two years for the post-2000 condition. The model receives a Sea Surface Temperature (SST) anomaly video, a heat content (HC) anomaly video, and an augmented time series to predict the Niño 3.4 Index. We utilize a multimodal neural network to elicit all the embedded spatio-temporal information in the input data. The model consists of a 3D Convolutional Neural Network (3DCNN) that deals with short-term videos and a Time Series Informer (TSI) that finds the base signal in long-term time series. Finally, an adaptive ensemble module (AEM) delivers an ensemble prediction based on uncertainty analysis. We successfully tested the model against observational data and the state-of-the-art CNN model for a long and challenging period from 2000 to 2020, ensuring its validity and reliability as a reliable tool for predicting ENSO in the upcoming Earth’s climate.
Effects of kudzu vine ( Pueraria lobata ) on the intestinal microflora and volatile fatty acids in meat rabbits
Authors: Gao Chengfang , Sang Lei , Sun Shikun , Chen Dongjin , Wang jinxiang , Xie XiPing 
Published: March 2024

Abstract

Adding flavonoid-rich kudzu vine (Pueraria lobata) meal to animal feed can improve intestinal microflora. Here, we investigated the effects of kudzu vine meal on the growth performance,caecal microbial diversity, caecal microbial number, intestinal pH, and volatile fatty acids (VFAs) of meat rabbits. Two hundred weaned Ira rabbits were randomly divided into four groups. Meat rabbits in the control group (group A) were fed a basal diet without kudzu vine meal; those in the three test groups were fed experimental diets comprising 15% (group B), 25% (group C), and 35% (group D) kudzu vine meal. The daily feed intake and mortality of meat rabbits decreased significantly after adding kudzu vine meal to their diet. The feed-to-gain ratio and mortality rate in group D were 3.5 and 7.5%, respectively, significantly lower than those in the control group. The richness and evenness of the bacterial diversity decreased significantly after kudzu vine consumption. Kudzu vine meal also altered the composition of the dominant gut bacterial groups. The intestinal total VFAs were the highest in group B, followed by group D, and significantly higher in both than those in the control group. Hence, adding kudzu vine meal significantly decreased the mortality rates of meat rabbits, decreased the feed-to-gain ratio, and inhibited Escherichia coli and Salmonella growth in the intestinal flora, while altering the intestinal composition of the dominant gut bacterial groups and VFA content. Thus, group D conditions are recommended to achieve optimal results in meat rabbits.
Effect of orange pulp with or without zeolite on productive performance, nitrogen utilization, and antioxidative status of growing rabbits
Authors: Ghoneem Wafaa , Rahmy Hassan Awny Fouad , El-Tanany Reham Roshdi Ali 
Published: March 2024

Abstract

Seventy-two V-line male rabbits (6 weeks old) were divided into 4 experimental groups to investigate the effect of dried orange pulp inclusion (OP diet), natural zeolite addition (Z diet), or both (OPZ diet) compared to control (CON diet) on digestibility, growth performance, nitrogen utilization, blood biochemical, antioxidative status, and cecum microbiota. Results showed that administration of dried orange pulp or zeolite especially the OPZ diet significantly improved nutrient digestibility and nutritive values. Rabbits fed the experimental diets (OP, Z, or OPZ) recorded significantly higher values of average daily gain, N-retention, and N-balance compared with those fed the CON diet. Data on blood biochemical, revealed non-significant increases in globulin concentrations, and significant decreases in levels of cholesterol, LDL (low-density lipoproteins), triglycerides, and MDA (malondialdehyde) as an antioxidant biomarker with OP, Z, or OPZ diets. Moreover, the incorporation of orange pulp or zeolite in diets significantly decreased the cecal count of E. coli, with no significant difference in total bacterial count among the experimental groups. It could be concluded that a combination of dried orange pulp and natural zeolite in the diet can enhance the growth performance, antioxidant and health status of rabbits.
Enhancing High-School Dropout Identification: A Collaborative Approach Integrating Human and Machine Insights
Authors: Bulut Okan , Wongvorachan Tarid , He Surina , Lee Soo 
Published: March 2024

Abstract
Despite its proven success in fields like engineering, business, and healthcare, human-machine collaboration in education remains relatively unexplored. This study aims to highlight the advantages of human-machine collaboration for improving efficiency and accuracy of decision-making processes in educational settings. High school dropout prediction serves as a case study for examining human-machine collaboration's efficacy. Unlike previous research that prioritized high accuracy with immutable predictors, this study seeks to bridge gaps by identifying actionable factors for dropout prediction through human-machine collaboration. Utilizing a large dataset from the High School Longitudinal Study of 2009 (HSLS:09), two machine learning models were developed to predict 9th -grade students' high school dropout history. Results indicated that the Random Forest algorithm outperformed the deep learning algorithm. Model explainability revealed the significance of actionable variables such as students’ GPA in the 9th grade, sense of school belonging, and self-efficacy in mathematics and science, along with immutable variables like socioeconomic status, in predicting high school dropout history. The study concludes with discussions on the practical implications of human-machine partnerships for enhancing student success.
Fish Active Packaging with ZnO/Fe-MMT nanoparticles
Authors: Rahmanifarah Kaveh , Mahmoudian Mehdi , Eskandarabadi Somayeh Mahmoudi 
Published: March 2024

Abstract

Today, active packaging has become important to increase food safety and decrease its spoilage. In this study, the aim was to delay spoilage and increase the shelf life of rainbow fish fillets with a new hybrid nanocomposite active packaging. Packaging was fabricated with Ethylene vinyl acetate and active compounds such as rosemary extract, zinc oxide nanoparticles, and modified iron (Fe-MMT). Various experiments such as XRD and FESEM analyses were performed on active films, and for fish fillets, total sulfhydryl, volatile nitrogen, and lipid oxidation tests were conducted to determine the shelf life of fish fillets in packages. The highest increase in volatile nitrogen, which is related to spoilage of fish fillet, was 9.45 mg/100g, although the limit is 25 mg/100g. It can be concluded that films containing active compounds have increased the shelf life of fish fillets until the sixth day of storage without changing the texture, color and odor.
“Attitude is the fifth delay”: Perspectives of obstetric near-miss survivors and health care professionals on continuity and coordination of maternal care
Authors: Mulongo Samuel M. , Kaura Doreen , Mash Bob 
Published: March 2024

Abstract

Background
Fragmentation in maternal healthcare contributes to preventable maternal deaths. Improving continuity and coordination can mitigate this issue by influencing interactions among providers, interdisciplinary teams, and patient-provider relationships. The obstetric near-miss approach has the potential to offer insights into continuity and coordination in maternal health. The aim of this study was to explore the perspectives of near-miss survivors and health care professionals on continuity and coordination of care in a primary health care system in Uasin Ngishu region, Kenya.
Methods
This was a descriptive qualitative single case study with two embedded units of analysis, building on an exploratory quantitative phase. Data was collected through individual interviews focus group discussions, and observation.
Results
Four deductively identified themes emerged: sequential coordination, continuity, parallel coordination, and access. Longitudinal and interpersonal continuity were driven by positive interactions between women and healthcare providers, characterized by availability, willingness to listen, and addressing personal issues. Sequential coordination was influenced by antagonistic relationships between healthcare providers in primary care facilities and the main referral hospital. Parallel coordination was affected by heavy workloads and ineffective task shifting within primary care facilities. Finally, access-related issues included accommodation strategies such as telephone hotlines for pregnant women, out-of-pocket payments for specialist consultation, and alternative referral pathways different from the formal pathways in the health system.
Conclusion
To promote continuity in primary health care for pregnant women, there is a need to focus on social competencies and skills among health care professionals providing obstetric care, encourage accommodation strategies in facilities, reduce or eliminate out-of-pocket payments for referred women, address professional conflicts among midwives at different levels in the referral pathway and address workloads and task shifting in primary care facilities.
Energy production through enhanced organic matter recovery in high-rate contact stabilization with Klebsiella pneumoniae
Authors: Song Minsu , Park Jihye , Jeong Sanghyun , Choi Daehee , Shin Yong-Uk , Bae Hyokwan 
Published: March 2024

Abstract

The study focuses on identifying cultivable microbial species within the sludge of a high-rate contact stabilization (HRCS) process and evaluating the enhancement of organic matter recovery using Klebsiella pneumoniae as the sole inoculum. The Klebsiella pneumoniae, identified as a cultivable microorganism from sludge in the HRCS process, exhibited rapid growth with a doubling time of 2.4 h. Comparative analysis between the standard HRCS system and the HRCS-K system, inoculated exclusively with Klebsiella pneumoniae, results in organic matter removal efficiency and methane production. The HRCS-K system, despite being less efficient in removing overall organic matter, nitrogen, and phosphorus, demonstrated enhanced energy recovery due to its high sludge yield and efficient degradation during anaerobic digestion. Significantly, the carbon recovery rate (CRR) in the HRCS-K system was 0.567 ± 0.130 g-CODCH4/g-CODinf. This value indicates a 48% enhancement in comparison to the microbial consortia. This progress establishes a basis for further research into the feast-famine regime of wastewater treatment and contributes to enhanced energy production efficiency in the sector. Furthermore, the enhanced methane production capability of the HRCS-K system offers a promising approach to energy recovery and supports more sustainable wastewater treatment practices.
S-allyl Cysteine and Cannabidiol are Equally Effective as Metformin in Preserving Neurovascular Integrity, Retinal Structure, and Cognitive Function in db/db Type 2 Diabetic Mice
Authors: Majimbi May , Mamo John , Lam Virginie , McLenachan Samuel , Nesbit Michael , Brook Emily , Sharif Arazu , Mooranian Armin , Al-Salami Hani , Chen Fred , Takechi Ryu 
Published: March 2024

Abstract
Type 2 diabetes mellitus (T2D) is associated with central nervous system (CNS) alterations marked by neurovascular, inflammatory, and oxidative damage, resulting in cognitive dysfunction and retinal neurodegeneration. This study explored the therapeutic potential of naturally derived S-allyl-cysteine (SAC) and cannabidiol (CBD) in LepR db/db mice, targeting blood-brain/retinal barrier (BBB/BRB) leakage, glial activation, and DNA oxidative damage to alleviate memory deficits and retinal neurodegeneration. Diabetic mice underwent 23 weeks of dietary treatments: diabetic db/db controls, SAC, CBD, SAC + CBD, and metformin, with nondiabetic db/+ mice as negative controls. Memory function was assessed using novel object recognition and passive avoidance tests, while retinal thickness was measured via in vivo OCT imaging. Immunofluorescence imaging quantified neurovascular leakage (IgG extravasation), glial activation (GFAP and Iba1) and DNA oxidation (8OHdG) in brain sections and retinal whole-mounts. In diabetic db/db mice with hallmark metabolic dysregulation, CNS alterations included BBB/BRB leakage, glial activation, and retinal neurodegeneration of the ganglion cell complex (GCC), correlating with memory impairments. SAC and CBD exhibited significant therapeutic effects against CNS pathophysiologies, attenuating glial activation and synergistically preventing BBB leakage. In the retina, these compounds attenuated BRB leakage risk and reduced glial-mediated neuroinflammation. SAC and CBD preserved GCC thickness and improved memory functions, proving to be as effective as or superior to metformin against diabetic-associated CNS pathophysiology.
The association between knee synovial methylation and knee osteoarthritis in different ethnic populations from different altitude
Authors: Li Zhaowei , Zhang Dongge , Ren Rong , Lu Zhonglin , Li Guang , Geng Tiezhu , Luosong Jiumei , Jin Xu 
Published: March 2024

Abstract
Objective: To determine genome-wide DNA methylation profiles of knee cartilage
from patients with osteoarthritis (OA) at different altitudes.
Method: Twenty-four synovial tissue samples were selected. OA synovial tissue samples were obtained from 10 Tibetan OA patients at high altitude and 8 Han OA patients at low altitude. Six normal synovial tissue samples were used as the control group. Illumina Methylation Analyzer package was employed for identifying differentially methylated CpG sites.GO, Pathway and disease annotation enrichment analysis were performed for differential genes corresponding to differential methylation sites.
Results: In high-altitude osteoarthritis patients and normal controls, 413 methylation differential sites were associated with osteoarthritis, including 92 hypermethylated sites and 321 hypomethylated sites. In low-altitude osteoarthritis patients and normal controls, 723 methylation differential loci were associated with osteoarthritis, including 436 hypermethylated loci and 297 hypomethylated loci. There were 60 different loci in patients with osteoarthritis at different altitudes.
Conclusions: This multistage study identified an interferon-inducible gene interaction network associated with OA and highlighted the importance of gene in OA pathogenesis. The results enhanced our understanding of the important role of DNA methylation in pathology of OA.
Breakdown of thermalization in spin chains with single-ion anisotropy
Authors: de Souza Marcio Guimarães , Costa Rafael Freitas Pereira , Vernek Edson , Neto Gentil Dias de Moraes 
Published: March 2024

Abstract

The principles of ergodicity and thermalization constitute the foundation of statistical mechanics, positing that a many-body system progressively loses its local information as it evolves. Nevertheless, these principles can be disrupted when thermalization dynamics lead to the conservation of local information, as observed in the phenomenon known as many-body localization. Quantum spin chains provide a fundamental platform for exploring the dynamics of closed interacting quantum many-body systems. This study explores the dynamics of a spin chain with $S\geq 1/2$ within the $J_1-J_2$, incorporating a non-uniform magnetic field and single-ion anisotropy. Through the use of exact numerical diagonalization, we unveil that a nearly constant-gradient magnetic field suppress thermalization, a phenomenon termed Stark many-body localization (SMBL), previously observed in $S=1/2$ chains. Furthermore, our findings reveal that the sole presence of single-ion anisotropy is sufficient to prevent thermalization in the system. Interestingly, when the magnitudes of the magnetic field and anisotropy are comparable, they compete, favoring delocalization. Despite the potential hindrance of SMBL by single-ion anisotropy in this scenario, it introduces an alternative mechanism for localization. Our interpretation, considering local energetic constraints and resonances between degenerate eigenstates, not only provides insights into SMBL but also opens avenues for future experimental investigations into the enriched phenomenology of disordered free localized $S\geq 1/2$ systems.