bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgeon Implicit Association of Women With Supportive Roles in Medicine
Authors: Alexander Jeremiah , Rajagopalan Dayal , Ramtin Sina , Ngoue Marielle , Ring David , Adams Julie 
Published: September 2023

Background:
In a previous study, we documented patient implicit bias that surgeons are men. As a next step, we tested the implicit bias of surgeons that women in medicine have leading (chair, surgeon) or supporting roles (medical assistant, physician assistant).

Questions/purpose:
(1) What is the relationship between the implicit associations and expressed beliefs of surgeons regarding women as leaders in medicine? (2) Are there factors associated with surgeon implicit association and explicit preference regarding the roles of women in medicine?

Methods:
A total of 102 musculoskeletal surgeon members of the Science of Variation Group (88 men and 12 women) completed an implicit association test (IAT) of implicit bias regarding sex and lead/support roles in medicine and a questionnaire that addressed respondent demographics and explicit preference regarding women's roles. The IAT consisted of seven rounds with five rounds used for teaching and two rounds for evaluation.

Results:
On average, there was an implicit association of women with supportive roles (D-score: −48; SD 4.7; P < 0.001). The mean explicit preference was for women in leadership roles (median: 73; interquartile ranges: 23 to 128; P < 0.001). There was a correlation between greater explicit preference for women in a leading role and greater implicit bias toward women in a supporting role (ρ = 0.40; P < 0.001). Women surgeons and shoulder and elbow specialists had less implicit bias that women have supporting roles.

Conclusion:
The observation that musculoskeletal surgeons have an explicit preference for women in leading roles in medicine but an implicit bias that they have supporting roles—more so among men surgeons—documents the gap between expressed opinions and ingrained mental processing that is the legacy of the traditional “roles” of women in medicine and surgery. To resolve this gap, we will need to be intentional about promotion of and emersion in experiences where the leader is a woman.

Level of evidence:
III.
The Fragility of Statistical Significance in Sham Orthopaedic Surgery: A Systematic Review of Randomized Controlled Trials
Authors: Pearsall Christian , Constant Michael , Saltzman Bryan M. , Parisien Robert L. , Levine William , Trofa David 
Published: September 2023

Objectives:
The purpose of this study was to determine the stability of statistical findings among sham surgery randomized controlled trials (RCTs) in orthopaedic surgery using fragility analysis.

Methods:
PubMed systematic review was conducted to include studies reporting dichotomous outcomes pertaining to sham surgery. The final review included eight RCTs involving only partial meniscectomies and vertebroplasties from 2009 to 2020. With a fixed sample size with dichotomous outcome measures (events versus non-events), the Total Fragility Index (TFI), which is composed of the fragility index (FI) and reverse fragility index (RFI), was calculated by altering the ratio of events to non-events in an iterative fashion until results were reversed from significant to nonsignificant findings (FI) or vice versa (RFI). The TFI, FI, and RFI were divided by their sample sizes to obtain the respective total fragility quotient, fragility quotient (FQ), and reverse fragility quotient. Median fragility indices and quotients were reported for all studies.

Results:
The eight RCTs included 50 dichotomous outcomes involving either partial meniscectomies or vertebroplasties, with a median TFI and total fragility quotient of 5 [interquartile range (IQR) 4 to 6] and 0.035 (IQR 0.028 to 0.048), respectively, indicating that a median of five total patients or 3.5 per 100 patients would need to experience a different outcome to reverse significant or insignificant findings for each of the eight trials. Among the 8 statistically significant (P < 0.05) outcome events (16%), the respective FI and FQ were 2 (IQR 1 to 5) and 0.018 (IQR 0.010 to 0.044). Among the 42 statistically insignificant outcome events (84%), the respective RFI and reverse fragility quotient were 5 (IQR 4 to 6) and 0.04 (IQR 0.034 to 0.048). The median number of patients lost to follow-up was 1.5 (IQR 0.5 to 2).

Conclusion:
The unstable findings in partial meniscectomy and vertebroplasty sham surgical RCTs undermine their study conclusions and recommendations. We recommend using fragility analysis in future sham surgical RCTs to contextualize statistical findings.

Level of evidence:
Level IV; Systematic Review.
Advising Orthopaedic Hopefuls in the Wake of a Pass/Fail US Medical Licensing Examination Step 1: A Proposed Method for Predicting US Medical Licensing Examination Step 2 Clinical Knowledge Outcomes
Authors: Paladino Lucas , Deshpande Abhishek , Lichtig Asher , Lin Ye , Tafur Julio Castillo , Diaz Alondra , Hirshfield Laura E. , Thames Geoff , Gonzalez Mark H. 
Published: September 2023

Introduction:
Matching into orthopaedic residency has become difficult, and the US Medical Licensing Examination Step 1 transition to pass/fail scoring has complicated the process. Advisors' ability to mentor students has decreased, and program directors may rely on Step 2 Clinical Knowledge (CK) scores in selecting which candidates to interview. This study aims to offer a method to predict Step 2 CK outcomes based on preadmission and preclinical performance.

Methods:
The study investigated 486 students from a US medical school who enrolled in 2017 and 2018. Data on demographics, preadmission, and preclinical performance were collected. Before model creation, it was found that sex, Medical College Admission Test scores, Comprehensive Basic Science Examination performance, and preclinical curriculum performance produced optimal models. Multivariate ordinal logistic regression models were built to predict probabilities of four outcome levels of Step 2 CK: <235, 235 to 249, 250 to 265, and >265. Finally, nomograms were created to visualize probability calculations.

Results:
Each model's odds ratios revealed that female sex, higher MCAT scores, and better Comprehensive Basic Science Examination and preclinical performance were associated with an increased likelihood of being in higher Step 2 CK scoring groups. Preclinical performance had a profound effect, especially for those in the top 1/3. Models were successful in assigning higher probabilities to students in higher Step 2 CK scoring groups in more than 80% of instances. Nomograms presented provide examples of how to apply these models to an individual student.

Discussion:
This study presents a novel method for predicting probabilities of Step 2 CK outcomes that can be used to mentor students at a time point when Step 1 previously filled this role. It may assist in identifying orthopaedic hopefuls at risk of performing poorly on Step 2 CK and can foster the development of individualized guidance and mitigation strategies.
Demographics and Early Outcomes of Commercial Antibiotic Cement Usage for Infection Prophylaxis During Primary Total Knee Arthroplasty in Patients Older Than 65 Years: An American Joint Replacement Registry Study
Authors: Ricciardi Benjamin F. , Porter Kimberly R. , Myers Thomas G. , Ginnetti John G. , Kaplan Nathan , Thirukumaran Caroline P. 
Published: September 2023

Introduction:
The use of antibiotic-laden bone cement (ALBC) for infection prophylaxis in the setting of primary total knee arthroplasty (TKA) remains controversial. Using data from the American Joint Replacement Registry (AJRR), (1) we examined the demographics of ALBC usage in the United States and (2) identified the effect of prophylactic commercially available ALBC on early revision and readmission for prosthetic joint infection (PJI) after primary TKA.

Methods:
This is a retrospective cohort study of the AJRR from 2017 to 2020. Patients older than 65 years undergoing primary cemented TKA with or without the use of commercially available antibiotic cement were eligible for inclusion (N = 251,506 patients). Data were linked to available Medicare claims to maximize revision outcomes. Demographics including age, sex, race/ethnicity, Charlson Comorbidity Index (CCI), preoperative inflammatory arthritis, region, and body mass index (BMI) class were recorded. Cox proportional hazards regression analysis was used to evaluate the association between the two outcome measures and ALBC usage.

Results:
Patients undergoing cemented TKA with ALBC were more likely to be Non-Hispanic Black (P < 0.001), have a CCI of 2 or 3 (P < 0.001), reside in the South (P < 0.001), and had a higher mean BMI (P < 0.001). In the regression models, ALBC usage was associated with increased risk of 90-day revision for PJI (hazards ratio 2.175 [95% confidence interval] 1.698 to 2.787) (P < 0.001) and was not associated with 90-day all-cause readmissions. Male sex, higher CCI, and BMI >35 were all independently associated with 90-day revision for PJI.

Discussion:
The use of commercial ALBC in patients older than 65 years for primary TKA in the AJRR was not closely associated with underlying comorbidities suggesting that hospital-level and surgeon-level factors influence its use. In addition, ALBC use did not decrease the risk of 90-day revision for PJI and was not associated with 90-day readmission rates.
Large Variation in Listed Chargemaster Price for Total Joint Arthroplasty Among Top Orthopaedic Hospitals in the United States
Authors: Pollock Jordan R. , Doan Matthew K. , Moore M. Lane , Haglin Jack M. , Arthur Jaymeson R. , Deckey David G. , Patel Karan A. , Bingham Joshua S. 
Published: September 2023

Background:
Chargemasters are lists of all services offered by a hospital and their associated cost. This study analyzes chargemaster data to determine price differences among different hospitals for total joint arthroplasty.

Methods:
In May 2020, the chargemaster data for highly rated orthopaedic hospitals were accessed, and the diagnostic-related group (DRG) codes related to primary and revision total joint arthroplasty were analyzed (DRGs 466, 467, 468, 469, and 470). The prices listed for each hospital were averaged, and descriptive statistics were calculated. Furthermore, Medicare reimbursement was collected. A subanalysis was performed to determine relationships between geographic and demographic information.

Results:
The median price for a major hip or knee joint arthroplasty without complications was $68,016 (range: $39,927 to $195,264). The median price of a revision of hip or knee arthroplasty without complications was $90,966 (range: $58,967 to $247,715). The cost of living in the city in which the hospitals are located was weakly correlated with procedure pricing, whereas the median income had no notable relationship to chargemaster pricing.

Conclusion:
The published cost of DRG codes in arthroplasty is widely variable among the top 20 US orthopaedic hospitals, with little correlation to the cost of living or median income of the area.
ANALISIS KEKUATAN SISTEM AKTUATOR LINIER DC PADA ALAT PENGANGKAT PASIEN
Authors: Lukman Prasetyo  , Sunaryo  , Heru Nugroho  , Ryan Sulihtiono  , Taat Bagus Sampurno  
Published: September 2023

merancang alat yang digunakan mengangkat pasien adalah tujuan penelitian yang diharapkan memudahkan dokter dan perawat untuk memindahkan pasien yang tidak memungkinkan berdiri dan berjalan dari suatu tempat ke tempat lain. prinsip kerja alat ini menerapkan prinsip pesawat sederhana menggunakan sistem aktuator linier DC sebagai gaya pengungkit, sumber arus yang digunakan adalah aki 12 V, jadi dapat digunakan dimanapun. Konstruksi alat dirancang menggunakan besi hollow tebal 3 mm, panjang 6 cm, dan lebar 3 cm. Alat pengangkat pasien diperoleh dimensi dengan beban pengangkat terberat 977 N dimana Panjang rangka bawah : 70-120 cm, Panjang lengan kuasa : 45 cm, Panjang lengan beban : 55 cm, Lebar : 50 cm, Tinggi : 127 cm. Kecepatan angkat 5 mm/s, dengan ketinggian angkat maksimal 180 cm dari lantai.
Analisis Sentimen Terhadap Kinerja KPU Menjelang Pemilu 2024 Berdasarkan Opini Twitter Menggunakan Naïve Bayes
Authors: Fuad Amirullah  , Syariful Alam  , M.Imam Sulistyo S  
Published: September 2023

Era globalisasi saat ini memengaruhi pesatnya kemajuan teknologi informasi yang beredar di masyarakat salah satu perantaranya ialah melalui media sosial Twitter, Twitter dapat dimanfaatkan sebagai sarana menyampaikan pendapat terkait saran, kritik, maupun opini-opini publik. Salah satunya perihal kinerja KPU menjelang pemilu 2024 yang muncul diakhir tahun 2022 dan awal tahun 2023, mengenai skandal manipulasi data keanggotaan parpol di website KPU, hingga penundaan pemilu. Penelitian ini menggunakan metode text mining yang terdiri dari tahapan scraping data, labeling, cleansing, preprocessing, algoritma Naïve Bayes, pembobotan memakai perhitungan TF-IDF, pengujian data memakai confusion matrix dengan menggunakan pemrograman python. Didapatkan data yang berjumlah 2475 data, yaitu sebanyak 321 data positif, 409 data netral, dan 1745 data negatif. Berdasarkan hasil pengujian confusion matrix dengan pemrograman python didapatkan hasil akurasi negatif sebesar 74.5% berdasarkan nilai tersebut membuktikan tingkat kepercayan pada kinerja KPU menjelang proses pemilu 2024 mendatang tergolong kurang baik.
ANALISIS SENTIMEN PADA PRODUK CUSHION DI WEBSITE FEMALE DAILY MENGGUNAKAN METODE SUPPORT VECTOR MACHINE (SVM)
Authors: Ariqoh Soultan , Sunandar M.Agus , Muhyidin Yusuf 
Published: September 2023

Saat ini produk kosmetik sudah menjadi kebutuhan utama kaum wanita yang merupakan target utama dari industri kosmetik. Salah satu merek produk kosmetik yang popular saat ini ialah produk kosmetik merek pixy, saat ini cushion pixy mempunyai tiga jenis shades yaitu 301 Medium Beige, 201 Natural Beige, dan 101 Light Beige. Namun tidak semua jenis shades memiliki kualitas yang baik sesuai kebutuhan konsumen dan hal ini yang harus diperhatikan oleh para konsumen sebelum konsumen memutuskan untuk membeli produk cushion merek pixy. Dalam penelitian ini penulis menggunakan metode Text mining Dengan tahap-tahap yang dilakukan adalah Scrapping Data, Labelling, Cleaning, Preprocessing text (Tranformation, Tokenization, Filtering). Algoritma yang digunakan yaitu Support Vector Machine (SVM) karena teknik yang relatif baru untuk melakukan prediksi, baik dalam kasus klasifikasi maupun regresi. Pembobotan kata menggunakan pehitungan TF-IDF dan pengujian data menggunakan Confusion Matrix pada Python. Berdasarkan proses pengumpulan data diperoleh sebanyak 2044 data, setelah melakukan proses Text Mining dihasilkan sebanyak 1999 data.
Lagere regels onder parlementaire controle
Authors: Groen L.C. , Munneke S.A.J. 
Published: September 2023

Lagere regels onder parlementaire controle. Een andere kijk op het primaat van de wetgever
In de Aanwijzingen voor de regelgeving staat dat met parlementaire betrokkenheid bij gedelegeerde wetgeving terughoudendheid moet worden betracht. De praktijk geeft daarvan echter niet steeds blijk, zo volgt (ook) uit een beknopt onderzoek naar in 2018, 2019 en 2022 gepubliceerde wetgeving. De auteurs bepleiten het ‘primaat van de wetgever’ een andere invulling te geven. Parlementaire betrokkenheid bij de totstandkoming van belangrijke normen is daarbij leidend. Aanwijzingen 2.35, 2.37 en 2.40 kunnen vervallen.
Wendbaar wetgeven revisited: de rol van de medewetgever als systeembeheerder
Authors: Lokin M.H.A.F. 
Published: September 2023

Wendbaar wetgeven revisited: de rol van de medewetgever als systeembeheerder
In de bijdrage wordt ingegaan op het belang van expliciete en gerichte aandacht voor ICT- en digitaliseringsaspecten van wetgeving in het parlementaire wetgevingsproces. Aan de hand van de (herziene) reglementen van orde wordt geschetst welke mogelijkheden en bevoegdheden de Tweede en Eerste Kamer ten dienste staan om de ICT-component van wetsvoorstellen te beoordelen en daarover het goede gesprek te voeren bij de schriftelijke voorbereiding en mondelinge behandeling. Voor die beoordeling is een concrete vragenlijst uitgewerkt. In de slotbeschouwing wordt ingegaan op de haalbaarheid van de geschetste mogelijkheden.
De rolinvulling van overheidsjuristen
Authors: van Lochem P.J.P.M. 
Published: September 2023

De rolinvulling van overheidsjuristen. Bespreking van het proefschrift van Wubbo Wierenga
Wierenga’s proefschrift gaat over de wijze waarop overheidsjuristen hun rol invullen en de verklaring daarvan. Zijn promotieonderzoek bestond uit een drietal empirische deelonderzoeken, gericht op alle overheidsjuristen. Zijn onderzoek heeft geleid tot drie kernbegrippen van de rolinvulling (professioneel handelen, zelf gedefinieerde werksituatie en gekozen beroepsopvatting) en vier ideaaltypische rolinvullingen (maximeren van de juridische kwaliteit, bijdragen aan een bredere opgave, beïnvloeden van beleids- en besluitvorming en laveren tussen rechter en bestuur), waarvan de keuze wordt beïnvloed door omgevingsfactoren zoals de organisatiegrootte en persoonlijke kenmerken zoals het aantal dienstjaren. Zo blijkt dat onervarenheid (weinig dienstjaren, lage schaal) samenhangt met de rolinvulling ‘maximeren van de juridische kwaliteit’.
Decision mining als bijdrage aan kwaliteit van uitvoering
Authors: Leewis S. , Meuwese A.C.M. 
Published: September 2023

Decision mining als bijdrage aan kwaliteit van uitvoering
Deze rubriekbijdrage introduceert ‘decision mining’ bij de RegelMaat-lezer. Decision mining is een techniek die vanuit concrete beslisdata de regels die daaraan ten grondslag hebben gelegen reconstrueert. Het promotieonderzoek van Sam Leewis ontwikkelt deze techniek verder in de context van de uitvoering van wetgeving. Uiteindelijk heeft decision mining de potentie om te helpen controleren of de regels die gebruikt worden in digitale beslissystemen van uitvoeringsorganisaties wel in lijn zijn met de daaraan ten grondslag liggende wetgeving.
Discrimination as a relational matrix of analysis: race, gender, age, social class, immigration, religion, politics, and civil identification: a case study of Rio de Janeiro, Brazil
Authors: Da Conceição Maria Cristina Gomes 
Published: September 2023

The general objective of this research is to analyze how and to what extent racist, patriarchal, classist and political arguments are interlocked and mutually reinforced in multiple residual forms today. This article adopts Foucault’s concepts of biopower and normalization to analyze the persistence of racism surrounding unequal and discriminatory power relations and the oppression of racialized, gender, and social inequalities (Foucault 1994; Koopman 2013). A representative survey was applied to 759 urban inhabitants of Rio de Janeiro, Brazil, who answered a questionnaire asking for their socio-demographic characteristics, perceptions, expectations, attitudes, practices, and intergroup relationships regarding racism, patriarchalism, sexism, homophobia, xenophobia, class discrimination and political-ideological self-identification. The multivariate method of Principal Component Analysis (PCA) was applied, and the results show the predominance of patriarchal values against women, LGBTQ+, Black, youth and poor persons, through explicit racism and the legitimation of the use of violence for both, men and women. Women primarily reject providing sex education at school, agree with their domestic role as wives and with the idea that females’ behavior causes their own rapes, reject LGBTQ marriage, and discriminate against youths, while men rank first the domestic role of women, explicit racism and criminalization of Black people.
A Sensitivity Analysis of a Mathematical Model for the Transmission of Endemic Malaria under Periodic Climatic Conditions
Authors: M. Ndung’u Reuben 
Published: September 2023

We perform sensitivity analysis on a periodic mathematical model of endemic malaria transmission to determine the relative importance and impact of model parameters to disease transmission and prevalence. In this analysis, two sets of baseline parameter values are compiled: one for areas that exhibit high transmission rate and another one for areas with low transmission rates. Sensitivity indices for the basic reproductive number and the endemic equilibrium points are computed. The study established that in areas of low transmission, the reproductive number is most sensitive to the mosquito biting rate, but the equilibrium proportion of the infectious humans is most sensitive to the human recovery rate. Sensitivity analysis on all state variables was conducted. The results indicated that the most influential factors in the transmission and persistence of malaria in the society are those related to vectorial competence. These findings suggests that strategies that target the vector characteristics such as the mosquito biting rate and those that target the human recovery rate can be very successful in controlling malaria. These strategies include the use of insecticide-treated mosquito nets, indoor residual spraying, prompt diagnosis and treatment of infectious individuals. However, a combination of intervention strategies is more effective than application of a single intervention.
Menumbuhkan Jiwa Kewirausahaan Di Era Digital SMA Masehi 01 Semarang
Authors: Erlitawati Kaharudin  , Hesti Fajarsari  
Published: September 2023

The use of technology for entrepreneurship has become a very important factor in driving innovation and business growth in the digital era. Technology has given entrepreneurs powerful tools to design, manage, and expand their ventures in unprecedented ways.
This article delves into various aspects of utilizing technology in entrepreneurship. This includes using AI to find business ideas and leveraging them to make work more efficient. In addition, technology has enabled in-depth data analysis and a better understanding of the market, enabling entrepreneurs to make smarter decisions. This article will discuss various aspects of utilizing technology in entrepreneurship, from opportunities to challenges, as well as the importance of integrating technology with a business vision that is sustainable and has a positive impact on society.