bluuebunny/crossref_metadata_2025_split huggingface dataset:
Síndrome metabólico y hemoglobina glicosilada en Latinoamérica
Authors: Chiquito-Guale Brenda Mariel , Plúas-Vargas Miriam Priscila , Lucas-Parrales Elsa Noralma 
Published: August 2023

El síndrome metabólico (SM) es un conjunto de trastornos crónicos que está relacionado con enfermedades cardiovasculares, el control de los niveles de hemoglobina glicosilada (HbA1c) es fundamental para evaluar el control metabólico. El objetivo fue analizar la prevalencia del síndrome metabólico y la utilidad de la hemoglobina glicosilada en Latinoamérica. Metodología: fue de diseño cualitativo, de revisión sistemática, los buscadores científicos Google académico, Scielo, Pubmed, Elsevier, Redalyc y DOAJ; se incluyeron artículos originale, desde el año 2018, se utilizaron los operadores booleanos AND, OR y NOT, en idioma inglés y español. El Flujograma de Prisma evaluó la calidad de los artículos. Resultados: el síndrome metabólico dentro de los países Latinoamericano la mayor prevalencia, Perú fue 45% (855 personas) 2022, Ecuador presentó el 42% ( 1.997 personas) en 2021 y Brasil presenta el 36.1 % (714 personas) en 2020; los valores de HbA1c en pacientes con SM en: Brasil la Hb1Ac fue mayor a 9% y el SM fue de 52.6% (8541) pacientes, Paraguay con Hb1Ac mayor a 8,9% y el SM de 49,2% (1243) pacientes, Chile con niveles de Hb1Ac simbolo 7,5% y el SM de 69% (575) pacientes; factores de riesgo más frecuentes fueron HbA1C, hipertensión arterial, falta de actividad física, tabaquismo y diabetes; en Perú, Bolivia, Brasil, Cuba y Ecuador. Conclusión: La prevalencia del síndrome metabólico es prominente en los países de Latinoamérica, los factores de riesgo son predisponentes para que presenten los pacientes comorbilidades como diabetes, enfermedades cardiovasculares.
World trends in health science student publications
Authors: Gonzalez-Argote Javier , Aveiro-Róbalo Telmo Raul 
Published: August 2023

Background: the training and promotion of new researchers as an essential contribution in the construction of science is now a crucial aspect in higher education. Aim: to characterize communication patterns and impact of medical science student scientific output worldwide. Methods: a bibliometric study was carried out on student scientific output in health sciences, using the Scopus database. It was defined as "article with student participation" those in which at least one author who declared in his affiliation to be a student of one of the careers in health sciences (Medicine, Dentistry or Nursing) appeared. Results: Were retrieved 21162 documents, 94,77 % were original, followed by reviews (8,25 %) and letters (5,30 %). The most productive region was the Middle East. The Biomedical categories prevailed in the study, headed by Medicine. Conclusions: the pattern of student scientific communication at a global level is characterized by a tendency to increase scientific output with a high leadership of authors from the Middle East and North America. These results reflect the rise of the scientific student movement in recent years, in terms of raising the scientific quality of graduates of health sciences careers
The Effect Of Perceived Organization Support and Work Motivation On Employee Engagement In Improving Employee Performance At Regional Revenue Agency In Tegal Regency
Authors: Putra Setya Yurissa , Raharja Edy 
Published: August 2023

The purpose of this research is to test the influence of perceived organizational support, and work motivation on employee engagement to impact employee performance. Using these variables, the use of these variables is able to solve the problems arising withinemployees of the Regional Revenue Agency of Tegal Regency. The statement of this problem is how to increase employee performance?.
The sample size of this research is 44employees of the Regional Revenue Agency of Tegal Regency. Using the Smart PLS (Path Least Square). The results show that perceived organizational support and work motivation on employee engagement impact employee performance.
The effect ofperceived organizational supporton employee engagement are significant;the effect ofwork motivationon employee engagement are significant;the effect ofperceived organizational supporton employee performance are significant;the effect ofwork motivation on employee performance is significant;the effect ofemployee engagementon employee performance is significant.
Choreographing a chemical ballet: what happens if you change one of the actors?
Authors: Rzepa Henry 
Published: August 2023

Earlier, I explored the choreography or “timing”, of what might be described as the curly arrows for a typical taught reaction mechanism, the 1,4-addition of a nucleophile to an unsaturated carbonyl compound (scheme 1). I am now going to explore the consequences of changing one of the actors by adding the nucleophile to an unsaturated imine rather than carbonyl compound (scheme 2). **
Liberalismo, Governamentalidade e Seguridade
Authors: Almeida André Pereira de 
Published: August 2023

Diante do atual contexto de fortalecimento do pensamento liberal no Brasil e no mundo, resolvi pensar suas estruturas de funcionamento e seus mecanismos de gerenciamento e manutenção da ordem social. Faço assim uma análise crítica a partir da leitura foucaultiana da governamentalidade, da seguridade e dos liberalismos alemão (ordoliberalismo) e estadunidense (Escola de Chicago), como formas de gerenciamento e controle da população e/ou sociedade civil, a partir dos cursos Sécurité, territoire, population e Naissance de la biopolitique, ministrados no Collège de France nos biênios de 1977-1978 e 1978-1979, respectivamente.
Aristóteles e a questão da δύναμις desde a ótica de Martin Heidegger
Authors: Santos Manuela 
Published: August 2023

Talvez uma das questões mais obscuras legada à história do pensamento seja a questão da δύναμις (dynamis) enquanto tal. Na Física e na Metafísica, Aristóteles parece querer dar a conhecer a imbricação interna que ocorre entre o conceito ontológico e o conceito ôntico de δύναμις , e isto para tentar compreender a que concerne o movimento em essência. Para orientar o curso desta tarefa de reconhecimento da proposta de Aristóteles, elegemos como orientadora do nosso estudo preliminar a perspectiva que o pensador Martin Heidegger propõe acerca do que, para o filósofo contemporâneo, ainda hoje permanece inaudito. Heidegger ensina que o essencial do que para os gregos significava o movimento só é compreendido quando observamos que em uma mudança, algo que até então não era, passa a ser donde surge a fundamental questão de saber acerca das condições de possibilidades do não-ente vir-a-ser. Para o grego, o movimento enquanto uma forma do Ser tem este caráter do “emergir à presença”.
The Modern Universal TKA: Improved Value without Compromising Quality
Authors: Law Jesua I. 
Published: August 2023

In the current economic state of healthcare, efficiency and cost reduction has come into focus. Healthcare spending is accelerating faster than the growth in GDP and with a large portion of hospital costs associated with operating room expenses, inefficiencies are something that should be scrutinized closely. Several studies have demonstrated increased efficiency with an intelligent reduction in instrumentation and trays. European studies have analyzed the cost of sterilization demonstrating up to $11.52 USD per instrument sterilized. Universal tibial components have been accepted in the past and several studies have demonstrated noninferiority or even superiority over asymmetric tibial designs. Modern universal femoral designs have improved from antiquated symmetric femoral designs and recent studies have demonstrated similar femoral rollback and axial rotation compared with non-resurfaced knees along with excellent knee society scores. A modern total knee system designed around efficiency capable of maximizing patient outcomes and restoring normal knee kinematics is needed. Reductions in tray and instrument counts have saved over $250,000 annually in sterilization and storage space while improving tray utilization. Set up time is reduced, thereby enhancing room turnovers. This cost reduction comes at no detriment to the patient and with the excellent knee kinematic and outcome scores boasted by this implant, the modern universal knee system is a great value to healthcare.<br></br> Abbreviations: USD = United States Dollar; GDP = Gross Domestic Product; TKA = Total Knee Arthroplasty; CMS = Centers for Medicare and Medicaid; OR = Operating Room; PSI = Patient Specific Instrumentation
Admitting Geriatric Hip Fracture Patients to the Orthopaedic Service Decreases Cost of Care
Authors: Zelenski Nicole A. , Brock John Logan , DeAngelis Ryan D. , Charette Ryan S. , Neuwirth Alexander L. , Mehta Samir 
Published: August 2023

Introduction Hip fractures are common and costly, costing $12 billion annually in the US. A large portion of the cost of care is related to inpatient care, which is highly variable. There is a lack of strong evidence regarding whether medicine or orthopaedics should serve as the primary admitting and managing service in the care of hip fracture patients with neither having improved outcomes. The purpose of this study is to compare the cost of care between patients who were admitted to orthopaedic vs. non-orthopaedic services after geriatric hip fractures. Methods A retrospective chart review was conducted of patients over the age of 55 with hip fractures undergoing operative treatment at a Level 1 trauma center between 2010-2013. We examined demographic information, admitting service (orthopaedic vs. non-orthopaedic), length of stay, ASA score as well as reimbursement and cost information. Statistical analysis was performed to evaluate what factors most influence cost of care. Results A total of 326 patients with hip fractures were included in the analysis. After controlling for age, sex, BMI, and ASA score, admission to the orthopaedic service was associated with $3,172 lower total costs than admission to a non-orthopaedic service (p=0.0001). Patients admitted to the orthopaedic service were discharged an average of 2.6 days earlier than patients on the non-orthopaedic service (p<0.0001). There was no difference in 30-day readmission or 90-day mortality between the two groups. Discussion Hip fracture patients admitted to the orthopaedic service are discharged sooner than patients admitted to a non-orthopaedic service, even when controlling for ASA score. Nationally, this implies substantial potential cost savings from admitting patients to orthopaedic rather than non-orthopaedic services. Systems should develop clear guidelines on when it is appropriate to admit hip fracture patients to non-orthopaedic services, and the orthopaedic service should be the default admitting service.
Trends in Reverse Total Shoulder Arthroplasty: How the Early Trends in New Innovation Provide Experience in Utilization of Later Designs
Authors: Navarro Ronald A. , Mellano Chris R. , Sievers Dennis A. , Harrast John J. , Carpenter James E. , Jackson Kent R. , Dillon Mark T. 
Published: August 2023

Background Recent literature has described an increase in overall rates of shoulder arthroplasty procedures being performed. To date few reports have characterized the yearly trended earliest incidence of introduction of the then innovative reverse total shoulder arthroplasty (RTSA) since FDA approval in 2003. This study aimed to describe the earliest surgical trends in RTSA use performed in the United States over time. We believe this knowledge will help show how early trends in new innovations provide experience to understand later iterative innovation in the same device. Methods Two complementary datasets that recorded RTSA use discretely at the advent of use in America were reviewed to compare the rates of RTSA being performed on national and regional levels over time. The American Board of Orthopaedic Surgery (ABOS) national database was reviewed, to identify all shoulder arthroplasty cases reported by Part II candidates from 2005-2010. RTSA, total shoulder arthroplasty (TSA), and shoulder hemiarthroplasty cases were each identified separately. Additionally, a regional integrated healthcare system implant registry was reviewed to identify all RTSA, TSA, and shoulder hemiarthroplasty cases performed from 2005-2010. Surgical trends in RTSA rates from both datasets were calculated and compared. Results From 2005-2010 the national ABOS database reported 2,674 shoulder arthroplasty cases, of which 425 were RTSA. In 2005, 19 RTSA cases were reported to the ABOS and constituted 5.2% of all shoulder arthroplasty cases reported. In 2010, 108 RTSA cases were reported and constituted 24.5% of all shoulder arthroplasty cases, an increase of 369%. Meanwhile the regional integrated healthcare system implant registry from 2005-2010 reported 1519 shoulder arthroplasty cases of which 174 were RTSA. In 2005, 8 RTSA cases were reported through this registry and constituted 4.1% of all shoulder arthroplasty cases. In 2010, 49 RTSA cases were performed and constituted 14.9% of all shoulder arthroplasty cases, an increase of 173%. Conclusion Rates of RTSA being performed have increased dramatically since FDA approval. Both regional and national rates showed this increase, suggesting a lack of regional bias. The rise of RTSA use has continued since these early documented rates with newer literature supporting increases in indications and volumes. This report serves as a retrospective comparison of the earliest documented RTSA use. The use rates early in the experience of the innovative idea of RTSA may be instructive and educational to surgeons in this time of expanding indications for RTSA and with utilization of newer RTSA designs. Level of Evidence Level III Retrospective Comparative Study
How has Return on Investment of a Career in Orthopaedic Surgery Changed Over Time?
Authors: Mody Kush S. , Mikhail Christopher , Barbera Joseph , Cho Samuel K. , Parekh Selene G. 
Published: August 2023

INTRODUCTION The rising cost of medical education, coupled with a lack of personal finance education, can have detrimental effects on both the personal and professional well-being young orthopaedic surgeons. This study utilizes a career in orthopaedic surgery as a case study to 1) elucidate changes in the return on investment (ROI) of a career in medicine 2) discuss the personal and professional implications of these changes for young surgeons, and 3) advocate for widespread personal finance education for trainees. METHODS Financial analysis principles, including net present value (NPV), internal rate of return (IRR), and multiple on invested capital (MOIC), were used to examine ROI of a career in orthopaedics in 1989, 1999, 2009, and 2019. Data was collected on undergraduate and medical school tuition, resident salary, and orthopaedic surgeon compensation from publicly available databases. Student loan payments were excluded from this study. All values were adjusted for inflation to $US Dollars in 2020 for comparison. RESULTS From 1989 to 2019, there was no change in NPV, IRR decreased from 25% to 15%, and MOIC decreased from 21.5x to 8.0x. During this time, there was also a 172% inflation-adjusted increase in the cost of medical education. This resulted in a 3-year change in the orthopaedic surgery break-even point from the fourth year in residency to the second year in practice as an attending surgeon. DISCUSSION Since 1989, ROI has decreased substantially, and the break-even point has been delayed by 3 years. By understanding how their financial situation differs from those who graduated decades ago, young orthopaedic surgeons can better inform themselves and plan accordingly. Leaders in the field and training programs should consider offering personal finance education that is uniquely tailored to young orthopaedic surgeons and trainees today.
Analysis of Patient Comments on Patient-Reported Outcome Measures in Orthopaedic Trauma
Authors: Carlson Tim A. , Vang Sandy , Sibley Andrew , Huspeni Rachel , Schroder Lisa K. , Cole Peter A. , Nguyen Mai 
Published: August 2023

Background Patient-reported outcome measures (PROM) surveys are being increasingly utilized in orthopaedic trauma. However, the current validated outcome tools generally do not permit individualized patient narrative responses. With the implementation of a new electronic PROM program that allowed for additional comments, we sought to determine the comment rate on PROM surveys and to define the most common themes discussed by patients. Methods A prospectively collected orthopaedic trauma registry from a single metropolitan Level I trauma center from January 2018 to April 2020 was retrospectively reviewed for PROM data. Validated general and injury specific PROM surveys were sent to patients electronically at six weeks, three months, six months, one year and two years post-operatively. Patients were able to leave comments following the multiple-choice questions. These comments were categorized into groups based on their content. Results Out of 3068 completed PROM surveys, 1112 (36%) had additional comments. There was no statistically significant difference in age, gender, or PROMIS-10 scores between the group who left comments on completed PROMs and those who did not. A total of nine themes were identified including: positive communication, negative communication, empathy, pain management, positive functional outcome, negative functional outcome, appreciation for care, survey suggestions, and neutral comments. There were more positive comments (57%) than negative comments (35%). Eight percent of the comments had neither a positive nor negative theme. The most common themes were related to interactions with the surgical team and communication (68%). Only 14% of comments were related to functional outcome. Following the dissemination of these findings in our department, we observed a 2.5% increase in satisfaction rating in the proceeding three-month period. Conclusions More than one-third of the patients that completed PROM surveys provided additional comments regarding their care. Analysis of patient narrative responses provides valuable information to improve patient-centered, value-based care.
The Next Frontier for Rotator Cuff Augmentation? Strength + Bio-Induction
Authors: McMillan Sean , Arciero Robert , Ford Elizabeth 
Published: August 2023

Rotator cuff repair (RCR) is one of the most common arthroscopic orthopedic procedures performed worldwide. A high number of clinical and subclinical re-tears exist post procedure, particularly in the subset group of large (>3cm) to massive tears and revision tears (Agrawal 2012; Galatz et al. 2004; Djurasovic et al. 2001; Burkhart et al. 2007). Advances in RCR over the past two decades have nearly eliminated failures related to implant failure. Currently the most common mechanism of failure lies in suture “pull through” at the suture-tendon interface (Mirzayan et al. 2019; Ponce et al. 2013; Ma et al. 2006). The addition of rotator cuff augmentation has seen significant growth, with improved outcomes rates compared to non-augmented repairs. However, each of the most commonly used synthetic and biologic augmentation options have drawbacks. We describe the current overview of RCR augmentation and introduce a novel bio-composite scaffold featuring a highly porous type I collagen scaffold reinforced with bio-resorbable poly(L-Lactide) (PLLA) microfilaments. This scaffold is intended for the reinforcement of soft-tissue repair and uniquely combines bio-inductive properties with load-sharing strength.
Reduced Opioid Use and Hospital Stay in Patients Undergoing Total Knee or Total Hip Arthroplasty when Treated with Sublingual Sufentanil Compared with Standard of Analgesic Care
Authors: Wiesner Lawrence , Tvetenstrand Christian D 
Published: August 2023

INTRODUCTION A prospective study with a historical control group was performed to assess opioid use and length of stay in patients receiving a sufentanil sublingual tablet (SST) perioperatively for hip or knee arthroplasty compared to standard opioid administration. METHODS Patients were prospectively enrolled following informed consent and were dosed with one SST 30 mcg in the post-anesthesia care room following spinal anesthesia. Patients unable to receive spinal anesthesia received one SST 30 mcg dose prior to general anesthesia. The comparator group was patients undergoing the same procedures within the previous 3 months. All patients received non-steroidal anti-inflammatory drugs and acetaminophen, with peripheral anesthesia blocks for knee arthroplasty. Intravenous and oral opioids were used as rescue analgesics. RESULTS A total of 110 patients were evaluated, with 53 patients prospectively treated with SST and 57 patients in the comparator group. Patient demographics, anesthesia techniques and type of surgery were similar between the groups. The SST group utilized less morphine milligram equivalents throughout their stay (17.8 ± 2.4 vs 25.0 ± 3.3 for control patients [P < .05]). Hospital length of stay was shorter for the SST group (0.87 ± 0.12 vs 1.23 ± 0.16 nights [P < .05]). In the control group, 9 patients (15.8%) were discharged to a skilled nursing facility compared to none in the SST group (P < .01). DISCUSSION In patients undergoing hip or knee arthroplasty, the addition of SST to a multimodal analgesic regimen is associated with lower opioid utilization, more rapid discharge and fewer admissions to skilled nursing facilities.
An Evidence-Based Approach to the Treatment of Knee Osteoarthritis
Authors: Brown Gregory A. 
Published: August 2023

The Journal of Orthopaedic Experience and Innovation editorial (Kirschenbaum 2021) requesting knee osteoarthritis (OA) treatment protocols or algorithms is important. The American Academy of Orthopaedic Surgeons’ (AAOS) Treatment of Osteoarthritis of the Knee Evidence-Based Guideline (2nd Edition) (Jevsevar et al. 2013) provides evidence of the effectiveness of knee OA treatments, but does not provide a treatment algorithm or protocol. Neither does the clinical practice guideline provide a rank ordering of the effectiveness of different treatments or guidance regarding when to initiate or discontinue treatments. Consequently, information must be incorporated from other sources and synthesized into an evidence-based approach. “Approach” is used because the diversity of patients, their co-morbidities, and their responses is not amenable to a defined protocol or algorithm.
Summary of outcomes of a non-invasive biomechanical therapy for patients with knee osteoarthritis
Authors: Bartels Matthew , Suk Michael 
Published: August 2023

Osteoarthritis (OA) is the second most frequent chronic musculoskeletal (MSK) condition after low back pain and a leading cause of disability in the elderly. The number of people living with disability will continue to rise with the aging of the population. Moreover, the rapid increase in rates of surgical intervention, i.e. Total knee replacement (TKR) and revision TKRs, is expected to place an immense burden on the health care system and society. There is a call for better rehabilitation, new interventions, and disease management for patients with knee OA. The purpose of this article is to review the biomechanics of knee OA and biomechanical interventions and to summarize the current literature on a non-invasive, home-based biomechanical treatment for patients with knee OA. The evidence suggests an improvement in symptoms and biomechanical indicators after using the home-based biomechanical intervention. In the presence of value-based payment to improve efficiency and effectiveness in delivering medical care, these results are promising.