bluuebunny/crossref_metadata_2025_split huggingface dataset:
Guest post: Why our Open Data project worked
Authors: Brembs Björn 
Published: August 2023

Why our Open Data project worked, (and how Decorum can allay our fears of Open Data). I am honored to Guest Post on Björn’s blog and excited about the interest in our work from Björn’s response to Dorothy Bishop’s first post. As corresponding author on our paper, I will provide more context to our successful Open Data experience with Björn’s and Casey’s labs.
The Influence of Self-Efficacy on Job Satisfaction, Organizational Commitment, Motivation and Job Performance in Private School Teachers
Authors: Rossiandy Yemima , Indradewa Rhian 
Published: August 2023

Self-belief in an individuals abilities is essential for influencing behavior, decision-making and achieving organizational goals. The purpose of this study is to investigate the role of teacher self-efficacy that can influence job satisfaction, organizational commitment, motivation and job performance in the scope of formal education. This study used data collection by survey method and online questionnaire distribution, respondents were selected by purposive sampling method. The sample of this research is teachers who teach at the kindergarten, elementary, junior high, and high school levels in the 2022-2023 school year. The data analysis technique used Structural Equation Model (SEM) with SmartPLS 3.0. Some of the findings in this study are that self-efficacy has a direct effect on job satisfaction, motivation and job performance of teachers. Self-efficacy has no direct influence on job performance through the mediating effects of motivation and organizational commitment. The managerial implication of this study for school administrators and researchers is to strengthen the perception of teacher self-efficacy through professional development, appreciation and rewards, so that it can have a broad positive impact on teacher motivation in various aspects of life.
Correlation between APACHE II Score and Mortality Rate in PKU Gamping Hospital ICU patients
Authors: Setiawan Yosy Budi , Prambudi Dito Mahardika 
Published: August 2023

The intensive care system have a duty to help patients in healing process and not to delay patient’s death. Therefore many scoring methods was developed to predict the outcome of care and mortality rate in the ICU. One of those methods is APACHE II that scores 12 physiological variables and pre-existing conditions in the patients. This research was done to find the correlation between APACHE II score and mortality rate of PKU Gamping hospital ICU patients. The data used medical records for 61 non-operative patients from June-December 2019. This research found that 37 (60.6%) died and 24 (39.4%) lived after treatment. The average APACHE II score was 21.28 with the lowest score of 3 and the highest score of 43, after the data gathering a correlation test was conducted using Spearman-correlation test. In the data analysis p value of 0.000 (p<0.05) and correlation coefficient of .698 was found. there was a significant correlation between the APACHE II score and the mortality rate of the PKU Gamping hospital ICU patients, where with higher number of score there was higher number of patient’s death.
Peripheral Precocious Puberty In A Four Years Old Boy With Classic Simple Virilizing Congenital Adrenal Hyperplasia
Authors: Ria Natal , Suryawan I Wayan Bikin , Arimbawa I Made , Yuda I Made Darma 
Published: August 2023

The study aims to describe a case of precocious puberty caused by classic simple virilizing congenital adrenal hyperplasia. This is a case of 4 years-old boy who developed premature pubarche 5 month before consultation. Patient also has penis enlargement with prepubertal testes and facial acne since age of three. His voice also changed to be more like an adult male voice. Physical examination revealed an alert boy, with normal vital sign, body weight of 27 kilograms (>P95, CDC Growth Chart 2000) and height of 126 centimeter (>P95, CDC Growth Chart 2000), with advanced bone age of 14-years-old child. The Sexual Maturity Rating score was G1P3( tanner stage 3), and his height was more than his mid-parenteral height. Laboratory test was done revealed 17-OHP of 196.03 ng/ml (n: <= 0.90ng/ml), high level of testosterone at 270.1 ng/ml (n: <= 0.19ng/ml), level of B-HCG : <2.3mIU/ml, low level of LH : 0.1 mIU/ml (n: >0.6 mIU/ml), and low level of FSH: 0.1 mIU/ml (n: 0-5.0mIU/ml). Ultrasound of Kidney shows a picture of hyperplasia of left adrenal gland. All of these findings allowed diagnosing him with classic simple virilizing congenital adrenal hyperplasia. Based on this diagnosis, he was then started on hydrocortisone, and after 6 months of starting the treatment, he has a favourable clinical outcome, without any secondary sex characteristics or bone age progression. Peripheral precocious puberty due to classic simple virilizing congenital adrenal hyperplasia may be asymptomatic from birth to the preschool age, therefore early detection, immediate and appropriate managements are crucial and important to prevent late outcomes.
The Clinical and Economic Impact of High Value External Fixation Utilization at a Level II Trauma Center
Authors: Gurnea Taylor , Swanson David , Bryan Joshua , Shul Craig 
Published: August 2023

Introduction: In the current climate of cost containment and fiscal responsibility, high value implant alternatives represent a substantial opportunity for the treatment of orthopedic trauma patients. As patents have expired on many commonly used trauma implants, high value alternatives have become available. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, low cost external fixation components for temporary spanning constructs in the treatment of tibial plateau and pilon fractures. Methods: 62 patients with tibial plateau and pilon fractures treated with temporary high value external fixation devices were compared to 62 patients treated with conventional brand external fixation devices over the same time period. The groups were analyzed for differences in intraoperative and post-operative outcomes in order to analyze the clinical efficacy of high value devices. Operative records were analyzed to identify intraoperative complications, operative time and estimated blood loss. Cases of infection, malunion, nonunion or need for repeat surgery were recorded. Hospital financial records were appraised to determine implant costs. Results: There were no significant differences in age, sex, presence of diabetes, smoking or fracture type between the high value and conventional groups. No difference in operative time was noted. No intraoperative or postoperative complications occurred in either group from the time of external fixation to the time of external fixator removal and conversion to definitive fixation. Overall the hospital realized a 58% reduction in implant costs, an average of $2,200 savings per case and a total savings of $136,400 during the study period. Conclusions: Use of high value external fixation implant constructs has been a very successful endeavor at our institution providing equivalent clinical outcomes while significantly reducing implant expenditures. Based on this data the use of high value implants has the potential to markedly reduce operative costs as long as quality products are utilized.
Perceptions of Regional Anesthesia for Pediatric Supracondylar humerus fractures – a multispecialty survey
Authors: Mansour Alfred , Biaggi-Ondina Andrea , Crawford Lindsay , Younas Shiraz , Matuszczak Maria , Cameron Staci , Warth Ryan J. , Haidar Layla 
Published: August 2023

Background The purpose of this study was to compare the prior experiences, perceived risks, benefits, complications, and practice patterns in the use of regional anesthesia for pediatric supracondylar humerus fractures between orthopaedic surgeons and anesthesiologists to better understand the attitudes and experiences governing perioperative pain management in the opioid crisis. Methods An online survey consisting of 22 multiple-choice questions regarding usage of regional anesthesia for perioperative pain management of supracondylar humerus fractures was approved by the Evidence-based Practice committee of the Pediatric Orthopaedic Society of North America (POSNA) and distributed to the active members. The same survey was also distributed to anesthesiologists associated with pediatric anesthesiology teaching centers between January 2019-June 2019. The results were captured anonymously using a RedCAP database, after which the data was exported for analysis. Results Two hundred and seventy nine physicians participated in this survey (n=249 orthopaedic surgeons [89.2%]; n=30 anesthesiologists [10.8%]). In total, 162/279 (58.1%) reported at least 10 years of practice, 236/279 (84.6%) reported practicing in an academic setting, and 185/279 (66.3%) reported a minimum volume of 20 applicable cases per year. 69.9% of Orthopaedic surgeons were moderately or highly concerned regional anesthesia would mask a compartment syndrome compared to only 10% of anesthesiologist sharing that same level of concern (p<0.001), although similar numbers of respondents treated patients with volkman’s contracture after a supracondylar humerus fracture. 76.1% of orthopaedic surgeons did not believe the level of perioperative pain warranted regional anesthesia compared to only 6.7% of anesthesiologists (p=0.005). Conclusion This multidisciplinary survey highlights the distinct differences in perceptions of regional anesthesia for supracondylar humerus fractures. These perceptional differences frame our opinions and willingness to changes our practices. This survey suggests perceptions on pain, risks, and benefits of regional anesthesia vary greatly between two major stakeholders treating the same injury.
Stable intertrochanteric hip fracture fixation: Device choice does not impact cost of care
Authors: DeAngelis Ryan D. , Zelenski Nicole A. , Brock John Logan , Charette Ryan S. , Neuwirth Alexander L. , Mehta Samir 
Published: August 2023

Introduction There are over 300,000 hip fractures in the U.S. annually. Hip fractures create a substantial health and economic burden, with one-year mortality after a hip fracture approaching 30% and hip fractures creating healthcare costs of over $12 billion annually. Stable intertrochanteric hip fractures can be treated with either an extramedullary implant (sliding hip screw, SHS) or an intramedullary nail (IMN), which has a higher hardware cost. This study compared the cost of care between patients treated with IMN versus SHS after stable intertrochanteric hip fracture. Methods This was a retrospective cohort study of patients over age 55 with stable intertrochanteric hip fractures at a Level 1 trauma center over a 4-year period. We collected demographic information, fixation method, outcomes measures, and cost data. Statistical analysis compared patient characteristics, costs, and outcomes between SHS and IMN patients. Results 83 patients were included, of whom 57 received an SHS and 26 received an IMN. There were no differences in age, gender, BMI, and ASA score between patients who received SHS vs. IMN (p>0.05 for all). There were no significant differences in mortality or readmission rates. SHS and IMN patients had no significant differences in length of stay (8.3 +/- 5.2 vs 8.0 +/- 3.5 days, p=0.76), direct costs ($22,324 +/- $10,603 vs $19,881 +/- $5,894, p=0.18), or health system profit (-$1,313 +/- $8,559 vs -$4,373 +/- $8,394, p=0.13). Discussion We compared the cost of care between patients treated with IMN versus SHS after stable intertrochanteric hip fracture. The use of IMN for the treatment of stable intertrochanteric hip fractures is controversial due to the significant cost of the implant. We found no differences in length of stay or care costs between patients treated with IMN versus SHS. Differences in implant cost were insignificant compared to the total cost of care.
Management of Prosthetic Joint Infection following Total Knee Arthroplasty with an Articulating Antibiotic Knee Spacer: An Early Experience
Authors: Alden Kris J. 
Published: August 2023

Eradication of deep prosthetic joint infection (PJI) following total knee arthroplasty (TKA) is a vexing problem to patients, surgeons, and the health care system. At present, two-stage exchange is a widely accepted method to treat and resolve PJI following TKA. Various spacers are available following resection arthroplasty and are designed for the local delivery of antibiotics and stability of the knee joint. We report our experience with management of PJI in TKA patients with a novel mobile knee spacer. Methods We retrospectively reviewed 31 consecutive infected knee arthroplasties, (primary TKA, 26) and (revision TKA, 5) performed between 2014 and 2016 treated with two-stage exchanges. The outcome of the spacer cohort and subsequent reimplantation procedure was examined to determine spacer range of motion, postoperative range of motion, and reinfection rate following two-stage exchange. Results Minimal spacer-related complications are reported and a stable knee spacer with flexion up to 95° were observed in most patients. The overall mean ± SD time of interim spacer placement for all patients was 25.7± 21.9 weeks (range, 8-109 weeks). The mean ± SD postoperative follow-up (following reimplantation surgery) was 3.52 ± 1.36 years (range, 1.29-6.03 years). Two patients re-infected and required a second two-stage exchange procedure. Following post second stage reimplantation surgery, all patients demonstrated no evidence of recurrence of infection. Conclusions This customized and modular articulating knee spacer has the potential to significantly reduce spacer-related complications following PJI in both primary and revision TKA and provide enhanced stability and improved knee range of motion. Level of Evidence Prognostic Level IV.
Risk Factors for Physician Burnout in Early Career Arthroplasty Surgeons
Authors: Arguelles William , Salami Joseph , Patel Shaun P. , Courtney P. Maxwell , Lange Jeffrey K. , Suarez Juan P. , Martin J. Ryan 
Published: August 2023

Introduction We sought to identify the prevalence and risk factors for physician burnout and job satisfaction among arthroplasty surgeons within their first five years of practice. Methods The American Association of Hip and Knee Surgeons (AAHKS) Young Arthroplasty Group was surveyed for this study. The survey collected data regarding surgeon demographics, extracurricular activities, and job satisfaction. The abbreviated Maslach Burnout Inventory (aMBI) was utilized to evaluate emotional exhaustion, depersonalization, and personal accomplishment. Demographic and practice variables were analyzed to identify any association with aMBI scores. Results 82 surgeons (35%) responded to the survey with 78% satisfied with their current job. Surgeons who were satisfied with their current job were more likely to have hobbies outside of orthopedics (OR = 7.50, p = 0.005), be younger (OR = 11.11, p = 0.047), and to be employed in a physician-owned practice type (OR = 9.09, practice, p = 0.019). The median personal accomplishment score was higher for those reporting hobbies outside of orthopedics (16 vs. 13.5, p = 0.040), performing research (16.5 vs. 16, p = 0.006), and having less call (17 vs. 14.5, p = 0.001). Depersonalization and emotional exhaustion scores were not related to any characteristic measured. Conclusion Emotional exhaustion, depersonalization, and sense of personal accomplishment varied greatly amongst early career arthroplasty surgeons. Having hobbies outside of orthopedics was most strongly associated with a sense of greater personal accomplishment and job satisfaction. Understanding risk factors related to burnout may help improve identification and prevention of this potential cause of job dissatisfaction and turnover.
Three-Dimensional Gait Analysis in a Healthy Geriatric Cohort
Authors: Johnson Jeremiah D. , Rozumalski Adam , Thomas Avis J. , Huyke Fernando A. , Schroder Lisa K. , Switzer Julie A. 
Published: August 2023

Introduction Three-dimensional gait analysis assesses multiple parameters of lower extremity motion. Neither normative gait patterns nor an understanding of how health and demographic factors impact gait have been established for the geriatric population. Methods A single time-point observational study from October 2013 to February 2015 recruited 25 healthy geriatric participants within three cohorts: 60-69, 70-79, and 80 years-old and older. Participants underwent static lower extremity range of motion assessment and gait analysis to collect lower extremity joint kinematics, joint kinetics, and spatiotemporal data. Questionnaires and tools included: FRAX, SF-12, and Fried Frailty Index. Data was compared with non-geriatric controls with mature gait patterns. Results Mean age was 72(SD 8); 44% women. Significant kinematic differences between the geriatric volunteers and controls were observed. Minimum hip flexion was 1.6°(SD 11.9) versus -6.0°(SD 6.9) in controls. Minimum to maximum ankle dorsiflexion was -13.1°(SD 6.3) to 15.8°(SD 3.1) and -21.6°(SD 9.0) to -13.1°(SD 6.3) in controls. Maximum ankle dorsiflexion was significantly different across age cohorts (60-69, 70-79, 80+ respectively): 15.8°(SD 2.9), 13.9°(SD 3.1), 18.0°(SD 1.6). Minimum hip flexion and minimum knee flexion were significantly higher at older ages: 5.7°(SD 7.7) and 9.4°(SD 2.2) respectively in the age 80+ cohort versus -3.2°(SD 13.9) and 5.9°(SD 3.1) in the 60-69 year-olds. Conclusion Significant kinematic gait differences were observed between geriatric volunteers and controls. Age-related gait differences were found within the geriatric study population. These findings have clinical implications for understanding fall predisposition, directing rehabilitation, and guiding medical and surgical approaches to lessen the impact on gait changes. The study identifies significant declines in geriatric gait and serves as a useful reference for future studies in the geriatric population. Level of Evidence Prognostic Cohort Study, Level III
The Effects of the COVID-19 Pandemic on Orthopaedic Surgery Residency Match Results, a Cohort Study
Authors: Furman Andrew A , Linton Alexander A , Lanzetta Nicholas J , Hsu Wellington K 
Published: August 2023

Background The COVID-19 pandemic disrupted the 2021 Orthopaedic residency recruitment process by eliminating visiting rotations and in-person interviews. In the fields of Plastic Surgery and Urology, this led to a significant increase in the rate at which residency applicants matched into residency at the same institution (“home match”) as their medical school. This study sought to investigate the effects the pandemic had on the outcomes of the 2021 Orthopaedic Surgery Match compared to the preceding four cycles 2017-2020. Methods A list of all Orthopaedic Surgery residency programs with an affiliated medical school was obtained using ORINTM and Doximity. Program websites and official social media accounts were used to gather resident information including class year, medical school, and medical school state. Outcomes of interest were home matches and matches within the same region or state as one’s medical school. Results The rate of home matches increased by 41% from 22% in 2017-2020 to 31% in 2021 (p<0.001). This increased rate was consistent across medical school regions and sub-regions, as well as across program sizes and reputation rankings. Southern programs had a higher rate of home matches than all other regions both at baseline in 2017-2020 28% v. 20% (p<0.001) and in 2021 36% v. 28% (p<0.001). Conclusions In 2021, the first residency match affected by the COVID-19 pandemic, the proportion of home matches increased compared to the prior four cycles. This may be a result of the inability of prospective residents to visit programs in-person during an away rotation or interview, resulting in programs preferring individuals they already knew via their affiliated medical school. Many pandemic-related changes such as virtual rotations and virtual interviews might stay for the long term; it will be interesting to see how these impact Orthopaedic Residency recruitment and resulting Match characteristics in subsequent cycles.
Screw Thread Configuration Has No Effect on Operative Outcomes of Slipped Capital Femoral Epiphysis
Authors: Via Garrhett Glenn , Brueggeman David , Lyons Joseph G , Edukugho Derrek , Froehle Andrew W , Martinek Melissa A , Albert Michael C 
Published: August 2023

INTRODUCTION The current “gold standard” treatment for slipped capital femoral epiphysis (SCFE) is insertion of a single cannulated screw down the epiphyseal center. Debate remains as to whether partially- (PTCS) or fully-threaded (FTCS) cannulated screws, and what number, are optimal. The present retrospective cohort study compares such constructs in a clinical model. METHODS IRB approval was obtained. Patients (N=158) presenting to a level-one pediatric trauma center for in situ pinning of SCFE between January 2005 and April 2018 were included. Covariates analyzed were sex, race, BMI, history of endocrinopathy, and preoperative designation of unstable SCFE. Outcomes included return to the operating room (OR), avascular necrosis (AVN), hardware failure/removal, and the sequelae of femoroacetabular impingement (FAI). Multivariable logistic regression models included covariates with significant univariate effects, as well as thread configuration, number of screws, preoperative instability, and the screw*thread and screw*instability interactions. RESULTS Average patient age at surgery was 12.3±1.9 years; 63% of patients were male; 68% of patients were White/Caucasian and the remaining 32% were Black/African American. Mean BMI was 28.4±6.4 kg∙m-2. PTCS were utilized in 81.0% of constructs and 1 screw was placed in 83.5% of hips. Outcome rates were as follows: return to OR=15.8%, AVN=7.6%, FAI=7.0%, hardware failure/removal=9.5%. Univariate modeling demonstrated no significant covariate effects on return to OR (each P≥0.181) or AVN (each P≥0.099). Sex had a significant effect on FAI (P=0.012). Age and bilateral SCFE were significantly related to hardware failure/removal (P=0.039 and P=0.015, respectively). Multivariable models found that 2 screw constructs were associated with increased odds of return to OR [P=0.027; OR=3.01 (1.13-7.98)]. Odds of AVN were increased by older age (P=0.024; OR=1.45 [1.03-2.03]) and 2 screw constructs in stable SCFE [screws*stability interaction: P<0.001; OR=60.5 (5.60-652.31)]. Female sex increased odds of FAI (P=0.012; OR=5.17 [1.31-20.36]). Finally, odds of hardware failure/removal were increased by 2 screw constructs [P=0.038; OR=3.64 (1.13-11.70)] and bilateral SCFE [P=0.027; OR=3.51 (1.15-10.74)]. DISCUSSION AND CONCLUSION A single, PTCS comprises the majority of SCFE constructs, and this construct carries the least risk for negative outcomes in cases of stable SCFE. These data demonstrate no significant effects of thread configuration on outcomes. The authors caution orthopaedic surgery providers against using more than one screw in cases of stable SCFE, as well as to monitor older, female, and/or bilateral SCFE patients more closely due to an increased risk for complications.