bluuebunny/crossref_metadata_2025_split huggingface dataset:
South Korean immigrant workers in Germany: L2 German verb placement and sociolinguistic factors
Authors: Joo Hyoun-A 
Published: November 2022

Aims and objectives/purpose/research questions: This study explores the asymmetric placement of the finite verb in Korean L2 German speakers and examines the effect of sociolinguistic factors on the produced verb placement patterns. Design/methodology/approach: Fifty-eight participants performed a sentence completion task that elicited the preferred placement of the (finite) verb in matrix and subordinate clauses. In addition, language background interviews were conducted to better understand the sociolinguistic circumstances of the Korean immigrants. Data and analysis: The experimental data are analyzed using implicational scaling to identify patterns of verb placement. The effect of sociolinguistic factors was tested fitting an ordinal logistic regression model. Findings/conclusions: Contrary to the developmental stages of L2 German syntax found in previous research, the experimental results revealed that target-like subordinate clauses are produced more robustly than verb second (V2) constructions. It is argued that this result is better explained with difficulties producing subject-verb inversion, V2, than with facilitative L1 transfer effects from Korean, producing German subordinate clauses with V-final order. Concerning social factors, the type of occupation (coal miner or nurse) was most significant in predicting the preferred L2 verb placement pattern, followed by L2 education and age of immigration. Originality: This article adds to the understanding of L2 German syntax by revisiting previously identified stages of L2 German development with data that target the preferred verb placement in matrix and subordinate clauses from less-researched L1 Korean speakers. The intra-group distinction of Korean immigrants into coal miners and nurses further allows a differentiated look at the role of sociolinguistic factors. Significance/implications: This research is significant as it aims to draw a comprehensive picture of L2 German acquisition and usage in the context of labor migration, highlighting a less-studied group of immigrants.
Patients experience regarding home mechanical ventilation in an outpatient setting
Authors: Ribeiro Carla , Jácome Cristina , Oliveira Pedro , Conde Sara , Windisch Wolfram , Nunes Rui 
Published: November 2022

Background The patient’s experience of treatment is a cornerstone of high-quality healthcare, along with clinical safety and effectiveness. We aimed to evaluate the patients’ perspectives regarding home mechanical ventilation (HMV) follow up in an outpatient setting and ascertain differences between patients that started HMV in the outpatient setting compared to other settings. Methods This cross-sectional study was conducted with patients with chronic respiratory failure under HMV in the Outpatient Ventilation Clinic. Patients filled in a patient experience questionnaire and the S3-NIV questionnaire. Results The study included 235 patients (127, 54% male), median 70 [25–75 percentiles 64–76] years) and about half were adapted to HMV in the outpatient setting (117, 49.8%). Patients had a daily ventilator usage of 8.0 [6.0–10.0] hours and have been on ventilator for a median of 35.0 [12.0–66.0] months. Patients reported an overall good experience regarding education at initiation (209 [88.9%] considered the information given was enough), short time to adaptation [104 (44.3%) felt adapted after some hours], with perceived benefits (171 [72.8%] reported less shortness of breath, 158 (67.2%) improved quality of life and 150 (63.8%) less tiredness). Benefits overcame the treatment side-effects (158 [67.2%] reported mucosal dryness, 109 (46.4%) mask sores and 96 (40.9%) leaks). There was no difference in terms of reported health gains, side effects or time to adaptation between adaptation settings, but patients starting HMV in the outpatient setting reported better communication and education at adaptation. Conclusions Outpatient setting was perceived as a positive experience, both in HMV initiation and follow up, with good patient-physician communication leading to significant health reported gains, improvement of health status and well-being and good treatment adherence.
Understanding motivations and behaviours of our influencers: What can pharmacists learn from their leaders?
Authors: Gaballa Madonna , Kaupp Kristin , Gregory Paul , Austin Zubin 
Published: November 2022

Background: There has been considerable discussion regarding the “leadership crisis” in pharmacy, with concerns that insufficient numbers of pharmacists want to take on leadership roles in their own profession. This exploratory study of leaders and influencers in pharmacy was undertaken to characterize the motivations for and behaviours of titled and untitled leaders, in order to help other pharmacists learn from their experiences. Methods: Interviews with 28 individuals who self-identified or were described by others as leaders (with or without formal titles) and influencers in pharmacy were conducted using online platforms (e.g., Zoom, Teams). A semistructured interview guide was used and refined during the interviews. Data were analyzed using a constant comparative method to identify common themes. Results: While participants in this study all described different trajectories towards leadership or influencer roles, several common themes emerged, including 1) personal characteristics that enable leadership roles/activities, 2) environmental supports and drivers that propel leadership forward, 3) positive reinforcers that maintain momentum towards leadership aspirations and 4) general predictors of success as a leader/influencer in pharmacy. Discussion: To address the “leadership crisis” in pharmacy, it will be necessary to motivate and support individuals in assuming these roles. Findings from this study have highlighted the complex and individual pathways current leaders have undertaken to achieve these roles and have signposted ways in which organizations, managers and mentors can support nascent leadership aspirations in productive ways.
Inaccuracy of surgical irrigation fluid temperature hand assessment
Authors: Tuma Faiz , Shea Connor , Nadeem Muhammad , Shebrain Saad 
Published: November 2022

Introduction: Fluids are often used for irrigation during surgical procedures. The temperature of the fluid directly affects the exposed tissue and body temperature. The recommended practice is to use euthermic fluids to be homeostatic and optimise patient care. Hand checking the fluid temperature by surgeons and scrub practitioners is the commonly used method. This subjective measurement leaves room for error and can lead to inaccuracies. The purpose of the study is to assess the accuracy of the currently used method of checking irrigation fluids temperature by hand immersion. Method: Two sets of fluids were prepared. One was made at 37°C and the other was 30°C. Participants immersed their hands in the containers and then report if each of the two sets is (1) appropriately warm for irrigation, (2) too cool and (3) too warm. Data were collected and interpreted. Results: Results showed that about half of participants in our study perceived normal physiologic fluid temperature as too hot for use in irrigation, 30°C fluid was perceived as appropriate and physiologic by about a quarter of participants. Conclusions: Perception of surgical irrigation fluid temperature by hand immersion is inaccurate. Standard objective methods of measuring the temperature are recommended.
Continuous Glucose Monitoring in Pediatric Diabetic Ketoacidosis
Authors: Pott Thomas , Jimenez-Vega Jose , Parker Jessica , Fitzgerald Robert 
Published: November 2022

Background: Use of real-time continuous glucose monitoring (rtCGM) in ambulatory settings improves overall glycemic control and reduces the incidence of diabetic ketoacidosis (DKA) in adults and children/adolescents with type 1 diabetes (T1D). However, the use of rtCGM in children with DKA has not been well studied. Method: This prospective, single-arm, single-center study assessed the accuracy, reliability, and feasibility of a commercially available rtCGM device compared with point-of-care (POC) capillary and serum glucose values in pediatric patients admitted to the pediatric intensive care unit for DKA. The primary outcome was the accuracy of rtCGM glucose values compared with POC capillary and serum glucose values during standard treatment of DKA as assessed by Clarke Error Grid (CEG) analysis. Secondary outcomes were assessment of the relationship between rtCGM readings and degree of acidosis and mean length of hospital stay (LOS). Results: Data from 35 hospitalized children (mean ± SD age, 11.9 ± 4.1 years) with DKA were included in our analysis. Five hundred twenty-four time-matched glucose values between serum glucose and rtCGM and 91 time-matched glucose values between POC capillary glucose and rtCGM were obtained. The effect of acidosis on accuracy CEG analysis showed 95.4% of the 524 matched CGM/POC pairs and 95.6% of the 91 matched CGM/serum glucose pairs in the clinically acceptable A + B zones. The average LOS was 1.32 ± 0.73 days. Serum bicarbonate level did not appear to affect the accuracy of rtCGM in the setting of DKA. Conclusions: Continuous glucose monitoring use in inpatient pediatric DKA treatment was found to be feasible and reliable.
Acrometastasis of the Lower Limb Carries a Poorer Prognosis: A Retrospective Cohort Study
Authors: Thompson Rory P. , Raina Prince , Downie Samantha , Jariwala Arpit C. 
Published: November 2022

Background Bony metastasis distal to the knee is rare and often reported alongside metastasis distal to the elbow. We sought to provide empirical evidence of the epidemiology, presentation, and prognosis of lower limb acrometastasis, alongside investigation of the distribution of metastases present while lower limb acrometastases form. Methods This retrospective cohort study identified 44 radiologically confirmed cases of lower limb acrometastasis from a single region. Case note review facilitated the extraction of data relating to the stated aims. Patients were grouped by extent of metastasis at primary diagnosis. Mann-Whitney U test compared metastatic burden, and Kaplan-Meier analysis compared survival. Results Prostate and breast carcinoma were the most commonly diagnosed primary tumors. Sixty-eight acrometastatic lesions were identified, of which 70% presented asymptomatically. Lower limb acrometastasis was associated with metastatic disease at a significantly greater number of sites than those presenting with metastasis proximal to the knee only (P = .007) and conveyed a significantly worse survival than metastasis proximal to the knee or nil metastasis (P < .001). Median survival from diagnosis of lower limb acrometastasis was 1.0 year. Conclusion Lower limb acrometastasis is associated with a large metastatic burden and occurs in the terminal year of disease. Radiological identification of cases reveals a distinct cohort of acrometastatic lesions, more likely to present asymptomatically, and arises from alternate primary carcinomas than those in previous literature. Levels of Evidence: Level IV: Case series
Vancomycin Powder Is Highly Cost-Effective in Total Ankle Arthroplasty
Authors: Nam Hannah H. , Martinazzi Brandon J. , Kirchner Gregory J. , Adeyemo Adeshina , Mansfield Kirsten , Dopke Kelly , Ptasinski Anna , Bonaddio Vincenzo , Aynardi Michael C. 
Published: November 2022

Prosthetic joint infection (PJI) is a costly and potentially fatal complication in total ankle arthroplasty (TAA). Some surgeons apply topical vancomycin powder to minimize the risk of infection during TAA procedures. The purpose of our study was to determine the cost-effectiveness of using vancomycin powder to prevent PJI following TAA and to propose an economic model that can be applied by foot and ankle surgeons in their decision to incorporate vancomycin powder in practice. Using our institution’s records of the cost of 1 g of topical vancomycin powder, we performed a break-even analysis and calculated the absolute risk reduction and number needed to treat for varying costs of vancomycin powder, PJI infection rates, and costs of TAA revision. Costing $3.06 per gram at our institution, vancomycin powder was determined to be cost-effective in TAA if the PJI rate of 3% decreased by an absolute risk reduction of 0.02% (Number Needed to Treat = 5304). Furthermore, our results indicate that vancomycin powder can be highly cost-effective across a wide range of costs, PJI infection rates, and varying costs of TAA revision. The use of vancomycin powder remained cost-effective even when (1) the price of vancomycin powder was as low as $2.50 to as high as $100.00, (2) infection rates ranged from .05 to 3%, and (3) the cost of the TAA revision procedure ranged from $1000 to $10 000. Levels of Evidence: IV
Factors Associated With Unfavorable Radiological Outcomes After Opening-Wedge High Tibial Osteotomy for Varus Knees
Authors: Shim Seung Jae , Jeong Ho Won , Kim Saeil , Park Yong-Geun , Lee Yong Seuk 
Published: November 2022

Background: Corrective osteotomy around the knee is based on deformity profiles of the femoral and tibial sides. Opening-wedge high tibial osteotomy (OWHTO) can be favored if the outcomes are not different, even if there is a certain degree of abnormal parameters after correction. Purpose/Hypothesis: The purpose of this study was to identify the factors associated with unfavorable radiological outcomes after OWHTO for varus knees. Our hypothesis was that there would be an optimal situation in which double-level osteotomy (DLO) has advantages over isolated OWHTO and an optimal cutoff value of structural parameters for which DLO should be considered in patients with severe varus knees. Study Design: Case-control study; Level of evidence, 3. Methods: The radiological and clinical outcomes of 337 patients who underwent OWHTO were retrospectively evaluated. A subgroup analysis was performed according to the weightbearing line ratio (WBLR) (group 1: <25th percentile; group 2: 25th-75th percentile; and group 3: >75th percentile) and factors associated with unfavorable radiological outcomes. For the assessment of cutoff values of the parameters favoring DLO, unfavorable radiological outcomes were categorized as follows: (1) medial proximal tibial angle (MPTA) >95°, (2) joint-line convergence angle (JLCA) >4° (insufficient medial release), (3) JLCA <0° (medial instability), (4) recurrence of a varus deformity, and (5) lateral hinge fracture. Results: The mean follow-up period was 66.2 ± 19.1 months. A low preoperative WBLR was related to a larger preoperative to postoperative change (Δ) in the WBLR, a larger reduction in coronal translation, a larger ΔMPTA, a wide preoperative lateral joint space, and a narrow preoperative medial joint space ( P < .001, P < .001, P < .001, P = .016, and P = .003, respectively). However, only an MPTA >95° was significantly related to a low WBLR in the subgroup analysis according to unfavorable radiological outcomes ( P = .038). The cutoff value of ΔWBLR causing an MPTA >95° was 46.5%, which showed a good area under the curve of 0.800, with a sensitivity of 74.4% and a specificity of 82.7%. The clinical outcomes significantly improved at the final follow-up compared with those preoperatively, with no significant differences between the WBLR groups. Conclusion: A ΔWBLR ≥46.5% led to an MPTA >95°. However, clinical outcomes were not affected. DLO should be considered if the surgeon desires a postoperative MPTA ≤95°.
Factors Influencing the Booking Gestational Age Among Antenatal Clinic Attendees at Primary Health Centers in South West, Nigeria: A Cross-Sectional Study
Authors: Olufemi Olayinka Temitope , Sebutu Bello Ibrahim , Oluwafemi Olajubu Temitope , Oloyede Oyegbade Olanrewaju , Omobolanle Olajubu Aanuoluwapo , Tamunotonye Ezeoma Ikechi 
Published: November 2022

Background Antenatal care (ANC) is a recognized factor for favorable pregnancy outcomes. Despite the benefits associated with early initiation of antenatal care, late booking still predominates in sub-Saharan Africa including Nigeria. Objective This study aimed to assess the factors, including family dynamics, associated with the booking gestational age among women attending ANC clinics in a Local Government Area of Osun State, Nigeria. Methods A descriptive cross-sectional study was conducted among 255 pregnant women attending ANC at the Primary Health Centres in Osun State, who were selected by stratified random sampling technique. Data were obtained with aid of a semi-structured questionnaire and subjected to descriptive and inferential analyses. Results The mean age of respondents was 27.3 ± 5.1 years. Their mean booking gestational age was 23.0 ± 6.6 weeks, while the majority (85.3%) booked late for ANC. Most (122, 54.2%) of the respondents booked in the second trimester. The opinion of the husband influenced most women (54.2%) in the decision regarding the time of ANC booking. There was no association between the booking gestational age and each of respondents’ age, education, parity, perceived family support, level of family functioning, and other sociodemographic characteristics. The booking GA was however significantly related to the previous booking GA at the last pregnancy ( p = .004). Conclusion Late initiation of antenatal care was high among pregnant women attending PHCs in the study area and it was not associated with measures of family dynamics. The predominant influence of husbands’ opinion on time of booking suggests the need for strategic outreach to males through relevant reproductive health educational campaigns.
Minimally Invasive Foot & Ankle Surgery: A Review and a Novel Technique
Authors: Wendler Derrick E. , Stewart Gary W. , Bailey Erroll J. , Shofoluwe Ademola I. , Nwaibu Uzoma 
Published: November 2022

Category: Hindfoot; Midfoot/Forefoot Introduction/Purpose: There has been a growing interest in the utility of minimally invasive surgery (MIS) to correct foot and ankle deformities. MIS is performed using small, targeted incisions rather than large incisions required of open procedures. Proposed benefits of MIS include preservation of blood supply, limited injury to adjacent soft tissue, and fewer wound complications amongst many others. (Neufeld et al, Lu et al). To date, a large number of minimally invasive techniques have been developed to treat common deformities such as hallux valgus, hammertoe, and bunionette. However, there is no brief review that summarizes the literature comparing open surgery with its minimally invasive counterpart. Additionally the options available for MIS treatment of Flexible Adult Acquired Flat Foot/Progressive Collapsing Foot Deformity have failed to keep pace. Methods: We will begin by synthesizing data on MIS in the foot and ankle through analysis of those three aforementioned deformities, summarizing both technique and associated research. Then, we will introduce a novel technique for stage II (flexible) flat foot correction, the Mini-BEAR (bone extra articular reconstruction). Historically treated with the now largely insufficient FDL transfer, we believe this new technique will not only prove biomechanically efficacious but also lead to improved patient safety and lower complication rates. The rapid pace at which novel MIS procedures are developed requires surgeons to be disciplined in conducting and analyzing studies; this synopsis will aim to aid in that process. Results: A novel surgical technique that involves a minimally invasive, all bone extra-articular reconstruction (Mini-BEAR) system. We believe that this technique can potentially replace the multiple long surgical incisions that accompany the traditional medial displacement calcaneal osteotomy, lateral column lengthening, and Cotton procedures with minimal ones, reduce post-operative recovery time, reduce operating room procedure time, and produce a better cosmetic result. Additionally, we believe it will reduce narcotic use secondary to less pain by virtue of less surgical work on the patient. We have also performed a cadaveric anatomic study that qualitatively and quantitatively observed the tendinous and neurovascular structures at risk with the Mini- BEAR procedure. Conclusion: The majority of the publications on the use of MIS to address deformities in the foot and ankle are small cohort studies or retrospective case reviews; many of which lack a control group. Due to this, data showing improvements in MIS vs open techniques is rare. However this is to be expected in a newer, developing field and as larger studies are performed there is optimism that this trend may change. (attached file is example of chart, we have similar format for all 4 deformities discussed in this paper)
Comparative Risk Stratification for Prediction of Early Postoperative Morbidity and Mortality after Open Fixation of Periarticular Lower Extremity Fractures
Authors: Xu Amy L. , Raad Micheal , Sotsky Rachel B. , Hughes Alice J. , Aiyer Amiethab A. 
Published: November 2022

Category: Trauma; Ankle; Hindfoot Introduction/Purpose: The standardized identification of patients who are at higher risk of early postoperative adverse events has implications for quality improvement, preoperative medical optimization, and cost reduction through bundled payments. The purpose of the present study was to develop points-based risk stratification systems for predicting 30-day adverse events (AEs) and mortality after open fixation of periarticular hip, knee, and ankle fractures. Methods: Query of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database yielded 65,529 patients who underwent periarticular hip, knee, and ankle fracture repair from 2010-2019. We collected patient demographics and preoperative risk factors. To generate our risk stratification systems, 60% of patients were randomly designated as the development cohort and analyzed with multivariable regression plus bootstrap modeling to identify independent risk factors for early AE and mortality. A nomogram analysis was then conducted to assign scores for each risk factor and generate two points-based risk stratification systems, for AE and mortality. To validate our models, the systems were applied to the remaining 40% of patients (the validation cohort) and tested for predictive ability. Results: In total, 13,212 patients (20.2%) experienced any AE and 3,613 patients (5.5%) mortality within 30 days of fracture fixation. Patients were assigned points for each of the following in both risk stratification systems: fracture type (+4 hip, +2 knee, +0 ankle), male gender (+1), age (>=80 years +5, 60-79 years +3, 40-59 years +2), functionally dependent (+2), anemia (+2 for AE, +1 for mortality), pulmonary disease (+3 for AE, +1 for mortality), congestive heart failure (+3 for AE, +2 for mortality), and end- stage renal disease (+3 for AE, +1 for mortality). Corticosteroid use (+1), hypertension (+1), and insulin-dependent diabetes (+2) were additional predictors for only AEs. The AE and mortality models had maximum scores of 27 and 17 points, and Harrell C statistics of 0.66 and 0.75, respectively. The estimated risk of developing early AE ranged from 3.4-79.5% and mortality from 0.08- 54.4%. Conclusion: Fracture type, male gender, age >=40 years, corticosteroid use, functional dependence, anemia, hypertension, insulin-dependent diabetes, pulmonary disease, congestive heart failure, and end-stage renal disease can be used in the prediction of early AE or mortality following open fixation of periarticular lower extremity fractures, with a marked disparity in estimated risks depending on the number of risk factors possessed by a patient.