bluuebunny/crossref_metadata_2025 huggingface dataset:
ATORES SOCIAIS E DEMOCRACIA
Authors: Vieira do Nascimento Letícia , Gurjão Sampaio De Cavalcante Rocha Luiz Alberto
Published: May 2024

A pesquisa apresentada originou-se no projeto de extensão universitária “Educação para a Democracia” que adentra as escolas de ensino médio da Região Metropolitana de Belém, Estado do Pará. O estudo teve como referencial teórico a democracia no viés de Alain Touraine, vez que o teórico buscou estudar a democracia em âmbito mundial, pontuando algumas particularidades da América Latina. Buscou-se responder se o projeto de extensão universitária, em contato com os alunos secundaristas, consegue contribuir para a formação de atores sociais, por meio da proposta de diálogo e reflexão, no regime democrático exposto por Alain Touraine. Os objetivos traçados para analisar esse problema foram: 1) Compreender a teoria da democracia referente ao sociólogo; 2) Verificar o plano de trabalho de 2018 e 2019 e seus respectivos resultados; 3) Verificar o plano de trabalho de 2020 e comparar com as atividades realizadas; 4) Verificar nas redes sociais do projeto “Educação para a Democracia” o alcance das suas postagens e atividades realizadas durante o ano de 2020. A metodologia utilizada foi bibliográfica-documental, bem como pesquisa exploratória e quantitativa. Dessa maneira, o método de abordagem empregado foi o dedutivo e o método procedimental foi o monográfico. O resultado foi dividido em dois períodos. Nos anos de 2018 e 2019, com encontros presenciais, houve uma resposta eficaz na contribuição do projeto na compreensão sobre os temas abordados nas salas de aula, promovendo a reflexão sobre os direitos básicos dos alunos. Em contrapartida, o ano de 2020 não possibilitou o alcance desejado pelo projeto de extensão, possuindo critérios frágeis e prejudicados para o devido estudo da reflexão dos estudantes sobre o tema.
Palavras-chave: Democracia; Alain Touraine; Projeto de Extensão Universitária.
Cultural competence: the key to enhancing patient satisfaction and outcomes in physiotherapy
Authors: Chitapure Tajuddin , Malani Rinkle , Kawathekar Utkarsha
Published: May 2024

Tajuddin Chitapure, Rinkle Malani and Utkarsha Kawathekar discuss cultural competence and how it promotes improved patient–provider communication, leading to better diagnoses, treatment adherence and overall satisfaction.
Yükseköğretim Öğrencilerinin Öğrenme Tutumları: Türk Cumhuriyetleri Arasında CHAID Analizine Dayalı Bir Karşılaştırma
Authors: Atmaca Taner , Mammadov Rza
Published: May 2024

Bu araştırmanın amacı Türk Cumhuriyetlerinde yükseköğretim öğrencilerinin öğrenmeye ilişkin tutumlarını birincil düzeyde etkileyen faktörlerin belirlenmesi ve Türk Cumhuriyetleri arasında bir karşılaştırma yapılmasıdır. Araştırmada nicel metodolojiden yararlanılmış ve kesitsel tarama modeli kullanılmıştır. Araştırmaya beş farklı Türk Cumhuriyetinden (Türkiye, Kazakistan, Özbekistan, Azerbaycan ve Kırgızistan) toplam 1868 yükseköğretim öğrencisi katılmıştır. Türkmenistan’daki öğrencilere ulaşılamadığı için örnekleme dâhil edilmemiştir. Veriler “Öğrenmeye Yönelik Tutum Ölçeği (ÖYTÖ)” ile elde edilmiş ve SPSS ile analiz edilmiştir. Bulgulara göre beş farklı Türk Cumhuriyeti içinde yükseköğretim öğrencileri arasında öğrenmeye yönelik tutumu en yüksek olan öğrenciler Özbekistan’da iken en düşük tutum düzeyi Kazakistan’dadır. Öğrenmeye yönelik tutumda ülkeler arasında anlamlı farklılıklar söz konusudur. CHAID analizi sonuçlarına göre Türk Cumhuriyetlerindeki yükseköğretim öğrencilerinin öğrenmeye ilişkin tutumlarını alanları ile ilgili akademik gelişmeleri takip etme, yeni şeyler öğrenme çabası, bireysel öğrenmelere ayrılan süre, düzenli kitap okuma çabası, başarı notu gibi değişkenler belirlemektedir. Özellikle, öğrencilerin öğrenme tutumlarını iyileştirecek desteklerin sağlanması, eğitim ekosistemlerinde öğrenme alanlarının genişletilmesi yarar sağlayabilir.
The Preparing Background of Kipchak Written Language with Armenian Letters
Authors: Öztürk Abdulkadir
Published: May 2024

The Turkish language, one of the ancient languages in the world, has continually evolved and expanded across various geographical regions, establishing diverse historical and contemporary branches through the creation of written languages based on numerous alphabets. The formation processes of these branches of the Turkish language, which emerged gradually over time, are directly related to their ethnological structures, religious and social lifestyles, interactions in the ethno-linguistic field, geographical settlements, political situations and economic conditions. The Turkish language, which advanced as a unified written language between the 8th and 13th centuries, within the Eastern Turkish written tradition, began to diversify from the 13th century onwards, a trend that persisted into the subsequent centuries. Today, the historical and contemporary aspects of the Turkish language, encompassing over 20 written variants, should be examined by subjecting it to studies with an interdisciplinary approach.. Additionally, determining the background factors that led to the emergence of these written languages will enable a correct interpretation of the language’s evolutionary phases. This study aims to unveil the developmental trajectory of the Kipchak written language, which emerged in Eastern Europe during the 16th and 17th centuries through the use of Armenian letters. Determinations and evaluations will be conducted to explore the underlying factors that facilitated the emergence of this written language.
EARLY RESULTS OF GLUTEAL CUFF RECONSTRUCTION AND AUGMENTATION
Authors: Langdown Andy , Goriainov Vitali , Watson Ross
Published: May 2024

Gluteal Tendinopathy is a poorly understood condition that predominantly affects post-menopausal women. It causes lateral hip pain, worse when lying on the affected side or when walking up a hill or stairs. It has been labelled ˜Greater Trochanteric Pain Syndrome” a name that recognises the lack of understanding of the condition.

Surgical reconstruction of the gluteal cuff is well established and has been undertaken numerous times over the last 16 years by the senior author (AJL). However, the quality of collagen in the tendons can be very poor and this leads to compromised results. We present the results of gluteal cuff reconstruction combined with augmentation using a bioinductive implant.

14 patients (11 female, 3 male; mean age 74.2 ± 6.3 years) with significant symptoms secondary to gluteal tendinopathy that had failed conservative treatment (ultrasound guided injection and structured physiotherapy) underwent surgical reconstruction by the senior author using an open approach. In all cases the iliotibial band was lengthened and the trochanteric bursa excised. The gluteal cuff was reattached using Healicoil anchors (3–5×4.75mm anchors; single anchors but double row repair) and then augmented using a Regeneten patch. Patients were mobilised fully weight bearing post-operatively but were asked to use crutches until they were no longer limping. All had structured post-surgery rehabilitation courtesy of trained physiotherapists.

There were no post-operative complications and all patients reported an improvement in pain levels (Visual Analogue Scale 7.8 pre-op; 2.6 post-op) and functional levels (UCLA Activity Score 3.5 pre-op; 7.1 post-op) at 6 months post surgery.

Surgery for gluteal tendinopathy produces good outcomes and the use of Regeneten as an augment for poor quality collagen is seemingly a safe, helpful addition. Further comparative studies would help clarify this.
ROUTINE CAPSULAR REPAIR VERSUS UNREPAIRED CAPSULOTOMY: MINIMUM FIVE-YEAR OUTCOMES FOLLOWING ARTHROSCOPIC CORRECTION OF FEMOROACETABULAR IMPINGEMENT
Authors: Filan David , Carton Patrick
Published: May 2024

To evaluate the impact of routine capsular repair on patient-reported outcomes, survivorship and achievability of clinically important improvement, minimum 5-years post-surgery.

Our prospective institutional registry was reviewed for cases undergoing primary HA for FAI, and stratified into two groups depending on whether the capsule was repaired or not. Routine repair was introduced in late 2013. The No Repair group consisted of patients undergoing HA between Jan 2010-June 2013 while the Repair group consisted of patients undergoing HA between Jan 2015-Sept 2018. Exclusion criteria consisted of >50 years, Tonnis>1, dysplasia(LCEA<25), concomitant hip pathologies. PROMs consisted of mHHS, SF36 and UCLA. Metrics of clinically important improvement was evaluated using MCID and SCB. Rates of repeat HA or THA conversion were recorded.

985 cases were included (359 No Repair; 626 Repair), 86% male, average age 27.4±6.7years. Significant improvement in all PROMs at minimum 5-years was observed for both groups (p<0.001 for all; large effect sizes for mHHS and SF36, medium effect sizes for UCLA). At 5-years post-op there was no significant difference between groups for mHHS(p=0.078) or UCLA(0.794). SF36 was significantly poorer for those cases undergoing routine repair(p<0.001) however effect size was small (0.20). Thresholds of MCID and SCB were calculated as 69% and 86% for mHHS, 64% and 77% for UCLA, 43% and 60% for SF36.Â Both groups achieved MCID and SCB at similar rates for mHHS and UCLA. A significantly lower proportion of cases in the repair groups achieved MCID for SF36 (53.6% vs 63.5%, p=0.034) and SCB for SF36 (37.3% vs 52.8%, p<0.001). No significant difference between groups for THA conversion (0.6% No Repair vs 0.5% Repair) or repeat HA (9.7% No Repair vs 8.1% Repair).

Routinely repairing the capsule following HA for FAI demonstrates no clinical benefit over not repairing the capsule 5 years post-surgery
ARE WE MEETING PATIENTS’ EXPECTATIONS FOLLOWING REVISION TOTAL HIP ARTHROPLASTY?
Authors: Shaarani Shahril , Mohammad Omar , Mohammad Adnan , Konan Sujith
Published: May 2024

The number of revision total hip arthroplasties (THA) is increasing. This procedure is associated with a higher complication rate than primary THA, and so it is important for patients to have realistic expectations. The aim of this systematic review was to gather and summarise the available evidence on patients’ expectations following revision THA.

A literature search was conducted in PubMed, PsycINFO, Cochrane, Google Scholar and Web of Science from inception to December 2021. Methodological quality was assessed by two independent reviewers using the National Heart, Lung and Blood Institute (NIH) study quality assessment tool for observational cohort and cross-sectional studies.

The search strategy generated 3132 references of which 4 articles met the inclusion criteria. Methodological quality scores ranged from 7–10. Patients have high expectations concerning future walking ability, pain and implant longevity. Implant longevity expectations vary according to the longevity of the primary implant. A significant positive correlation was found between fulfilled expectations of pain and walking ability and patient satisfaction (r = .46 – .47). Only one study assessed fulfilment of patient expectations. Great variability was seen in operationalisation and assessment of expectations.

Patients undergoing revision THA appear to have high expectations with regards to future outcomes. Whilst results are promising, there is a paucity of high-quality data in this area. Further research is needed, which places emphasis on developing a sound theoretical framework for expectations, allowing for the consistent implementation of valid measurement tools.
THE EFFECT OF OSTEOARTHRITIS GRADE ON PATIENT-REPORTED OUTCOME MEASURES AFTER TOTAL HIP ARTHROPLASTY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Dulleston Joe , Yoshitani Junya , Fard Amir Reza Rafati , Khanduja Vikas
Published: May 2024

Although total hip arthroplasty (THA) is beneficial for many patients with hip osteoarthritis (OA), a subset of patients experience minimal benefit. It is therefore pertinent to understand the predictors of poor functional outcome to facilitate shared decision making. One such predictor is preoperative radiographic OA severity. The aim of this systematic review was to determine whether preoperative radiographic OA severity could predict postoperative patient-reported outcome measures (PROMs) and satisfaction rates after THA.

This systematic review was conducted according to PRISMA guidelines, and the protocol published in PROSPERO (ID:Â CRD42023445918). A literature search was performed using Embase, MEDLINE and Cochrane Library databases. Demographics, radiographic OA severity, PROMs, satisfaction, and complications after THA were collected. A meta-analysis was performed, where appropriate, using a random-effects model.

Of 631 identified articles, 12 were included in the final analysis (8,034 participants; mean age 65.2, 38.1% male, mean BMI 29.1 kg/m2). There were three key findings. Firstly, those with mild OA are less likely to achieve a meaningful clinical improvement in PROMs (odds ratio (OR) 0.50, 95% confidence interval (CI) 0.38, 0.65; p < 0.00001). Secondly, two studies indicates that postoperative patient satisfaction was lower in participants with mild OA. Thirdly, participants with mild arthritis experience less improvement in SF-36 physical functioning (mean difference (MD) -8.31, 95% CI -10.97, -5.64; p < 0.00001) and role physical (MD -5.59, 95% CI -8.40, -2.77; p < 0.0001), but showed higher improvement in general health (MD 1.68, 95% CI 0.31, 3.06; p = 0.02).

Patients with mild OA, as determined radiographically, are less likely to achieve meaningful clinical improvements in PROMs and have lower postoperative satisfaction after THA. This information will improve collaborative decision-making in the preoperative period.
COMPARATIVE ANALYSIS OF GENERATIVE ARTIFICIAL INTELLIGENCE (AI) VERSUS MANUAL DATA ANALYSIS IN ORTHOPAEDIC PATIENT DATA
Authors: Al-Naib Mustafa , Afzal Irrum , Radha Sarkhell
Published: May 2024

As patient data continues to grow, the importance of efficient and precise analysis cannot be overstated. The employment of Generative Artificial Intelligence (AI), specifically Chat GPT-4, in the realm of medical data interpretation has been on the rise. However, its effectiveness in comparison to manual data analysis has been insufficiently investigated.

This quality improvement project aimed to evaluate the accuracy and time-efficiency of Generative AI (GPT-4) against manual data interpretation within extensive datasets pertaining to patients with orthopaedic injuries.

A dataset, containing details of 6,562 orthopaedic trauma patients admitted to a district general hospital over a span of two years, was reviewed. Two researchers operated independently: one utilised GPT-4 for insights via prompts, while the other manually examined the identical dataset employing Microsoft Excel and IBM® SPSS® software. Both were blinded on each other's procedures and outcomes. Each researcher answered 20 questions based on the dataset including injury details, age groups, injury specifics, activity trends and the duration taken to assess the data.

Upon comparison, both GPT-4 and the manual researcher achieved consistent results for 19 out of the 20 questions (95% accuracy). After a subsequent review and refined prompts (prompt engineering) to GPT-4, the answer to the final question aligned with the manual researcher's findings. GPT-4 required just 30 minutes, a stark contrast to the manual researcher's 9-hour analytical duration.

This quality improvement project emphasises the transformative potential of Generative AI in the domain of medical data analysis. GPT-4 not only paralleled the accuracy of manual analysis but also achieved this in significantly less time. For optimal accurate results, data analysis by AI can be enhanced through human oversight. Adopting AI-driven approaches, particularly in orthopaedic data interpretation, can enhance efficiency and ultimately improve patient care. We recommend future investigations on large and more varied datasets to reaffirm these outcomes.
BRIDGING THE GAP BETWEEN PRIMARY AND SECONDARY CARE POST-HIP FRACTURE WITH A NOVEL PATIENT ADVOCATE ROLE
Authors: Coward Alice , Stephen Arthur , Dokic Kim
Published: May 2024

Within an ageing population, the morbidity and mortality burden of neck of femur fractures will only worsen. Financially incentivising acute Trusts via the Best Practice Tariff for inpatient care has yielded good results(1,2,3,4) but post-discharge care is still variable. Most importantly, restoring patients to their pre-fracture mobility is key to their quality of life(5,6) and reducing both readmissions to hospital(7,8) and expensive local authority residential care. Unfortunately, physiotherapist vacancies are in their thousands(9,10) leading to waiting times of around three months once discharged(11).

In 2019, the Royal Derby Hospital created a novel Hip Fracture Patient Advocate (HFPA) to observe those who have fallen through gaps in community services. It involves monitoring patients’ progression, signposting to appropriate services, flagging issues to the responsible consultant and assisting in physical mobilisation.

A retrospective review examined data from patients discharged to their own homes. This included demographics, residential status and mobility, both pre-fracture and at 120 days post-fracture. Mobility was classified into five categories, in line with the national hip fracture database.

In 2018, of 238 patients, 41.2% returned to their baseline or increased mobility, and, after the introduction of the HFPA in 2019, this figure increased to 48.2%.

In one year, there was a 7% increase in patients recovering their baseline mobility. This is a cost-effective intervention that can successfully improve mobility, leading to improved long-term outcomes. This includes the potential to reduce acute readmissions and the need for residential care, appealing to Integrated Care Boards. It also bridges the gap to primary care to optimise medical management and after further development, could be financially-incentivised via the Best Practice Tariff. Rather than thinking more expensive clinicians are required, this study proposes that a HFPA can garner better outcomes for both the patient and the wider system.
PHARMACOLOGICAL INTERVENTIONS FOR THE PREVENTION OF BLEEDING IN PEOPLE UNDERGOING ELECTIVE HIP OR KNEE SURGERY: A COCHRANE SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS
Authors: Gibbs Victoria , Champaneria Rita , Sandercock Josie , Welton Nicky , Geneen Louise , Brunskill Susan , Doree Carolyn , Kimber Catherine , Palmer Antony , Estcourt Lise
Published: May 2024

Preoperative anaemia and intraoperative blood loss result in ∼90% of individuals being anaemic following hip and knee arthroplasty. Reducing blood loss offers the opportunity to improve outcomes and reduce the risk of transfusion and costs. This review's aim was to determine the effectiveness of drugs for preventing blood loss, and identify optimal dose, route, and timing of administration.

Cochrane network meta-analysis of randomised controlled trials was conducted. Inclusion criteria: adults undergoing primary or revision elective hip or knee arthroplasty. Drugs studied: tranexamic acid (TXA), aprotinin, epsilon-aminocaproic acid, desmopressin, factor VIIa and XIII, fibrinogen, fibrin sealants, and non-fibrin sealants. Primary outcomes: need for allogenic blood transfusion, all• cause mortality (within 30 days). Secondary outcomes: mean number of transfusion episodes, re-operation, length of hospital stay and adverse events (DVT, PE, CVA, MI).

102 studies with 8418 participants. Trials included more women (63%). 47 studies (4398 participants) were included within the blood transfusion NMA. TXA given intra-articularly and orally at a total dose of greater than 3g pre-incision, intraoperatively and postoperatively ranked the highest, with anticipated absolute effect of 147 fewer transfusions per 1000 (53% chance ranking 1st) (relative risk(RR) 0.02, 95% credible interval(CrI) 0–0.31); moderate-certainty). Aprotinin (RR 0.59, 95%:CrI 0.36–0.86; low certainty evidence), fibrin (RR 0.86, CrI 0.25–2.93; very-low certainty) and EACA (RR 0.60, 95%:CrI 0.29–1.27; very-low certainty) were not shown to be as effective as TXA.

TXA was the most effective drug for preventing bleeding in lower limb arthroplasty. Aprotinin and EACA were not as effective. Currently, the optimal dose, route and timing of administration of TXA is unclear. However, TXA given at higher doses and via mixed routes ranked higher in the treatment hierarchy. Oral TXA may be as effective as intavenous. There was no evidence of harm associated with higher doses of TXA.
SHORT-TERM COMPLICATIONS AND REOPERATION RATES AFTER HIP ARTHROSCOPY: A REVIEW OF 22,401 CASES IN ENGLAND FROM 2010 TO 2023
Authors: Kolhe Shivam , Khanduja Vikas , Malviya Ajay
Published: May 2024

Hip arthroscopy (HA) is an effective treatment for various hip conditions but has a steep learning curve and its effect on long-term joint preservation is unclear. This study uses population-level data to assess (1) the 90-day complication rate, and (2) the frequency and timing of revision HA, total hip replacement (THR), and pelvic osteotomy (PO) following primary HA.

We performed a retrospective analysis of the National Hospital Episode Statistics database, examining all patients who underwent primary HA in NHS hospitals in England from 2010 to 2023 using relevant OPCS-4 codes. We evaluated patient demographics, 90-day complications, and reoperation rates for revision HA, THR, and PO. Descriptive statistical analyses were performed to calculate frequencies and average time to reoperations.

We included 22,401 HA procedures in the study. The mean LOS was 0.82±2.04 days. The 90-day readmission rate was 0.17% at a mean of 54.4±8.1 days. The most common reasons for readmission were reoperation (0.071%), followed by infection (0.031%), pulmonary embolism (0.027%), pain (0.022%), bleeding (0.018%), and deep vein thrombosis (0.004%). One patient died within 90 days.

Overall, 4942 patients (22.1%) required further surgery at a mean of 2.71±2.27 years. The rates of revision HA, conversion to THR, and PO were 6.94%, 14.6%, and 0.50% at a mean of 2.39±1.79, 2.87±2.46, and 2.26±1.80 years respectively. Female patients had higher rates of reoperation than males for conversion to THR (9.99% vs 4.63%), revision HA (4.92% vs 2.02%), and subsequent PO (0.43% vs. 0.06%) (p<0.001).

This study demonstrates a low short-term complication rate after primary HA, supporting existing literature. However, a large proportion of patients required further surgery, especially females. These findings highlight the need for careful patient selection and counselling before HA to optimise outcomes, as well as further research on factors influencing longer-term outcomes and cost-effectiveness.
TEMPORAL TRENDS AND REGIONAL VARIATION OF HIP ARTHROSCOPY AND PELVIC OSTEOTOMY IN ENGLAND FROM 2010 TO 2023
Authors: Kolhe Shivam , Khanduja Vikas , Malviya Ajay
Published: May 2024

Hip arthroscopy (HA) and pelvic osteotomy (PO) are surgical procedures used to treat a variety of hip pathology affecting young adults, including femoroacetabular impingement and hip dysplasia respectively. This study aimed to investigate the trends and regional variation in the provision of HA and PO across England from 2010 to 2023 to inform healthcare resource allocation.

We analysed the National Hospital Episode Statistics database for all HA and PO procedures in NHS England using specific OPCS-4 codes: HA: ‘W83+Z843’ or ‘W84+Z843’; PO: ‘X222+Z75’. We collected patient demographics, age, sex, and region of treatment. We performed descriptive and regression analyses to evaluate temporal trends in PO volume, age, sex and regional variation.

22,401 HAs and 1,348 POs were recorded between 2010 and 2023. The annual number of HAs declined by 28.4%, whilst the number of POs increased by 64% (p<0.001). Significantly more females underwent PO vs HA (90% vs 61.3%) and were older than males undergoing the same procedure (PO: 29.0±8.7 vs 25.8±9.2 years; HA: 36.8±12.0 years vs 35.8±11.2 years, p<0.001). For HA, the mean age of both sexes decreased by 3.3 and 2.9 years respectively (p<0.001), whereas the age of PO patients did not change significantly over the study period. There were significant regional variations with a mean incidence of 1.60/100,00 for HA (ranging from 0.70–2.66 per 100,000) and 0.43/100,000 for PO (ranging from 0.08–2.07 per 100,000).

We have observed a decline in HA volume in England, likely due to improved patient selection and the impact of COVID-19, whilst PO volume has significantly increased, with regional variation persisting for both procedures. These trends highlight the need for equitable HA and PO access to improve patient outcomes and call for strategic healthcare planning and resource allocation to reduce disparities and improve training opportunities.
POST-COVID-19 RANDOMIZED CONTROLLED TRIALS COMPARING INTRAMEDULLARY NAILS AND SLIDING HIP SCREW CONSTRUCTS FOR INTERTROCHANTERIC FRACTURES DO NOT REPRESENT TYPICAL PATIENT DEMOGRAPHICS: A SYSTEMATIC REVIEW
Authors: Diffley Thomas , Yee Tsui , Letham Chloe , Ali Mohammed , Cove Rebekah , Mohammed Imaan , Kindi Ghaidaa Al , Samara Aziz , Cunningham Catriona
Published: May 2024

Extracapsular Hip Fractures (EHF's) are a significant health burden on healthcare services. Optimal treatment is controversial with conflicting evidence being reported. Currently treatment is undertaken with Intramedullary Nail (IMN) or Dynamic Hip Screw (DHS) constructs with a recent increase in IMN use (1). This study aims to conduct a systematic review of Randomised Control Trials published between 2020 and 2023 with particular focus on patient demographics and holistic patient outcomes.

Using a unified search-protocol, RCT's published between 2020 and 2023 were collected from CENTRAL, PubMed, MEDLINE and EMBASE. Rayyan software screened duplicates. Using the CASP and Cochrane Risk of Bias Tool papers were critically examined twice, and Blood Loss, Infection and Mobility described the patient journey.Â Patient demographics were recorded and were contrasted with geographically diverse cohort studies to compare population differences. Parametric tests were used to determine significance levels between population demographics, namely Age and Sex.

Eleven papers were included, representing 908 patients (436 Male). The mean age for patients was 64.39. There was considerable risk of bias in 7/11 studies owing to the randomization process and the recording of data. Four Cohort studies were selected for comparison representing 14314 patients. Mean age was significantly different between Cohort Studies and RCT's (Independent T-Test, df 13, t=7.8, p = <0.001, mean difference = 19.251, 95% CI = 13.888, 24.613). This was also true for sex ratios included in the studies (df 13, t = -2.268, p = 0.024, Mean Difference = -0.4884, 95% CI = -0.9702, -0.0066).

To conclude, RCT's published in the post COVID-19 era are not representative of patient demographics. This has the potential to provide inaccurate information for implant selection. Additionally further research must be conducted in how to better improve RCT patient inclusion so as to be more representative of patients whilst balancing the risks of operations.
ESTIMATING THE RISK OF POSTOPERATIVE PERIPROSTHETIC FEMORAL FRACTURES AFTER TOTAL HIP ARTHROPLASTY ASSOCIATED WITH COMMONLY USED IMPLANTS: AN ANALYSIS OF NATIONAL HEALTH DATA FROM ENGLAND
Authors: Lamb Jonathan , West Robert , Relton Samuel , Wilkinson Mark , Pandit Hemant
Published: May 2024

Current estimates of periprosthetic fracture risk associated with femoral implants is mostly limited to revision only estimates and does not accurately represent stem performance. The aim of this study was to estimate the risk of surgically treated post-operative periprosthetic femoral fracture (POPFF) more accurately associated with frequently used femoral implants used for total hip arthroplasty (THA).

A cohort study of patients who underwent primary THA in England between January 1, 2004, and December 31, 2020. Periprosthetic fractures were identified from prospectively collected revision records and national procedure coding records. Survival modelling was used to estimate POPFF incidence rates, adjusting for potential confounders. Subgroup analyses were performed for patients over 70 years, with non-osteoarthritic indications, and neck of femur fracture.

POPFF occurred in 0.6% (5100/809,832) of cases during a median (IQR) follow up of 6.5 (3.9 to 9.6) years. The majority of POPFF were treated with fixation after implantation of a cemented stem. Adjusted patient time incidence rates (PTIR) for POPFF varied by stem design, regardless of cement fixation. Cemented composite beam stems (CB stems) demonstrated the lowest risk of POPFF. Collared cementless stems had an equivalent or lower rate of POPFF versus the current gold standard polished taper slip cemented stem.

POPFF account for a quarter of all revisions following primary THA. Cemented CB stems are associated with the lowest POPFF risk. Stem design is strongly associated with POPFF risk, regardless of the presence of cement. Surgeons, policymakers, and patients should consider these findings when recommending femoral implants in those most at risk of POPFF.
Determining The Crystallite Size of TiO2/EG-Water XRD Data Using the Scherrer Equation
Authors: Ulhakim Muhamad Taufik , Sukarman Sukarman , Khoirudin Khoirudin , Fazrin Nazar , Irfani Tomas , Hakim Afif
Published: May 2024

X-ray diffraction (XRD) data and the Scherrer equation were utilized to analyze the crystallite Size of titanium dioxide (TiO2) in a solution of ethylene glycol (EG) and distilled water. The XRD analysis was conducted using a Rigaku Miniflex 600 instrument with an X-ray wavelength of approximately 0.15046 nm. The examination yielded the full-width half maximum (FWHM), which was subsequently examined using the Scherrer equation. This experiment employed TiO2 with a purity level of 99.8% and a crystal Size of 30 nm. The analysis revealed that the average crystallite Size of TiO2 in the sample is 19.45 nm, with the highest measurement at about 30.38 nm. The Spearman correlation equation was employed to validate the outcomes. The Spearman's correlation coefficient between the FWHM variable and the crystallite Size of TiO2 nanoparticles is -0.958. These findings shed light on the crystal structure of TiO2 under these conditions. These findings lend support to the use of TiO2 in a variety of nanotechnology applications. However, more research is needed to understand fully how crystallite-Size TiO2 nanoparticles work in different settings and to find the best ways to prepare samples, including understanding the specific phase and how it affects the stability of fluids. This research contributes significantly to the understanding of the properties of TiO2 in a solution of distilled water and EG, as well as to the characterization of nanomaterials, with particular emphasis on issue 9 of the SDGS Goal concerning industry, innovation, and infrastructure.
A Food Utopia? Italian Colonial Visions of Tripolitania and Cyrenaica, 1911–13
Authors: Rosenboim Or
Published: May 2024

Abstract: This article explores the uses of utopian rhetoric of food plenty in Italian colonial visions before the First World War. It examines the travel writings of three leading Italian journalists, Enrico Corradini, Arnaldo Fraccaroli, and Giuseppe Bevione, who visited the Ottoman provinces of Tripolitania and Cyrenaica and campaigned for their colonization by Liberal Italy. By reconstructing their utopian rhetoric of food plenty, this article seeks to show the relevance of arguments about food and agriculture produce to early twentieth century colonial visions, shedding light on an aspect of Italian political thought that has been hitherto marginalized in existing historical scholarship.
When Jupiter Meets Saturn: Aby Warburg, Karl Sudhoff, and Astrological Medicine in the Age of Disenchantment
Authors: Wen Xinyi
Published: May 2024

Abstract: As disenchantment began to be recognized as a recurring, never-ending process in recent scholarship, “When Jupiter Meets Saturn” argues that Aby Warburg and Karl Sudhoff’s debate on Reformation astrological medicine provided a new theory of the emergence of modern science and rationality. Drawing on their encounter and divergence in interwar Germany, especially their curatorial collaboration for the 1911 Internationale Hygiene-Ausstellung, the article shows that Warburg and Sudhoff generated completely opposite historical evaluations of astrological medicine using the very same materials. Approaching history as healers, they developed different ways of seeing from medical epistemologies and brought out entangled temporalities from images.
Conceitos and Conceptos: The Weight of Words in the Iberian World
Authors: Tenorio-Trillo Mauricio
Published: May 2024

Abstract: The essay reviews various volumes produced in the Spanish- and Portuguese-speaking worlds by the Iberconceptos research group. It is both a summary and a critique of history of concepts applied to the histories of Iberia and Ibero-America.
Trans-forming Narratology
Authors: Lanser Susan S.
Published: May 2024

ABSTRACT: From the vantagepoint of a feminist/queer/cisgender narratologist, “Trans-forming Narratology” asks which aspects of narrative practice might be particularly salient to developing a fruitful trans narratology while also calling our attention to elements of narrative that conventional (cis)narratology has undervalued or ignored. Keeping in mind matters that might be particularly relevant to trans narratives, this speculative essay explores aspects of voice, embodiment, character space, plotting, and closure in a set of recent American and British novels. It considers ways in which trans narratives can exploit the gender freedom of the first-person English pronoun or, conversely, signal temporally dual identities through heterodiegetic naming practices. It addresses tensions between a character’s proclaimed gender and their assigned sex and the differing implications of texts with narratees who are also textual actors and those whose narratees serve as external confidantes. Through brief forays into multiple aspects of narrative form, this essay argues for a narratology that can show the rich and varied capacities of trans writings past and present, with the hope that attention to trans narratives will both deepen our understanding of trans literature and advance the larger project of a comprehensive, situated narratology.
Diplomacy in Times of Pandemic and Wars: Transnational Actors Are Coming of Age in an Era of Fragmentation and Friction
Authors: Clavijo Jose
Published: May 2024

Abstract: This article looks at the coming of age of an assortment of international non-state actors, including transnational civil society, multinational corporations, subnational entities, and supranational organizations. With their agendas and structures, these actors are forcing a search for joint solutions to global challenges—from the pandemic to a recurrence of warfare to climate change—that transcend the realm of the nation-state. They do not necessarily challenge the global order as much as complement it. Through the nature of their interactions with nation-states and with each other, they are becoming diplomatic actors. If properly incorporated, they could help shape a new and more inclusive global order.
Inside/Outdoor Sign Savvy in Morrison’s “Recitatif” and Paradise
Authors: Mayberry Susan Neal
Published: May 2024

Abstract: In her 1993 Nobel Lecture in Literature , Toni Morrison asserts: “We die. That may be the meaning of life. But we do language. That may be the measure of our lives” (22). The Dancing Mind (1996), her extended meditation on the art of reading and writing, laments language proficiency as an imperiled survival skill. A Mercy ’s (2008) Florens confirms, however, that locating “[w] hich is the true reading” matters less than the reading itself since language itself is “a way” (139). If we adopt a neo-domestic/eco-critical approach, we not only address Morrison’s disparagement toward a state of modern criticism that talks about itself as though it were the work of art (LeClair, 376–77), but adhere to her directive that the critic should trail the writer. Tracking her use of ordinary inside/outdoor imagery allows us to solve the respective riddles of “Recitatif” (1983) and Paradise (1998): which girl is what race and who is the shot white girl.
Teaching Toni Morrison’s Beloved : From Genesis to the Reckoning
Authors: Roos Bonnie
Published: May 2024

Abstract: This comparative essay outlines one strategy for teaching Toni Morrison’s Beloved through a biblical lens, in order to encourage students with strong Christian backgrounds to read works that challenge some of their assumptions. I argue that in Beloved , Morrison uses Genesis 1–4 as the structure for her novel, offering a bridge to students who are comfortable reading the Bible as a way into a difficult work. I argue that the Garner’s Sweet Home resonates with Genesis 1 and 2, that Schoolteacher’s Sweet Home evokes Genesis 3, and that Morrison’s masterstroke in the novel is her ruminations on Genesis 4, including the death of the child, Beloved, which explains the protagonist, Sethe’s, name. Moreover, the better we understand those biblical chapters, the closer we get not only to interpreting Morrison’s novel, which is about understanding complicity and rebuilding community, but the closer we are, as educators, to living the mantra of Morrison’s message about communal understanding.
Enduring relevance of the Jaynes–Cummings model: a personal perspective [Invited]
Authors: Knight Peter L. , Gerry Christopher C. , Birrittella Richard J. , Alsing Paul M.
Published: May 2024

In this short perspective paper we present our personal highlights on how the Jaynes–Cummings model has become a central model to describe spin-boson couplings underpinning much of modern quantum optics. To the current authors, the key contribution is a demonstration of a measurable effect that showed the discreteness of the quantized radiation field.
Hermite–Gaussian–Talbot carpets
Authors: Bencheikh Abdelhalim , Deng Dongmei
Published: May 2024

In this Letter, we demonstrate the generation of Hermite–Gaussian–Talbot carpets (HGTC) based on the interference of a Hermite–Gaussian (HG) beam array with constant successive separation (shift). Despite the acceleration of HG beams during propagation, their symmetric structure ensures that the self-imaged carpets are generated in straight lines perpendicular to the propagation direction, at particular distances, multiples of the famous Talbot distance z
T
. By considering the separation as a multiple or a fraction of the Hermite–Gaussian beam width, the calculated Talbot distance z
T
is expressed as a function of the beam parameters, such as the Rayleigh length. The same carpets are also observed in planes situated at different fractions of z
T
, but with different frequency appearances. An interesting feature of these carpets is that the dimension of one cell of the beam array remains constant in each period (period fraction). We believe that such novel, to our knowledge, carpets will be useful in photonics for creating lattices and optical potentials.
Dual-wavelength synchronously mode-locked Cr:LiSAF laser with a tunable beating frequency and a central wavelength
Authors: Erturk Zekican , Kilinc Muharrem , Okuyucu Serdar , Ozturk Yusuf , Pergament Mikhail , Kärtner Franz X. , Demirbas Umit
Published: May 2024

We demonstrate a versatile dual-wavelength synchronous mode-locking of a diode-pumped Cr:LiSAF laser for the first time, to our knowledge. A two-color mode-locked operation is achieved by using intracavity birefringent filters (BRFs) or etalons as frequency-selective elements. Using filters with different thicknesses and hence different free spectral ranges (FSRs), wavelength separation in two-color mode-locking could be selected between 1 and 9 nm, with corresponding beating frequencies in the 0.4–3.5 THz range. Moreover, the central wavelength of the two-color output could be tuned smoothly between 840 and 875 nm, only limited by the bandwidth of the semiconductor saturable absorber mirror (SESAM) used for mode-locking. The method, which enables easy adjustment of the central wavelength and beating frequency of a dual-wavelength operation, is suitable for use in other laser gain media as well.
Determination of plasma properties in liquid jets through time-resolved experiments on third harmonic reflection dynamics
Authors: Hilal S. , Melnik M. , Ismagilov A. , Tsypkin A. , Kozlov S.
Published: May 2024

The study of plasma in liquid jets represents a significant area of research encompassing plasma science, dynamics, and properties. This paper presents experimental studies on plasma formation processes in liquid jets of water, ethanol, and isopropyl based on the dynamics of the third harmonic (TH) reflection from the induced plasma. Through time-resolved experiments, and theoretical estimations using the Keldysh theory, plasma properties including density and frequency for all three media are evaluated. Isopropyl demonstrates the highest values of the characteristics mentioned. These findings hold significant potential for advancing our understanding of plasma-based radiation sources, e.g., terahertz generation.
First-order type A waveguide Bragg gratings with under-diffraction-limited periodicities and sub-millimeter length for NIR applications
Authors: Loi Laura , Carpentier Mathis , Petit Yannick , Canioni Lionel
Published: May 2024

Since its demonstration in 2017, laser-induced Type A modifications in silver-containing glasses have been exploited for fabricating waveguides, couplers, volume Bragg Gratings and, more recently, waveguides Bragg Gratings. Laser-induced silver-supported structures exhibit sub-diffraction characteristics being always associated with a positive refractive index change resulting from multi-photon energy deposition under multiple-pulse femtosecond laser irradiation. These properties have been exploited in this work for the fabrication of efficient first-order helicoidal Type A waveguides Bragg gratings in the near-infrared (NIR) range, with periodicities well below the diffraction limit and with typical length L = 500 μm, showing narrowband mirror behaviours. Moreover, this work demonstrates that such helicoidal Type A waveguides Bragg gratings allow for modulating the refractive index of the waveguide at half the periodicity of the helix. Such a peculiarity has been exploited to fabricate efficient first-order Type A waveguides Bragg gratings in the NIR range, as well as in the far red range of the visible spectrum, showing a remarkably strong coupling coefficient, up to one order of magnitude higher than what is reported in the literature.
Procurement process and shortages of essential medicines in public health facilities: A qualitative study from Nepal
Authors: Adhikari Basant , Ranabhat Kamal , Khanal Pratik , Poudel Manju , Marahatta Sujan Babu , Khanal Saval , Paudyal Vibhu , Shrestha Sunil
Published: May 2024

Ensuring access to essential medicines remains a formidable challenge in Nepal. The specific reasons for the shortage of essential medicines within Nepal have not been extensively investigated. This study addresses challenges associated with access to essential medicines, procurement process difficulties, and functionality of inventory management systems at different levels of public health facilities. Fifty-nine semi-structured in-depth interviews were conducted with health managers and service providers at provincial and local levels in six randomly selected districts of Bagmati province, Nepal. Interviews were audiotaped and transcribed verbatim, and the results were analyzed using the inductive approach and were later mapped within the four domains of “Procurement of essential medicines”. The major barriers for the effective management of essential medicines included delays in the procurement process, primarily locally, leading to frequent stock-out of essential drugs, particularly at the health post level. Additionally, challenges arise from storage problems, mainly due to insufficient storage space and the need to manage additional comorbidities related to COVID-19. Other identified challenges encompass the absence of training on logistics management information systems, a lack of information technology resources in primary health facilities, inadequate qualified human resources to operate the IT system, and insufficient power backup. Moreover, unrealistic demand estimation from the service points, inadequate transportation costs, and manual inventory management systems further contributed to the complex landscape of challenges. This study identified procurement delays as the primary cause of essential medicine shortages in Bagmati Province, Nepal. We recommend implementing comprehensive procurement guidelines, collaborative training, and dedicated budgets to address this issue. Improving the procurement and inventory management process in low-resource settings requires a well-trained workforce, suitable storage spaces, and enhanced coordinated administrative tiers within health facilities at different levels to ensure the year-round availability of essential medicines in these settings.
HIV preventive practice and its associated factors among street dwellers in Ethiopia: Application of health belief model
Authors: Wassihun Yosef , Hunegnaw Zemed , Anagaw Tadele Fentabel , Yigzaw Zeamanuel Anteneh , Bogale Eyob Ketema
Published: May 2024

Street dwelling is the use of public space as a place of residence and nourishment for children, adolescents, and young people, revealing a complex and multifactorial situation. Moreover, homelessness facilitates HIV transmission and its progression due to the risky lifestyle of individuals. To the best of our knowledge, there is no study conducted in the study area on HIV preventive practices among street dwellers. The aim of this study was to assess HIV prevention practices and associated factors among street dwellers. A community-based cross-sectional study was conducted in Bahir Dar City from March 12, 2023 to April 30, 2023. By using the simple random sampling technique, 424 street dwellers were recruited. Bivariable and multivariable logistic regression were used for analysis. The magnitude of HIV preventive practice among street dwellers was 35.9%. Being male (AOR = 0.23, 95% CI: 0.10, 0.55), educational status (AOR = 7.53, 95% CI: 2.20, 25.6), practice of sex to earn money (AOR = 0.18, 95% CI: 0.08, 0.44), good knowledge about HIV preventive practice (AOR = 2.83, 95% CI: 1.46, 5.49), perceived susceptibility for HIV (AOR = 0.90, 95% CI: 0.81, 0.99), and perceived benefit of using HIV preventive practice (AOR = 1.09, 95% CI: 1.02, 1.17), were factors associated with HIV preventive practice. The magnitude of HIV preventive practice was low. Being male, the ability to read and write, the practice of sex to earn money, good knowledge about HIV preventive practice, perceived susceptibility to HIV, and the perceived benefit of using HIV preventive practice were significantly associated with HIV preventive practice. Therefore, responsible organizations, both governmental and non-governmental, should design inclusive strategies to improve HIV preventive practice among street dwellers by focusing on regular demand creation activities, awareness creation about HIV preventive practice, and sustainable condom distribution in the city.