bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic characterization and pathogenic effects of Hepatozoon canis infection in police dogs in Egypt
Authors: Mahdy Olfat A. , Khalifa Marwa M. , Zaki Ahmed A. , Al-Mokaddem Asmaa K. , Attia Marwa M.
Published: May 2024

Background

Hepatozoon canis is a protozoan parasite transmitted to dogs through ingesting the arthropod vector (hard ticks), which contains mature protozoal oocysts harboring infectious sporozoites.

Aims

This study aims to evaluate the blood parameters, biochemical assays and histopathological appraisal of infected police dogs with Hepatozoon canis, from kennels in the police academy of Egypt during 2020–2021.

Methods

Red blood cells count, hemoglobin, hematocrit, blood platelets and white blood cells count from collected blood samples were analyzed, and serum albumin, creatinine, urea, aspartate aminotransferase and alanine aminotransferase were analyzed from serum samples. Polymerase chain reaction amplified the 18S ribosomal RNAgene of the Hepatozoon species for genetic analysis, and the deoxyribonucleic acid products were sequenced and added to GenBank.

Results

The present study resulted in 5% of the police dog population being infested with Rhipicephalus sanguineus. This study registered the sequences of the Hepatozoon canis 18S ribosomal RNAgene in Egypt for the first time in Genbank (MW362244.1–MW362245.1). The biochemical assay revealed that the parasite severely affected the protein, significantly increasing serum albumin in positive polymerase chain reaction testing dogs.

Conclusion

A thorough inspection discovered that 100 police dogs had clinical symptoms like fever, emaciation and anemia, while the other 200 were healthy and had no evident clinical indicators.
Estimating the risk of SARS-CoV-2 infection in New Zealand border arrivals
Authors: Arnold Richard , Binny Rachelle N. , Lumley Thomas , Lustig Audrey , Parry Matthew , Plank Michael J.
Published: May 2024

Background

Travel restrictions and border controls were used extensively during the COVID-19 pandemic. However, the processes for making robust evidence-based risk assessments of source countries to inform border control policies was in many cases very limited.

Methods

Between April 2020 and February 2022, all international arrivals to New Zealand were required to spend 14 days in government-managed quarantine facilities and were tested at least twice. The infection rates among arrivals in the years 2020, 2021 and 2022 were respectively 6.3, 9.4 and 90.0 cases per thousand arrivals (487, 1064 and 1496 cases). Test results for all arrivals were linked with travel history, providing a large and comprehensive dataset on the number of SARS-CoV-2-positive and negative travellers from different countries over time. We developed a statistical model to predict the country-level infection risk based on infection rates among recent arrivals and reported cases in the country of origin. The model incorporates a country-level random effect to allow for the differences between the infection risk of the population of each country and that of travellers to New Zealand. A time dependent auto-regressive component of the model allows for short term correlation in infection rates.

Results

A model selection and checking exercise found that the model was robust and reliable for forecasting arrival risk for 2 weeks ahead. We used the model to forecast the number of infected arrivals in future weeks and categorised countries according to their risk level. The model was implemented in R and was used by the New Zealand Ministry of Health to help inform border control policy during 2021.

Conclusions

A robust and practical forecasting tool was developed for forecasting infection risk among arriving passengers during a period of controlled borders during the COVID-19 pandemic. The model uses historical infection rates among arrivals and current infection rates in the source country to make separate risk predictions for arrivals from each country.
Thyroid-related Hormones and Hypertension Incidence in Middle-Aged and Older Hispanic/Latino Adults: The HCHS/SOL Study
Authors: Abasilim Chibuzor , Persky Victoria , Sargis Robert M , Argos Maria , Daviglus Martha , Freels Sally , Cai Jianwen , Tsintsifas Konstantina , Isasi Carmen R , Peters Brandilyn A , Talavera Gregory A , Thyagarajan Bharat , Turyk Mary E
Published: May 2024

Background

Thyroid-related hormones act to regulate metabolic pathways and blood pressure (BP). However, the relationship of TSH and peripheral thyroid hormones and the role of the hypothalamic-pituitary-thyroid axis on hypertension development is not fully understood. We assessed sex-specific associations of thyroid-related hormones with BP and hypertension in Hispanic/Latino adults followed for 6 years.

Methods

We studied 1789 adults, ages 45 to 74, free of diabetes at baseline from a subcohort of the Hispanic Community Health Study/Study of Latinos. We assessed TSH, free T4 (FT4), T3, and various indicators of thyroid axis. Using multivariable linear and Poisson regression adjusted for survey design and confounding variables, we estimated a priori sex-specific associations of thyroid-related hormones with changes in BP and hypertension development.

Results

In men and women, TSH and TSH/FT4 ratios were associated with changes in diastolic BP and T3 with changes in pulse pressure and the development of hypertension from prehypertension. In men, a 1-SD increase in TSH [incident rate ratio (IRR) = 1.42; 95% confidence interval (CI): 1.15, 1.75] and TSH/FT4 ratio (IRR = 1.20; 95% CI: 1.07, 1.35) were positively associated with the development of hypertension from prehypertension while the TSH/FT4 ratio (IRR = 0.85; 95% CI: .72, 1.00) was protective in women. We observed sex-specific differences in associations of the T3/FT4 ratio and indices of pituitary sensitivity to thyroid hormones with changes in pulse pressure and hypertension development.

Conclusion

Thyroid-related hormones are associated with sex-specific changes in BP and hypertension among Hispanic/Latino adults consistent with selected studies conducted in other populations. Mechanisms underlying associations of pituitary sensitivity to thyroid hormones with BP and hypertension development warrant further study.
TRUST AND SATISFACTION WITH HELP RECEIVED FROM SIGNIFICANT LOVED ONES
Authors: Kuznetsova Irina V. , Ilalova Elina S. , Baalbaki Juliana , Gvozdkova Reniga I.
Published: May 2024

Background. Numerous studies have noted the role of trust in building a variety of relationships. In our study, we focused on studying the connection between trust (personalized and generalized) and a person’s perception of the help provided to him in difficult life situations from their loved ones.
Research methods. Method of “Critical life situations” by I.V. Kuznetsova, A.L. Sventsitsky; Method of “Trust” L.G. Pochebut, M.I. Kiloshenko, A.L. Sventsitsky, T.V. Kazantseva; Method of “Psychological Well-Being Scale” by K. Rieff, adapted by T.D. Shevelenkova; socio-demographic questionnaire. Processing of the obtained data was carried out in IBM SPSS Statistics Subscription. The following methods of mathematical statistics were used in the study: analysis of primary statistics, Student's t test, multiple analysis of variance (Scheffé test and intergroup effects), correlation and regression analyses.
Results. Our study confirms the important positive relationship between trust (both personal and generalized) and the level of satisfaction with assistance. The most requested help (regardless of gender) is the need for moral support. The most significant person is mostly either the mother or the father. An overabundance of help is often associated with the excessive involvement of loved ones in solving situations of interpersonal interactions and providing help without a request. Men with a high level of psychological well-being admit that more often.
Conclusion. This study also touched upon such issues as the roles and functions of modern friends, partners (spouses/wives/fiancés and grooms) in the life of a modern young man, in which he can only receive basic help from relying on himself or his parents. This issue will be further discussed in the future.
TRANSFORMATION OF FOREIGN LANGUAGE EDUCATION AS A BASIS FOR THE FORMATION OF LINGUODIGITAL CULTURE OF STUDENTS AT SECONDARY SCHOOL
Authors: Shcherbatykh Lyudmila N.
Published: May 2024

The article considers the possibilities of effective response of the Russian society to great challenges taking into account the interaction of man and nature, man and technology, social institutions at the present stage of global development, including applying the methods of humanities and social sciences.
The modern world is changing very quickly, technological progress and digitalisation affect all spheres of human activity, including education. The formation and development of a modern child is increasingly taking place in a kind of virtual reality created by a variety of devices.
The research problem is to identify what are the theoretical, methodological and scientific-methodological bases for creating the model of the effective formation of linguodigital culture of students at different levels of compulsory and additional foreign language education with the use of digital resources and technologies, taking into account the risks and opportunities (by the example of the English language teaching).
The aim of our work is to develop theoretical, methodological and scientific-methodological foundations of the strategy of forming linguodigital culture of students through digital resources and technologies in the process of teaching English and its experimental verification.
The research was conducted on the basis of the authentic materials in English. The research methods used - the theoretical analysis of literature, study of normative documents, the observation of the teaching process, comparative analysis. The author came to the conclusion of the effectiveness of application of the developed programme for the purpose of the formation of this category of culture in the context of continuous foreign language education; the prospects of research in the direction of the project are defined.
EXISTENTIAL VALUES AS THE BASIS OF PSYCHOLOGICAL WELL-BEING OF A UNIVERSITY TEACHER: THEORETICAL AND EMPIRICAL ANALYSIS
Authors: Busygina Tatyana A.
Published: May 2024

Purpose. The article analyzes the relationship between the existential values of a university teacher and the manifestations of indicators of the emotional sphere. In this study, we consider the problem of a teacher’s psychological well-being from the perspective of an existential approach. An analysis of scientific sources on the issues of neuroticism, emotional and professional burnout of teachers, as well as directions for overcoming a stressful state to achieve psychological well-being, led us to the conclusion that most researchers see a way out exclusively through satisfying needs, regulating work and rest schedules, and mastering self-regulation methods . We agree that such areas of psychological work help to cope with situational stress, but at the same time, we have identified a gap in the study of the psychological properties of the individual, his value field, which can be the support of a stable emotional state, self-satisfaction and professional activity, significantly reducing risks of neurotic symptoms. We propose that there is a fundamental factor, namely existential values, that underlies the state of psychological well-being.
Methodology of the research. During the research process, a detailed theoretical examination of various literary sources was carried out, as well as a comparison and assessment of various points of view expressed in the literary works under consideration. An empirical study was conducted on a sample of 130 Russian university teachers of both sexes, from 40 to 75 years old, with more than 18 years of experience, using psychodiagnostic techniques. Quantitative processing of the results was carried out on the basis of the statistical program STATISTICA 6.0.
Results. As a result of empirical research, we received an extensive array of data proving the influence of developed existential values on the state of psychological well-being, namely, we came to such conclusions as: ignoring existential values contributes to the manifestation of such neurotic states as maladaptation, guilt, non-acceptance of oneself, non-acceptance of others, hostility, exhaustion, depersonalization, external control, control, escapism. The acceptance of existential values by a teacher entails the formation of such emotional states as adaptability, internality, self-acceptance, acceptance of others, and emotional comfort. Based on empirical data, we formulated a definition of the term “existential well-being”.
Scope of the results. The results of the study will help expand the possibilities of individual and group psychological work with emotionally stressful situations to reduce the risks of neurotic manifestations and the formation of adaptive emotional states in the professional activities of a university teacher at the level of acceptance, awareness and disclosure of the individual’s existential values.
THE FUTURE OF FOREIGN LANGUAGE TEACHING IN THE CONTEXT OF THE 5TH COGNITIVE REVOLUTION
Authors: Volegzhanina Irina S.
Published: May 2024

Purpose. The article addresses the issue of identifying the possible ways of foreign language teaching transformation, which is crucial in the face of a technological paradigm exponential shift experienced by the contemporary society. The subject of this research is changes in this process within the expecting 5th Cognitive Revolution. The author aims to show the prospects of professional development of a foreign language department instructor in view of the mass implementation of artificial intelligence systems based on Large Language Models.
Methodology. The basis of the research is the personalised and symbolic approaches, as well as the principle of interdisciplinarity.
Results. The results and novelty of this study are that the author specifies the periodisation of cognitive revolutions applied to education by analysing Russian and foreign researches. It is the technologies of the 5th Cognitive Revolution, distinguished by the synergy of human and machine intelligence, will determine the nature of foreign language teaching transformation in universities. The author assumes that the activity of instructors working for foreign language departments will be the most sensitive to professional turbulence due to the achievements of world research in the field of Large Language Models. The professional development of instructors appears to be related to their ability to interact with artificial systems with emotional intelligence and multimodal behaviour, such as Artificial Intelligent tutors and non-biological department employees within the hybrid education environment of a university.
Practical implications. The results of this research can be applied in the development of technologies and methods of teaching foreign languages at universities.
FOREIGN LANGUAGE TEACHING AT A NON-LANGUAGE UNIVERSITY: MEDICAL UNIVERSITY EXPERIENCE
Authors: Sokolova Alina Yu.
Published: May 2024

Purpose. The main goal of the proposed work is to describe a person-centered systemic hierarchical model of foreign language teaching at a non-linguistic university successfully implemented by teachers of the Department of Foreign Languages at Tver State Medical University. The article presents the main structural features of the model, characterizes its basic components, and substantiates its use in the Russian practice of foreign language teaching.
Materials and methods. Theoretical foundations of the study include the analysis of pedagogical and methodological literature on this problem, comparison and generalization. The leading practical method is practice-oriented pedagogical experiment.
Results. The main point of the proposed model is person orientation. It is achieved due to the presence of several stages (areas) of studying a foreign language, allowing to satisfy the knowledge needs of the student during their professional development in a higher educational institution; taking into account, firstly, the personal socio-cultural experience of the student, and, secondly, basic school foreign language education, which allows the student to perceive easily (even in their native language) and comprehend the foreign language information; the widespread use of interdisciplinary connections aimed at increasing the motivation of the student’s personality and allowing for the activation of already acquired experience and knowledge; selection of language material: expansion of vocabulary through the introduction of special vocabulary and terminology and limitation of already mastered grammatical structures.
Practical implications. The model described can be applied in the practice of foreign language teaching to students at non-linguistic universities.
ANALYSIS OF THE PROFESSIONAL COMPETENCIES OF PHYSICAL EDUCATION TEACHERS IN THE CONTEXT OF THE UPDATED CONTENT OF EDUCATION
Authors: Stafeeva Anastasiya V.
Published: May 2024

Purpose. The article is devoted to the problem of professional competence of physical education teachers in the process of implementing the updated content of the subject "Physical culture" in secondary schools. The purpose of the study was to analyze the professional competencies of physical education teachers in the context of the requirements of the updated content of general education.
Methodology. A systematic and activity-based approach is fundamental in the study. Research methods: analysis, diagnostic methods, conversation.
Results. The results of diagnostics of the formation of professional competencies of physical education teachers within the framework of advanced training courses at the levels of formation (optimal, acceptable, critical, unacceptable) in the field of subject, psychological, pedagogical and methodological training are presented and interpreted. Professional deficits of normative and legal competence among teachers have been identified, the levels of professional skills for the implementation of the educational process on the subject of "Physical culture" in the context of the requirements of the updated content of general education have been determined.
Practical implications. The results of the study can be applied in the field of additional professional education of teachers, as well as in the educational process of university training.
La responsabilidad patrimonial extracontractual del Estado por los daños producidos con ocasión de los ataques subversivos contra estaciones de policía
Authors: López Caballero Juan Camilo
Published: May 2024

Este capítulo no pretende elaborar un estudio histórico de la forma en que se han venido reconociendo las lesiones causadas por grupos ilegales al atacar estaciones de policía, únicamente se centrará en determinar si la jurisprudencia del Consejo de Estado ha sido uniforme en materia de responsabilidad patrimonial extracontractual del Estado frente a los daños ocasionados por ataques contra las estaciones de policía perpetrados por los grupos armados ilegales.
Automatic implantable cardioverter defibrillator (AICD) implantation as secondary prevention of cardiac sarcoidosis-associated ventricular tachycardia
Authors: Saliba Fares , Mina Jonathan , Aoun Laurence , Khattar Georges , Bou Sanayeh Elie , Mourad Omar , Abu Baker Saif
Published: May 2024

Background: Cardiac sarcoidosis can cause a wide range of symptoms, including shortness of breath, chest pain, oedema, and fatal arrhythmias such as ventricular tachycardia (VT). Because the symptoms can be nonspecific, diagnosing cardiac sarcoidosis can be challenging. Treatment options may include corticosteroids to reduce inflammation, immunosuppressive drugs to prevent further damage, medications to control symptoms, ablation procedures, and defibrillators to prevent cardiac arrest. Case: A 60-year-old woman who has sarcoidosis affecting multiple organs including cardiac sarcoidosis, non-ischemic cardiomyopathy with reduced ejection fraction, and hypertension, was admitted with tachycardia, shortness of breath, and a recently fired automatic implantable cardioverter defibrillator (AICD). Three months prior, the patient was admitted for a syncopal episode and diagnosed with cardiac sarcoidosis through cardiac magnetic resonance imaging (MRI) and positron emission tomography (PET), which demonstrated active inflammation, and an AICD was implanted. During this admission, the patient had an episode of ventricular tachycardia and was treated with amiodarone and lidocaine. The patient received steroids, sacubitril/valsartan, and methotrexate. After 48 hours of observation, the patient was discharged without further events. Conclusion: Cardiac sarcoidosis is a rare but serious disease that can lead to life-threatening cardiac complications such as ventricular tachycardia. Early diagnosis and aggressive management are crucial for improving outcomes and preventing sudden cardiac death. AICD implantation as a secondary prevention in cardiac sarcoidosis might prevent cardiac arrest.
Hamman syndrome with a rare feature of pneumorrhachis – an unusual complication of polysubstance abuse and e-vaping
Authors: Anwar Muhammad Saad , Khan Anosh Aslam , Dua Richa , Kausar Nawaz Fatima , Khalid Farhan , Du Doantrang
Published: May 2024

Hamman syndrome is defined as dissection of air in mediastinum and skin fascia usually due to increased intrathoracic pressure. The air leak tends to make its way into pleural and pericardial layers; however, in rare instances air can also dissect into epidural spaces, regarded as pneumorrhachis. We present a case of a young male with a history of polysubstance abuse and e-vaping, who presented with symptoms of altered mental status. Given the concerning physical examination, a computed tomography of the chest was undertaken, which showed pneumothorax, pneumomediastinum and pneumorrhachis. The patient was closely monitored in the intensive care unit and improved after symptomatic management. The symptoms of pneumorrhachis depend on the volume and location of air in intracranial and intraspinal space. Although asymptomatic in our case, it is crucial for clinicians to be aware that pneumorrhachis with Hamman syndrome can potentially cause neurological deficits and cardiopulmonary arrest in severe cases due to increased intraspinal and intracranial hypertension, emphasising the need for close monitoring.
Satisfaction, trust, and risk perception as antecedents of customer loyalty
Authors: Astriani Iis
Published: May 2024

Purpose-Customer loyalty is an important aspect that must be owned and maintained by every business actor. Maintaining customer loyalty increases opportunities for businesses to survive in business competition. Many internal or external factors can affect customer loyalty. This study aimed to determine how satisfaction, trust, and risk perception affect customer loyalty.
Design/Methodology/Approach-Smart PLS 4.0 is a statistical tool used to process research data. This study analyzes the effect of satisfaction, trust, and risk perception on customer loyalty to Tokopedia customer objects. Research data were obtained by distributing questionnaires and collecting data from up to 96 respondents.
Findings-Two of the three hypotheses were rejected or unsupported. Satisfaction and risk perception had no effect on consumer loyalty, while trust had a positive effect on consumer loyalty.
Research limitations/implications-The findings of this research are expected to be a reference and learning, especially for business actors in Tokopedia, who are expected to be able to understand that to grow or maintain consumer loyalty, there are many things that must be considered. This study shows that satisfaction, trust, and risk perception are factors that can affect customer loyalty.
Originality/value-There is still very little research on consumer behavior, especially customer loyalty, using the Tokopedia e-commerce service. In this study, factors that influence consumer behavior, especially Tokopedia consumer loyalty.
INTELIGÊNCIA ARTIFICIAL E A AUTOMATIZAÇÃO DA DECISÃO JURÍDICA
Authors: Hoffmam Fernando , Viero Machado Isadora
Published: May 2024

A era da digitalização conduziu inúmeros aspectos da vida em sociedade a tecnologias revolucionárias protagonizadas, sobretudo, por mecanismos de Inteligência Artificial. Nessa lógica, a jurisdição também assume a posição inevitável de adequar-se aos anseios sociais, a partir da revisão da tutela jurisdicional, agora sob esta nova perspectiva tecnológica de aceleração da vida. À vista disso, o presente trabalho tem como escopo o exame dos fundamentos e particularidades acerca do funcionamento de mecanismos de Inteligência Artificial, especialmente aqueles que interessam a aplicação ao campo jurídico processual e seus eventuais impactos, positivos e negativos, na jurisdição. Desse modo, o estudo buscou resolver o seguinte problema de pesquisa: a tomada de decisões automatizadas no processo jurisdicional pode representar a consolidação de uma visão excessivamente lógica e racional da jurisdição, ensejando ofensa à perspectiva democrática-constitucional do processo? Pode, ainda, denotar o comprometimento da efetividade da tutela jurisdicional? Empreendeu-se, para tanto, o método de abordagem dialético, visando uma interpretação dinâmica das condições determinantes e dos resultados inerentes ao fenômeno da inserção da IA no contexto jurídico, visto que, de certo modo, apresentam características paradoxais. No que tange ao método de procedimento, adotou-se o método histórico-comparativo para adentrar às bases paradigmáticas e os acontecimentos históricos-políticos que influenciaram a dilapidação do processo jurisdicional brasileiro, para, posteriormente, correlaciona-las aos vieses que amparam as justificativas do implemento de tecnologias inteligentes na jurisdição hoje. Por fim, pretendeu-se um estudo das maneiras de alinhar o uso da IA aos fundamentos de um processualismo democrático-constitucional, que atenda efetivamente à tutela de seus sujeitos processuais.
Palavras-chave: Inteligência Artificial. Direito Processual. Decisão Jurídica. Processualismo neoliberal. Processualismo democrático-constitucional.
Protecting confidential information when employees leave: how nursing and care homes can prevent data leaks
Authors: Bernstein Adam
Published: May 2024

Adam Bernstein discusses what nursing and care homes can do to protect confidential information after an employee has left their role.
Changes from April 2024: what nursing and care homes need to know
Authors: Williams Vicki
Published: May 2024

In this article, Vicki Williams discusses changes that will affect nursing and care homes from April 2024.
IS IT SAFE TO USE A CERAMIC-ON-POLYETHYLENE BEARING IN REVISIONS FOR CERAMIC FRACTURE?
Authors: Gunn Christopher , Thakker Vivek , Jones Henry Wynn , Barrow Jonathan
Published: May 2024

Ceramic bearing fracture is a rare complication following implantation using modern day ceramic bearing materials. Revision bearing options in such cases is debated, with the choice between ceramic-on-ceramic and ceramic-on-polyethylene bearings. Revision to a hard on soft bearing raises concerns about potential catastrophic wear secondary to a third-body reaction caused by the fractured ceramic particles.

Data was collected retrospectively from the NJR, electronic patient records, revision database and picture archiving and communication system. Templating software was used to determine linear wear between first post-operative radiograph and the latest available follow up. Univariate analysis was used to examine patient demographics and the wear rates for revision of ceramic bearing fractures to ceramic on polyethylene components. The intra and inter-rater reliability of wear measurements was calculated.

There were twelve patients identified as meeting the inclusion criteria. The average age at revision was 62 years (54–72). There were 6 liner and 6 head fractures revised to delta ceramic heads and cross-linked polyethylene acetabular components. The most frequently used head size was 32mm. At mean follow up of 3.8 years (0.5 6.1 years), median 4.4 years, linear wear rate was calculated at 0.08± 0.06 mm/year. Both intra-rater and inter-rater reliability was excellent with ICC scores of 0.99 at all timepoints.

Revision to ceramic on polyethylene (CoP) bearings following ceramic fracture does not cause early catastrophic wear at early follow up. It appears safe to use this hard on soft bearing combination, given that wear rates are comparable to what is expected in a primary hip replacement setting. Longer follow up is required to establish if this trend persists.
MCKIBBIN INDEX AND FEMORAL VERSION NOT PREDICTIVE OF IHOT12 CHANGE AT TWO YEARS IN PATIENTS UNDERGOING ISOLATED PERIACETABULAR OSTEOTOMY
Authors: Amer Mohammad , Smith Christian , Kumar Karadi H Sunil , Malviya Ajay
Published: May 2024

Adult hip dysplasia AHD is a complex 3D pathology of lateral coverage, version and/or volume and is often associated with increased femoral anteversion. The Mckibbin index MI is the combination of acetabular version AV and femoral version FV and is used as a measure of anterior hip Stability/ Impingement(1). The Bernese Periacetabular osteotomy PAO is a powerful tool in treating AHD, but it does not address FV. De-rotational femoral osteotomies FO increases risk of complications, operative time and might condemn the patient to Secondary osteotomies to balance the gait. We aim to investigate the effect of MI and FV on PROMs in patients undergoing PAO only.

593 PAOs identified on the Local Hip preservation registry between 01/2013 and 7/2023. PAOs for retroversion, residual Perthes and those combined with FO were excluded. Patients with no available PROMS at 2 years were excluded. Independent variables were collected from E-notes and imaging including MI and FV. A multiple linear regression analysis was performed against preoperative iHot12, and iHot12 change at 2years.

The mean FV was 18.86± 12.4 SD. Mean MI was 36.07, SD 15.36. Mean preop iHot12 score was 29.83 ± 17.38 SD. Mean change in iHot12 at 2 years was+36.47 ± 28.44 SD. Females and a higher BMI were statistically correlated to a lower preoperative iHot12. A lower preop iHot12 score and a higher preop AI were correlated to a bigger change in iHot12 at 2years with statistical significance. MI and FV were not found to have a statistically significant correlation with Outcome measures,

An increased Mckibbin index and femoral anteversion were not correlated with worse outcomes at two years. PAO alone in the presence of increased femoral anteversion avoids risks associated with FO which can be performed later if required.
PROPOSAL OF A MODIFIED TIP APEX DISTANCE FOR PREDICTION OF LAG SCREW CUT-OUT IN TROCHANTERIC HIP FRACTURES
Authors: Selim Amr , Al-Hadithy Nawfal , Diab Nader , Ahmed Abdulla , Kader Khaled Abdel , Hegazy Mohamed , Abdelazeem Hazem , Barakat Ahmed
Published: May 2024

Lag screw cut-out is a serious complication of dynamic hip screw fixation in trochanteric hip fractures. Lag screw position is recognised as a crucial factor influencing the occurrence of lag screw cut-out. We propose a modification of the Tip Apex Distance (TAD) and hypothesize that it could enhance the reliability of predicting lag screw cut-out in these injuries.

A retrospective study of hip fracture cases was conducted from January 2018 to July 2022. A total of 109 patients were eligible for the final analysis. The modified TAD was measured in millimetres, based on the sum of the traditional TAD in the lateral view and the net value of two distances in the anteroposterior (AP) view. The first distance is from the lag screw tip to the opposite point on the femoral head along the lag screw axis, while the second distance is from that point to the femoral head apex. The first distance is a positive value, whereas the second distance is positive if the lag screw is superior and negative if it is inferior. Receiver operating characteristic (ROC) curve analysis was used to assess the reliability of various parameters for evaluating the lag screw position within the femoral head.

Factors such as reduction quality, fracture pattern according to the AO/OTA classification, TAD, Calcar-Referenced TAD, Axis Blade Angle, Parkerâ€™s ratio in the AP view, Cleveland Zone 1, and modified TAD were statistically associated with lag screw cut-out. Among the tested parameters, the novel parameter exhibited 90.1% sensitivity and 90.9% specificity for predicting lag screw cut-out at a cut-off value of 25 mm, with a p-value < 0.001.

The modified TAD demonstrated the highest reliability in predicting lag screw cut-out. A value of 25 mm may potentially reduce the risk of lag screw cut-out in trochanteric hip fractures.
OUTCOMES OF PRIMARY TOTAL HIP ARTHROPLASTY IN PATIENTS OVER 80 YEARS OF AGE: DATA FROM THE SCOTTISH ARTHROPLASTY PROJECT
Authors: McCann Conor , Brunt Andrew , Walmsley Phil , Akhtar Adeel
Published: May 2024

There is an increasing demand worldwide for total hip arthroplasty in patients over 80 years old. This study is the largest of its kind reporting long term outcomes and clinical survivorship of patients over 80 years old undergoing THR.

13171 patients 80 years or older who underwent THR between 2000 and 2019 were included. Demographic and operative data was collected including age, sex, laterality, date of surgery and operative technique. Presence and date of complications were collected. Data was also collected for the same time period on 80910 patients aged 51–79 years undergoing THR for comparison.

4103 (31.2%) male and 9068 female (68.8%) patients were included in the 80year old cohort. Median age was 83 (IQR 81–83, range 80–98). 32682 (40.4%) male and 48227 (59.6%) females were included in the 50–79year old cohort. Median age was 68 (IQR 62–73, range 50–79).

The 80 cohort was more likely to sustain post operative complications in the 6 months following surgery including DVT (81/13171 vs 364/80910, P<0.05), myocardial infarction (177/13171 vs 341/80910, P<0.05), acute renal failure (371/12800 vs 812/80910 P<0.05).

The 50–79year old cohort was over twice as likely to undergo revision surgery than the 80 year old cohort (HR 2.55, 95% CI 2.216–2.932, p<0.001). Of those requiring revision surgery, the elderly cohort were more likely to undergo earlier revision surgery (378days, 95%CI 236–519d vs 1586days, 95%CI 1471–1700d, p<0.001). In those undergoing revision surgery, a higher proportion were done for infection in the 80 year old cohort (39/219 (17.8%) vs 215/2809 (7.7%), p<0.05.

This study demonstrates good outcomes in terms of medical complications and a low overall risk of requiring revision surgery in patients 80years old undergoing THR. Patients over the age of 80 should be counselled on the relatively increased risk of medical complications post operatively.
THE USE OF CELL SAVER IN PROSTHETIC JOINT INFECTION SURGERY: IS IT REALLY CONTRAINDICATED?
Authors: Khaled Ahmad , Eyre-Brook Alistair , Petrie Michael , Gordon Andy , Harrison Tim , Salih Saif
Published: May 2024

The benefits of cell salvage autotransfusion are well reported. There is a common non-evidenced belief amongst revision arthroplasty surgeons that auto-transfusion is potentially contraindicated in infected revisions.

The aim is to study the immediate and delayed outcomes of using cell saver on patients undergoing PJI surgery.

Prospective cohort service evaluation registered with the local audit department. 20 PJI cases in 18 patients where cell saver was used over a period of 4 years. Intraoperative fluid and tissue samples were taken for culture. Blood culture from salvaged blood pre and post leucodepletion filter were sent for microbiological analysis. Data on type of surgery, blood loss, further allogenic transfusion and SIRS response was collected. Success of infection clearance was assessed using 2019 MSIS ORT. Five patients receiving autologous blood in non-infection cases were used as controls.

Mean age for the PJI group was 67.7 years, 67% female. 11 patients (67%) had 1st stage surgery and 5 (25%) underwent 2nd stage whereas 4 patients had single stage surgery. The mean calculated blood loss was 1398 mls (range 400–3000mls). 6 Patients required further allogenic transfusion. 16 patients received blood via a leuco-depletion filter. The same organism grown from tissues was identified in post-filter blood in 8/17 patients (47%).

2/20 have grown a different organism in post-filtered blood, _P.Acne._

2 patients developed SIRS upon auto-transfusion, however one was thought to be secondary to cementing. The control group had 443 mls mean amount of blood loss and 1 patient developed a SIRS response.

14/20 (70%) patients had successful clearance of infection (tier 1) 2 patients died prior to undergoing 2nd stage.

Using cell saver did not impact main outcome of infection clearance in PJI surgery. We would advocate its routine usage whilst avoiding direct collection of heavily contaminated blood.
USING FOETAL SKELETOGENESIS TO EVALUATE AND IMPROVE IN VITRO CHONDROGENESIS PROTOCOLS
Authors: Lawrence John , Woods Steven , Roberts Kenny , Tuck Elizabeth , Balogh Petra , Predeus Alexander , He Peng , Polanski Krzysztof , Prigmore Elena , Zhou Di , Webb Simone , Jardine Laura
Published: May 2024

The reliable production of _in vitro_ chondrocytes that faithfully recapitulate _in vivo_ development would be of great benefit for orthopaedic disease modelling and regenerative therapy(1,2). Current efforts are limited by off-target differentiation, resulting in a heterogeneous product, and by the lack of comparison to human tissue, which precludes detailed evaluation of _in vitro_ cells(3,4).

We performed single-cell RNA-sequencing of long bones dissected from first-trimester fetal limbs to form a detailed ‘atlas’ of endochondral ossification. Through 100-gene in-situ sequencing, we placed each sequenced cell type into its anatomical context to spatially resolve the process of endochondral ossification. We then used this atlas to perform deconvolution on a series of previously published bulk transcriptomes generated from _in vitro_ chondrogenesis protocols to evaluate their ability to accurately produce chondrocytes.

We then applied single-nuclear RNA-sequencing to cells from the best performing protocol collected at multiple time points to allow direct comparison between the differentiation ofÂ _in vitro_ and _in vivo_ cells.

We captured 275,000 single fetal cells, profiling the development of chondrocytes from multipotent mesenchymal progenitors to hypertrophic cells at full transcriptomic breadth. Using this atlas as the ground truth for evaluating _in vitro_ cells, we found substantial variability in cell states produced by each protocol, with many showing little similarity to _in vivo_ cells, and all exhibiting off-target differentiation.

Trajectory alignment between _in vivo_ and _in vitro_ single-cell data revealed key differences in gene expression dynamics between _in vitro_ and _in vivo cells,_ with several osteoblastic transcription factors erroneously unregulated _in vitro,_ including _FOXO1._

Using this information, we inhibited _FOXO1_ in culture to successfully increase chondrocyte yield _in vitro._

This study presents a new framework for evaluating tissue engineering protocols, using single-cell data to drive improvement and bring the prospect of true engineered cartilage closer to reality.
PERIPROSTHETIC FEMORAL FRACTURE RATES FOLLOWING THE USE OF DUAL-MOBILITY ACETABULAR COMPONENTS
Authors: Yan Alex , Yan Angela , Hoggett Lee , Helm Anthony
Published: May 2024

The increased torque required to dislocate dual mobility (DM) components may increase peri-prosthetic femoral fracture (PPF) risk. Current literature often relies on revision as an endpoint and may underestimate PPF. This study aims to review PPF rate, risks and treatment following primary DM implantation.

Prospective cohort study of 549 patients following primary DM total hip arthroplasty (THA) between 2013 and 2021. Collected data included demographics, indication for surgery, cortical index and PPF.

549 patients were identified with primary DM THA. Mean age was 73 years (26–96). 446 (81.2%) patients had their index surgery following hip fracture. 18 patients (3.27%) sustained a PPF. Cumulative PPF rate was 1.5% at 1-year, 2.2% at 5-years and 3.27% overall. PPF was higher in patients undergoing surgery following hip fracture (4%) vs. other indications (1%). OR 4.04 (95% CI:0.53, 30.72), p=0.219. Mean cortical index was lower in patients with PPF 0.4 (95% CI:0.36, 0.45) compared to those without 0.46 (95% CI:0.45, 0.46) p=0.029. Treatment for PPF included 10 (55.6%) open reduction internal fixation (ORIF), 7 (38.9%) revision THA and 1 conservatively managed.

PPF rate following DM use is higher in our cohort than published rates. Our rates are comparable to some papers when subgroup analysis of older patients and cemented taper slip stems are considered. PPF risk with DM may be increased in patients undergoing surgery after hip fracture or with a lower cortical index preoperatively. Over half of PPF were managed with ORIF and may mask PPF risk studies that report using revision as an endpoint.
DEVELOPMENT AND IMPLEMENTATION OF THE INFORM GUIDELINES FOR THE TREATMENT AND MANAGEMENT OF PROSTHETIC HIP INFECTION
Authors: Moore Andrew , Whitehouse Michael , Wylde Vikki , Walsh Nicola , Beswick Andrew , Jameson Catherine , Blom Ashley
Published: May 2024

Hip prosthetic joint infection (PJI) is a debilitating complication following joint replacement surgery, with significant impact on patients and healthcare systems. The INFection ORthopaedic Management: Evidence into Practice (INFORM:EP) study, builds upon the 6-year INFORM programme by developing evidence-based guidelines for the identification and management of hip PJI.

A panel of 21 expert stakeholders collaborated to develop best practice guidelines based on evidence from INFORM \[1\]. An expert consensus process was used to refine guidelines using RAND/UCLA criteria. The guidelines were then implemented over a 12-month period through a Learning Collaborative of 24 healthcare professionals from 12 orthopaedic centres in England. Qualitative interviews were conducted with 17 members of the collaborative and findings used to inform the development of an implementation support toolkit. Patient and public involvement contextualised the implementation of the guidelines. The study is registered with the ISCRTN (34710385).

The INFORM guidelines, structured around the stages of PJI management, were largely supported by surgeons, although barriers included limited awareness among non-surgical team members, lack of job planning for multidisciplinary teams, and challenges in ensuring timely referrals from primary care. Psychological support for patients was identified as a critical gap. Advanced Nurse Practitioners and multidisciplinary team (MDT) coordinators were seen as potential bridges to address these knowledge gaps. The guidelines were also viewed as a useful tool for service development.

This study presents the first evidence-based guidelines for hip PJI management, offering a comprehensive approach to prevention, treatment, and postoperative care. Effective implementation is crucial, involving wider dissemination amongst primary and community care, as well as non-specialist treatment centres. Further resources are needed to ensure job planning for MDTs and psychological support for patients. Overall, this study lays the foundation for improved PJI management, benefiting patients and healthcare systems.
EARLY TO MID-TERM OUTCOMES OF THE CUSTOM-MADE 3D-PRINTED TRIFLANGE ACETABULAR COMPONENT (AMACE) IN COMPLEX REVISION HIP ARTHROPLASTY: LARGEST UK STUDY REPORTING THE COMBINED EXPERIENCE OF TWO TERTIARY REVISION CENTRES
Authors: Khaled Ahmad , Khaliq Mehnoor , Barrow Jonathan , Balaji Gautham , Jones Henry Wynn , Harrison Tim
Published: May 2024

Different techniques have been described to address massive bone loss of the acetabulum in revision hip surgery. aMace has gained popularity as it provides customization aiming to restore hip centre and provide good initial stability in cases of large non-contained defects. It takes into account quality of host bone. Its porous defect filling scaffold provides an excellent surface for osteointegration.

Our aim was to assess the short and mid-term outcomes of patients who underwent revision surgery using aMace system.

Ethical approval was obtained. A retrospective study included all patients who had aMace between June 2013 and October 2022 allowing for a minimum of 12-months follow-up. Patients’ demographics, indication, bone-loss severity, reconstruction details, re-operation, complications, mortality, pain and function were assessed.

52 cases were performed by 13 surgeons with median 51 months follow-up. Median age was 72.7 years. 86.5% were female. Average BMI was 25.3. Average ASA grade was 3.

65% were classified as Paprosky IIIB and 32% were IIIA.

73% were found to have poor bone quality on CT. Main indication for aMace was massive bone loss/discontinuity secondary to aseptic loosening in 88.5%.

77% underwent single-stage revision. 53.8% had 2 or more previous revisions. 71% underwent stem revision in the same setting. 77% received a dual mobility bearing.

Re-operation rate was 5.7% for instability and femoral PPF. LLD was reported in 9.6%.

Permanent Sciatic nerve palsy occurred in 3.8% of the cases.

30-days mortality was 1.9%.

Statistically significant post-op improvements in pain and mobility were reported (p<0.001). None of the acetabular components have been revised.

Our study shows satisfactory surgical outcomes with a relatively low complication rate and significant pain and mobility improvements in the early to mid-term stages.

We recommend these costly cases to be done in highly specialist centres adopting MDT approach.
WHO DAIRS WINS?
Authors: Martin Rebecca , Fishley William , Kingman Anji , Carluke Ian , Kramer Derek , Partington Paul , Reed Mike , Petheram Tim
Published: May 2024

Periprosthetic joint infection is a serious complication of primary total hip replacement (THR) with significant associated morbidity. In acute infection, Debridement, Antibiotics and Implant Retention (DAIR) may be considered. Current national guidelines recommend a DAIR should be performed by “an experienced arthroplasty surgeonâ”• but do not specify the need for this to be a revision arthroplasty surgeon. We investigated outcomes in our NHS Trust of DAIR procedures performed by revision and non-revision arthroplasty surgeons.

Infection registry data and patient records were analysed for all DAIR procedures of infected primary THRs between 2017 and 2021. Data collected included details of the primary surgery, the presentation with infection, the DAIR procedure and any subsequent complications including return to theatre at any time point. Routinely collected pre- and post-operative patient reported outcome measures (PROMs) were reviewed.

54 periprosthetic joint infections of primary THRs received a DAIR procedure. 41 DAIRs were performed by a revision surgeon and 13 by non-revision surgeons. There was no significant difference in time from primary THR to presentation with infection, time from presentation to DAIR or pre-operative C-reactive protein between the two groups.

In 21 (38.9%) patients the DAIR procedure was classed as a treatment failure; 17 patients (31.5%) returned to theatre for further revision surgery, one (2.4%) died related to infection and three (5.6%) had persistent infection but did not receive further surgery. Treatment failure was significantly higher in the non-revision surgeon group (9/13 (69.2%)) than in the revision surgeon group (12/41 (29.3%)) (p = 0.02). Overall, improvement in PROMs after DAIR was seen at both six and 12 months.

The overall success rate of DAIR was 61.1% and there was a sustained improvement in PROMs after surgery. However, there was a significant difference in failure rates between revision surgeons and non-revision surgeons.