bluuebunny/crossref_metadata_2025 huggingface dataset:
Urbanization, female employment, and family care choice
Authors: Wang Jing , Wang Xue
Published: May 2024

This paper studies new changes in elderly care in urban areas against the background of population aging with data from the China Social Survey 2021. The study revealed that urban families mainly adopt two models—the “living-with-the-elderly” model and the “providing-economic-support” model—and that there is a substitution effect between the two models. Regarding individual characteristics, younger individuals with higher education levels tend to use the providing-economic-support model instead of the living-with-the-elderly model. In terms of family features, the greater the number of underage children in a family is, the greater the probability of giving economic support and the lower the probability of living with elderly people, reflecting a family resource allocation model centered on “children”. This paper further explores the impact of urban female employment on family care model choice and finds that employed women are more inclined to use economic support instead of living with elderly people. The study suggested that the government should gradually improve the public resource support system, promote community service infrastructure development, and expand professional service supply capabilities.
Preoperative weight loss interventions before total hip and knee arthroplasty: a systematic review of randomized controlled trials
Authors: Lau Lawrence Chun Man , Chan Ping Keung , Lui Tak Wai David , Choi Siu Wai , Au Elaine , Leung Thomas , Luk Michelle Hilda , Cheung Amy , Fu Henry , Cheung Man Hong , Chiu Kwong Yuen
Published: May 2024

Background

The high co-prevalence of obesity and end-stage osteoarthritis requiring arthroplasty, with the former being a risk factor for complications during arthroplasty, has led to increasing interest in employing preoperative weight loss interventions such as bariatric surgery and diet modification. However, the current evidence is conflicting, and this study aimed to investigate the effect of weight loss intervention before arthroplasty in prospective randomized controlled trials.

Methods

Four electronic databases (MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials) were searched for prospective randomized controlled trials that compared weight loss interventions with usual care from inception to October 2023 by following the PRISMA guidelines. The Cochrane risk of bias tool and GRADE framework were used to assess the quality of the studies. Meta-analyses were performed when sufficient data were available from 2 or more studies.

Results

Three randomized controlled trials involving 198 patients were identified. Two studies employed diet modification, and one study utilized bariatric surgery. All three studies reported significant reductions in body weight and body mass index (BMI), and intervention groups had fewer postoperative complications. There was no difference in the length of stay between the intervention group and the control group. Variable patient-reported outcome measures were used by different research groups.

Conclusion

Weight loss intervention can achieve significant reductions in body weight and body mass index before arthroplasty, with fewer postoperative complications reported. Further studies with different populations could confirm the effect of these interventions among populations with different obesity characteristics.
Investigations on solar PV integration and associated power quality challenges in distribution systems through the application of MCS and GA
Authors: Barutcu Ibrahim Cagri , Sharma Gulshan , Gandhi Ravi V. , Jadoun V. K. , Garg Akhil
Published: May 2024

In the forthcoming decades, significant advancements will shape the construction and operations of distribution systems. Particularly, the increasing prominence of photovoltaic (PV) systems in the power industry will impact the security of these systems. This study employs Monte Carlo Simulation (MCS) in conjunction with genetic algorithm (GA) and differential evolution (DE) to address uncertainties. The probability density functions (pdf) for total voltage harmonic distortion (UTHD), individual voltage harmonic distortion (UIHDh), and RMS voltage (URMS) have been determined for utilization in chance constrained framework. In addition, the uncertainty effects of PV systems on grid losses for various solar radiation conditions are also investigated. Specifically, the paper aims to evaluate these impacts within the context of stochastic limits. The PV system sizing problem has been addressed inside the distribution system using a chance-constrained framework. A key contribution is the integration of GA, DE, and MCS into a cohesive approach, and the study evaluates the benefits of this approach through an analysis of outcomes derived from the stochastic method. The simulation results illustrate the advantages of the proposed stochastic GA methodology.
Finding the missed millions: innovations to bring tuberculosis diagnosis closer to key populations
Authors: Byrne Rachel L. , Wingfield Tom , Adams Emily R. , Banu Sayera , Bimba John Samson , Codlin Andrew , Atienzar Ana Cubas , Garg Tushar , John Stephen , Gurgel Ricardo Queiroz , Sander Melissa , Santos Victor Santana , Squire S. Bertel , Vo Luan Nguyen Quang , Creswell Jacob
Published: May 2024

Current strategies to promptly, effectively, and equitably screen people with tuberculosis (TB) and link them to diagnosis and care are insufficient; new approaches are required to find the millions of people around the world with TB who are missed each year. Interventions also need to be designed considering how people interact with health care facilities and where appropriate should be suitable for use in the community. Here, the historical, new, and reemerging technologies that are being utilised for TB diagnosis globally are discussed, whilst highlighting that how we use and evaluate tests is just as important as the tests themselves.
Factors associated with domestic violence in pregnant women during the COVID-19 pandemic: Araraquara Cohort study
Authors: Biagio Leonardo Domingos , Devakumar Delanjathan , Falcão de Carvalho Leticia , Pinheiro de Castro Natália , López Rossana Verónica Mendoza , Luzia Liania Alves , Pizzi Argentato Perla , Rondó Patrícia Helen Carvalho
Published: May 2024

Aims and method

This cross-sectional study, carried out from 2021 to 2022, investigated the factors associated with domestic violence in 400 Brazilian pregnant women during the COVID-19 pandemic. Violence was assessed with the World Health Organization's Violence Against Women questionnaire and the Abuse Assessment Screen. Demographic, socioeconomic, obstetric, lifestyle and mental health data were collected.

Results

Violence at any time in their lives was reported by 52.2% of the women, and psychological violence was the most prevalent type (19.5%). Violence was associated with being single and mental health changes. Pregnant women exposed to any lifetime violence and psychological violence were, respectively, 4.67 and 5.93 times more likely to show mental health changes compared with women with no reported violence.

Clinical implications

Training health professionals involved in prenatal care in the early detection of single women and women with mental health changes could be important in preventing domestic violence.
No Bodies Business: Trapdoor Tactics and the Art of Transgender Disappearance in A Fantastic Woman
Authors: Nault Curran
Published: May 2024

Chilean Academy Award–winning drama, Una mujer fantástica/A Fantastic Woman (dir. Sebastián Lelio, 2017), is a film that navigates past the superficiality of surface into a transgender interiority and imagination situated below and against dominant culture's demand for transgender display. Within the media mainstream, transgender legibility has been predicated on a hypervisibility tailor-made for cisgender consumption—via celebrated magazine covers and charged cinematic spectacles. A Fantastic Woman, however, frustrates this ideology of the visible and the knowable certainties it feigns. Prying the cisgender gaze from its perch of power—disrupting its ability to detect, define, and dominate the transgender body—the film incites the “transgender gaze,” as first advanced by Jack Halberstam. A Fantastic Woman ultimately forsakes specular relations altogether, enacting a “disappearing act” that moves audiences beyond the flesh and into the heart of the matter: the internal depths of transgender fantasy and feeling. Aesthetically articulated, this transcension progresses from the private visions of the film's protagonist, Marina, to an acute emphasis on sound as well as surface. Through its “art of disappearance,” A Fantastic Woman conjures an enticing horizon in which transgender surveillance and subjugation are provisionally contravened, proffering the possibility of sidestepping the disciplining, normalizing powers of the cisgender gaze.
Factors associated with musculoskeletal pain in professional dancers, including lapse period of group practice due to the COVID-19 outbreak: repeated-measures analysis
Authors: Baek Kiook , Choi Yu-Mi , Sakong Joon
Published: May 2024

Background: This study investigated the prevalence and associated factors of musculoskeletal pain among professional dancers who experienced a lapse in group practice due to coronavirus disease 2019. Methods: General characteristics, practice time, region of musculoskeletal pain due to injury using the visual numeric scale (VNS), and causative motion were surveyed among professional dancers. Pain of VNS 0 to 3 was categorized as “no or minor,” 4 to 6 was categorized as “moderate,” and 7 to 10 was categorized as “severe.” The causal motions of musculoskeletal pain were analyzed according to body region. Factors other than motion associated with pain were also analyzed. Results: In total, 368 participants were included. In the univariate analysis, age and practice time were positively associated with “moderate” pain. Practice time, dance experience, and postural accuracy were positively associated with “severe” pain, as was performing Korean traditional dance. In the multivariable analysis, practice time, group practice, and age were positively associated with pain of VNS 4 to 10, and practice time, group practice, and Korean traditional dance were positively associated with pain of VNS 7 to 10. Conclusion: Among the factors related to dancer training, practice time, group practice, and dance type affect the occurrence of pain.
Parachute mitral valve and mid-aortic syndrome – unusual associations of Alagille syndrome
Authors: Bhagia Geeta , Hussain Nasir , Arty Fnu , Bansal Puneet , Biederman Robert
Published: May 2024

Background: Alagille syndrome (ALGS) is a multisystem disorder involving at least three systems among the liver, heart, skeleton, face, and eyes. Common cardiac associations include pulmonary artery stenosis/atresia, atrial septal defect (ASD), ventricular septal defect (VSD) and tetralogy of fallot (ToF). Coarctation of aorta (CoA), renal and intracranial arteries are commonly involved vessels in Alagille syndrome. We present two cases with rare cardiovascular manifestations of Alagille syndrome. Case description: Case 1: A 25-year-old female with a history of Alagille syndrome presented to the cardiologist office for progressive exertional dyspnoea, orthopnoea, and palpitations. She was tachycardiac on examination and had an apical diastolic rumble. A transthoracic echocardiogram (TTE) showed a left ventricular ejection fraction (LVEF) of 60% and parachute mitral valve (PMV) with severe mitral stenosis. A transoesophageal echocardiogram (TOE) showed insertion of chordae into the anterolateral papillary muscle, severe mitral stenosis with a valve area of 0.7 cm. She was referred to a congenital heart disease specialist and underwent robotic mitral valve replacement with improvement in her symptoms. Case 2: A 27-year-old female with known Alagille syndrome and resistant hypertension presented to the cardiologist office due to progressive exertional dyspnoea for a year. She was hypertensive and had a new 2/6 systolic ejection murmur along the left upper sternal border. TTE revealed an LVEF of 60% and pulmonary artery pressure of 19 mmHg. A CoA was suspected distal to the left subclavian artery due to a peak gradient of 38 mmHg. Cardiac magnetic resonance (CMR) imaging ruled out CoA, and diffuse narrowing of the descending thoracic aorta measuring 13–14 mm in diameter was noted. The patient was referred to a congenital heart disease specialist for further management. Conclusion: PMV presenting as mitral stenosis and mid-aortic syndrome are not commonly described anomalies in association with Alagille syndrome. TTE, TOE and CMR played a key role in diagnosis and management of these patients.
Development of a Sustainable Dyeing Process for Cotton fabric Utilizing Natural Dyes from Punica granatum L. and Curcuma Longa
Authors: Ahire Bajirao B. , Kasabe Sujata M. , Mali Archana B. , Jadhav Vikram R.
Published: May 2024

Pomegranate fruit grains and turmeric have naturally dyeing properties, making them nontoxic, non-allergic, and biodegradable alternatives to synthetic dyes for coloring various textiles, including cotton. This study used pomegranate and turmeric extracts to dye bleached cotton fabric using various mordants, including pre-, post-, and simultaneous mordanting techniques. The natural dyes in these extracts contains alkaloids, tannins, anthocyanins, glycosides, and curcumin, impart different colours to the fabrics. The light sensitivity of these dyes and also role of pH of the dyeing were also explored. The wide ranges of colors were obtained by varying the concentration, ratio, and pH of the extracts, as well as the choice of mordant used. Pomegranate and turmeric extracts demonstrates the potential results as sustainable dyeing and environmentally friendly dyes for cotton fabric.
Impact of Urbanization on Air Quality of Dehradun District
Authors: Dhankar Sneha , Singh Gayatri , Kumar Krishan
Published: May 2024

The increasing trend of urbanization poses a significant challenge to environmental sustainability, particularly concerning air quality. This study examines the impact of rapid urbanization on the Dehradun district land use and land cover (LULC), with the built-up area increasing from 44.2 km² to 276.5 km² between 2000-2019. The LULC analysis highlights a significant expansion of built-up areas influencing regional air quality. A comprehensive analysis of air pollutants and environmental factors spanning 2000 to 2019, utilizing TROPOMI, OMI, MODIS, MOPITT, and CHIRPS data, was also conducted. Spatial variations of air pollutants, including CO i.e. carbon monoxide, HCHO i.e. formaldehyde and NO2 i.e. nitrogen dioxide demonstrate higher concentrations in urbanized areas. Temporal variations exhibit seasonal peaks during the summer months. A 15-year trend analysis indicates a consistent rise in NO2 and HCHO, attributed to urbanization and anthropogenic activities. The correlation matrix highlights strong positive correlations among air pollutants, suggesting common sources or influences. The correlation between NO2 and CO stands at 0.652, between HCHO and CO is 0.583, and between HCHO and NO2 is 0.619. Higher correlation values of more than 0.4 are observed between the land surface temperature and pollutant concentrations, highlighting the influence of anthropogenic activities on temperature rise. In an attempt to mitigate the negative effects of uncontrolled urban sprawl on the district of Dehradun's air quality and overall environmental health, the study underscores the pressing need for sustainable urban planning. These findings contribute valuable insights for decision-makers to formulate effective strategies for environmental conservation against the unfavourable consequences of swift urbanization.
Decision making in prehospital and paramedic practice: part 1
Authors: Sibson Lynda
Published: May 2024

This first continuing professional development article in this 2-part series on decision-making explores this process in prehospital and paramedic practice and the complex world of how clinicians make decisions in often challenging and time-critical situations in prehospital settings. It gives a brief overview of the neuroanatomy involved in decision-making, problem-solving and critical thinking as well as Bloom's taxonomy and its application to prehospital practice. While it is outside the remit of this paper to incorporate all theories regarding decision-making, it will explore some key concepts and frameworks around it.
Multiple Spinal Epidural Abscesses with Concomitant Multifocal Systemic Abscesses and Multi-joint Septic Arthritis: A Case Report
Authors:   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore,, Yang Cassie , Gnanam Alagan ,   Department of General Medicine, Ng Teng Fong General Hospital, Singapore., Tat John Chen Li ,   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore,, Youheng Ou Yang ,   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore,
Published: May 2024

Introduction: Multiple spinal epidual abscesses with multifocal systemic abscess and multiple joint septic arthritis present with a large infective burden resulting in sepsis, systemic inflammatory dysregulation, and multi-organ failure. This requires pre-operative resuscitation and surgery of greater complexity, longer operative duration, and blood loss, creating challenges to surgical management. Case Report: A 69-year-old Chinese female presented with multilevel discrete spinal epidural abscesses along the cervical, thoracic, and lumbar spine, alongside concomitant multifocal systemic abscesses and multiple small joint septic arthritis. She received pre-operative resuscitation to restore organ function, reverse acidosis and coagulopathy, before surgical decompression of selected abscesses and joints under a multidisciplinary team. Remaining sites of infection without significant compression were undrained. The patient recovered well with no residual neurological deficits. Conclusion: Multifocal infections in critically ill patients require a multidisciplinary team for preoperative resuscitation, joint surgical planning, and prioritizing surgical interventions to prevent excessive surgical stress to the patient. Keywords: Spinal epidural abscess, multiple soft-tissue abscesses, septic arthritis.
Median Nerve Palsy after Shoulder Dislocation in a 10-year-old Girl: A Case Report
Authors:   Department of Physical Medicine and Orthopaedic Surgery, Ghent University, Ghent, Belgium,, De Lepeleere Bram , Maffeis Jacopo ,   Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia, Brescia, Italy,, Chevrier Benedicte ,   Department of Medical Imaging Oudinot, Groupe Union Imagerie, Paris, France,, Teboul Frédéric ,   [4] Centre International de Chirurgie de la Main, Brachial Plexus Surgery Institute Paris, France, [5] Department of Hand Surgery, HPPE, SOS Mains, Champigny, France, [6] Department of Hand Surgery, Institute De la Main, Clinique Bizet, Paris, France.
Published: May 2024

Introduction: Traumatic glenohumeral dislocation is very rare in skeletally immature patients, and there are no reports in the literature describing the risk of associated nerve injuries. In the general population, the most commonly affected nerve is the axillary, but anatomical variations with a common origin between the musculocutaneous and median nerves exist that alter the respective positions and courses of these nerves and can make them more prone to injury during a glenohumeral dislocation. Case Report: A 10-year-old girl presented with incomplete median nerve palsy without any recuperation 8 months after an anterior glenohumeral dislocation. Surgical exploration was performed and revealed a common origin of the musculocutaneus and median nerve, with bifurcation just distal to the glenohumeral joint, making it susceptible to compression-elongation trauma during dislocation. A careful neurolysis was performed, and there was a complete recovery of median nerve function. Conclusion: Glenohumeral dislocation associated with nerve injury is very rare in children. When a nerve injury occurs, one should be aware of possible anatomical variations of the infraclavicular plexus. Keywords: Shoulder dislocation, glenohumeral dislocation, high median nerve palsy, median nerve injury.
Uncommon Pathogen: Achromobacter xylosoxidans Infection Following Total Knee Arthroplasty
Authors:   Department of Orthopaedic, AIIMS, New Delhi, India., Ojha Mukund Madhav , Ansari Mohd. Akhtar Ali ,   Department of Orthopaedic, AIIMS, New Delhi, India., Kumar Vijay ,   Department of Orthopaedic, AIIMS, New Delhi, India.
Published: May 2024

Introduction: Achromobacter xylosoxidans is an uncommon opportunistic organism, mainly causing infection in immune-compromised hosts. A. xylosoxidans is a non-fermenting Gram-negative bacillus. Being closely associated with Alcaligenes species was also called A. xylosoxidans. Case Report: A few cases of periprosthetic infection by A. xylosoxidans have been reported outside India. A periprosthetic infection with A. xylosoxidans following a total knee arthroplasty is reported in a female. Conclusion: A. xylosoxidans is a pathogen capable of causing prosthetic joint infection even in immunocompetent patients. Thorough debridement and appropriate antibiotic treatment is essential for the success of revision surgery. Keywords: Prosthetic joint infection, total knee arthroplasty, Achromobacter xylosoxidans.
Early Reimplantation of Open Total Extruded Talus: A Case Report
Authors:   Department of Orthopedic Surgery, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India,, Wooly Sameer , Kumar Sachin ,   Department of Orthopedic Surgery, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India,Department of Orthopedic Surgery, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India,, Mane Akash Nagnath ,   Department of Orthopedic Surgery, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India,, Kumar Jayant ,   Department of Orthopedic Surgery, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India,, Pandey Prabhat ,   Department of Orthopedic surgery, Tata Main Hospital, Jamshedpur, Jharkhand, Ind
Published: May 2024

Introduction: Traumatic open total extrusion of talus without soft-tissue attachment and not associated with surrounding fracture is a very rare injury which requires very high energy impact. In literature, optimal treatment protocols are yet to be established. A few options described in literature are talectomy and tibiocalcaneal arthrodesis or reimplantation of talus which may be immediate or after some interval. Case Report: A 28-year-old female suffered road traffic accident and had total open extrusion of talus without soft-tissue attachment, and we managed it with thorough debridement of the wound, saline irrigation, and immediate reimplantation of the talus with stabilization by delta frame external fixator. Proper pre- and post-operative antibiotic coverage was given as per protocol. We did not face post-operative infection, wound complication, and until 12 months followed up, there are some signs of avascular necrosis of the talus but the good functional outcome. Conclusion: With this case experience, we suggest that this is the valid treatment protocol for total extrusion of the talus, and it will provide a better hindfoot mechanism, heel height, and the patient can resume his/her daily routine activity as early as possible. Keywords: Tibiocalcaneal arthrodesis, talar extrusion, avascular necrosis of talus
A rare Bosworth Variant Isolated Distal Fibula Dislocation with a Successful Closed Reduction: A Case Report and Technique
Authors:   [1] Department of Orthopaedic Surgery, McLaren Greater Lansing, Lansing, Michigan, USA, [2] Department of Orthopaedic Surgery, Sparrow Hospital, Lansing, Michigan, USA,, Snyder Laura L , Mesko Daniel R ,   [1] Department of Orthopaedic Surgery, McLaren Greater Lansing, Lansing, Michigan, USA, [2] Department of Orthopaedic Surgery, Sparrow Hospital, Lansing, Michigan, USA, [3] Michigan Orthopaedic Center, Lansing, Michigan, USA.
Published: May 2024

Introduction: The Bosworth fracture-dislocation is a rare injury originally described as an irreducible dislocation of a distal fibula fracture where the proximal fibular fragment becomes incarcerated behind the distal tibia. There have since been a few cases described of an intact distal fibula with dislocation and similar difficulties in closed reduction attempts, typically seen with associated injuries to the ankle or proximal fibula. Regardless of the specific fracture or dislocation pattern, closed reduction attempts have consistently failed in the significant majority of these cases, which can lead to complications including soft-tissue compromise, severe post-traumatic arthritis, compartment syndrome, avascular necrosis of the talus, and neurovascular compromise. There is only one case in recent literature that describes an isolated distal fibula dislocation without associated fractures or dislocations of the lower extremity; however, it required an open reduction. Cases where a closed reduction was successful to achieve an anatomic reduction of a Bosworth-type injury are exceedingly rare. Case Report: We present a rare case of a purely ligamentous, isolated distal fibula dislocation in a 21-year-old male who underwent a successful closed reduction upon initial presentation and later underwent surgical fixation with a syndesmosis repair system. We describe the technique used for a successful closed reduction for this injury and present a 1-year follow-up with excellent outcomes. Conclusion: This is the only known case report of a successful closed reduction in an isolated distal fibula dislocation, as well as demonstrating a minimally invasive technique for definitive treatment with a syndesmosis repair system. Accurate diagnosis, early treatment, and anatomic reduction are imperative for good clinical outcomes and reducing complications for Bosworth injuries. This technique may improve the rates of successful closed reductions of Bosworth injuries upon initial presentation, leading to decreased complications and improved patient outcomes. Keywords: Bosworth, fibula dislocation, reduction technique, syndesmosis repair.
Infected Post-traumatic Bone Defect of the Knee using Bipolar Osteochondral Allograft and 3D Printing: A Case Report
Authors:   [1] Limb of Lengthening and Reconstruction Unit, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia, [2] Department of Surgical Clinics, Faculty of Health Sciences, Pontificia Universidad Javeriana Cali, Colombia,, Medina-García Juan Camilo , Rios Adolfo de los ,   [3] Department of Orthopedic Surgery, Universidad del Valle, Cali, Colombia, [4] Arthroscopy Unit, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia., Benedetti Fernando ,   [1] Limb of Lengthening and Reconstruction Unit, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia, [2] Department of Surgical Clinics, Faculty of Health Sciences, Pontificia Universidad Javeriana Cali, Colombia,, Reina-Ramirez Federico ,   Limb of Lengthening and Reconstruction Unit, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia,, Llano Juan David Urrea ,   Limb of Lengthening and Reconstruction Unit, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia,, Zuluaga-Botero Mauricio ,   [1] Limb of Lengthening and Reconstruction Unit, Clínica Imbanaco Grupo QuirónSalud, Cali, Colombia, [2] Department of Surgical Clinics, Faculty of Health Sciences, Pontificia Universidad Javeriana Cali, Colombia, [3] Department of Orthopedic Surgery, Universidad del Valle, Cali, Colombia,
Published: May 2024

Introduction: Transplantation with fresh cadaveric osteochondral allograft (FOCA) is frequently used in defects of the femoral condyle and tibial plateau to preserve the knee joint. However, the use of FOCA in bipolar lesions remains controversial in cases with bipolar defects and a history of infection. Case Report: We present a 21-year-old male patient with a massive post-traumatic osteochondral defect of the lateral compartment of the knee and a history of infection, treated by a two-stage approach. In stage 1, infection was eradicated, and joint function recovered with aggressive debridement, polymethyl methacrylate beads, bone cement spacers, and Judet’s quadricepsplasty. In stage 2, transplantation was performed with a bipolar FOCA. All treatments were planned using 3D-printed models. Conclusion: The two-stage approach and 3D planning can increase the chances of transplant success by preparing the future allograft bed and obtaining an optimal match between the cadaveric allograft and the patient’s defect in cases with potential contraindications, such as a bipolar lesion in the femoral condyle and tibial plateau and a history of infection. A combined approach may lead to a more beneficial outcome for the patient to preserve joint function and improve quality of life. Keywords: Osteochondral allograft, bone defect, 3D planning.
Magnetic Resonance Imaging in the Evaluation of Avulsion Injuries of the Pelvis and Hip in Adolescent Professional Footballers: A Case Series
Authors:   Department of Radiology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Roma, Italy,, Cirimele Vincenzo , D’Amone Giulia ,   Department of Radiology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Roma, Italy,, Stellato Luigi ,   Department of Radiology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Roma, Italy,, Ferrini Augusto ,   [2] Department of Orthopaedic and Trauma Surgery Fondazione Policlinico Univeristario Campus Bio-Medico di Roma, Roma, Italy, [3] Department of Medicine and Surgery, Orthopaedic and Trauma Surgery Unit, Univeristà Campus Bio-Medico di Roma, Roma, Italy., Gregori Pietro ,   [2] Department of Orthopaedic and Trauma Surgery Fondazione Policlinico Univeristario Campus Bio-Medico di Roma, Roma, Italy, [3] Department of Medicine and Surgery, Orthopaedic and Trauma Surgery Unit, Univeristà Campus Bio-Medico di Roma, Roma, Italy., Faiella Eliodoro ,   Department of Radiology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Roma, Italy,
Published: May 2024

Introduction: Pelvic apophyseal avulsion fractures are uncommon injuries that frequently affect adolescents while participating in sports. This occurs because the enthesis cannot withstand the tractional force applied because the apophysis has not yet fully fused. Due to its complex muscular structure, being the origin of several muscles that cross two lower extremity joints, the pelvis has an increased risk for such injuries. The diagnosis of pelvic avulsion injuries depends heavily on imaging. The best way to detect soft-tissue changes, including tendon or muscle strain, bone marrow edema, hematomas, and soft tissue avulsion injuries, is with an magnetic resonance imaging . It is also the best at showing tendon retraction and can help the clinician spot patients who might benefit from surgical treatment. Case Report: We report six cases of adolescents professional footballers that suffered avulsion injuries while playing football. The patients had painfully restricted hip range of motion and were unable to bear weight. Some of them on physical examination felt pain at the palpation of the injured area. Magnetic resonance revealed apophysis growth plate avulsion with or without displaced bone fragments that were treated conservatively with an excellent clinical and radiological outcome. Conclusion: For an accurate diagnosis of pelvic avulsion injuries and clinical management, it is important that everyone caring for this patient population is aware of the common injury mechanisms, radiographic findings, and available treatments. Keywords: Musculoskeletal radiology, pelvis, musculotendinous junction, avulsion, enthesis, apophysis.
SpeedBridge Repair in Degenerative Achilles Tear: A Novel Technique
Authors:   Department of Orthopedics, Institute of Medical Sciences, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India,, Swaroop Shakti , Dureja Kamal ,   Department of Orthopedics, Head Foot and Ankle Surgery at Max Superspeciality Hospital, Saket, New Delhi, India,, Vellaipandi Venkatram ,   Department of Orthopedics, Mahatma Gandhi Medical College and Research Institute, Puducherry, India,, Patnaik Swati ,   Department of Public Health Dentistry, Institute of Dental Sciences, Siksha ‘O’ Anusandhan Deemed to be University, Bhubaneswar, Odisha, India.
Published: May 2024

Introduction: Retrocalcaneal pain in late adulthood and athletes has been attributed to insertional Achilles tendinosis (IAT). Another presentation of IAT is a degenerative Achilles tear, which can be partial or complete. Symptomatic patients with failed conservative management are treated by debridement and repair of the Achilles tendon. Often, they need augmentation with a tendon transfer. The flexor hallucis longus (FHL) is the most commonly used tendon for augmentation. The Speed Bridge technique to repair the degenerated tendoachilles tear gives better pullout strength and provides a larger surface area of contact between the bone and tendon. Case Report: We included 12 patients with symptomatic degenerative Achilles tears repaired with the Speed Bridge technique and FHL augmentation. Post-operatively, all patients were allowed active ankle mobilization on day 1 and were allowed weight bearing as tolerated in an airwalker shoe. All patients went through an accelerated rehabilitation protocol. Pre-operative and post-operative American Orthopedic Foot and Ankle Hindfoot Score (AOFAS) and Visual Analog Scale (VAS) scores were compared for all the patients. Conclusion: The mean age was 58.1 (range 50–68) years. The mean follow-up period was 13.1 (range 12–15) months. The mean pre- and post-operative AOFAS score at 12 months was 59.5 (range 58–71) and 90.2 (range 87–100), respectively. The mean pre-operative VAS for pain was 6.8 (range 6–8), and the mean post-operative VAS score was 0.5 (range 0–2). The mean interval to weight bearing was 8.4 days (range 7–10) days. Our study indicates that accelerated early rehabilitation and an early return to active life are possible with the Speed Bridge technique and FHL augmentation in degenerative Achilles tears. The mean post-operative AOFAS scores were comparable to other studies, but early return to activity, minimal need for immobilization, and accelerated rehabilitation were the advantages of the Speed Bridge technique in the repair of degenerative Achilles tears. Keywords: Haglund deformity, degenerative Achilles tendinosis, speed bridge repair
Pediatric Forearm Fractures: Investigating the Functional Outcomes of Titanium Elastic Nailing for Unstable Both-Bone Fractures
Authors:   Department of Orthopaedics, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India,, Saseendar Samundeeswari , KP Uma Anand ,   Department of Orthopaedics, Arunai Medical College, Thiruvannamalai, Tamil Nadu, India,, Latchoumibady Kaliaperumal ,   Department of Orthopaedics, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India., Shanmugasundaram Saseendar ,   Department of Orthopaedics, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India,
Published: May 2024

Introduction: Diaphyseal forearm fractures pose a common challenge in children and adolescents, impacting forearm function due to rotational deformities and angulation. The landscape of pediatric forearm fracture treatment has seen limited progression, with increased surgical intervention adoption driven by factors such as functional implications, technological advancements, societal expectations, and legal concerns. Materials and Methods: This study enrolled consecutive children aged 5–16 years with forearm fractures presenting between August 2018 and January 2020, requiring surgical intervention. The study assessed functional outcomes and complications in children treated with titanium elastic nailing. Results: Sixteen patients underwent surgery for both-bone forearm fractures. Elastic nailing was the primary intervention, with 75% undergoing closed nailing. Patients’ ages ranged from 5 to 15 years, with 87.5% being male. The study evaluated fracture characteristics, surgical procedures, post-operative care, and complications. Conclusion: The study demonstrates promising outcomes for flexible intramedullary nailing in pediatric forearm fractures. Despite the observed complications, the majority of cases achieved excellent results in fracture union and patient recovery, supporting the efficacy of this technique. Larger cohorts are needed for a comprehensive understanding of its applicability and outcomes in pediatric forearm fracture management. Keywords: Pediatric forearm fractures, flexible intramedullary nailing, titanium elastic nailing, functional outcomes, surgical intervention.
Single Stance Radiography of the Knee Joint – A Novel Approach to Assess the Degree of Knee Osteoarthritis
Authors:   Department of Orthopedics, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India., Kumar K V Arun , Raghul V R ,   Department of Orthopedics, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India., Pradeep E ,   Department of Orthopedics, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India., Pandian Haemanath ,   Department of Orthopedics, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India., Vijay Aswin ,   Department of Orthopedics, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India., Sheik Mohideen ,   Department of Orthopedics, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.
Published: May 2024

Introduction: Conventional radiography has always been cited as the gold standard for assessing the structural changes associated with osteoarthritis (OA) of the knee. The purpose of the study was to compare the joint space width between both leg-standing and one-leg-standing radiographs in an assessment of the severity of OA of the knee. Materials and Methods: Fifty patients with medial compartment OA were deployed for the study. Patients underwent both leg standing radiographs and one-leg standing radiograph on the affected leg. Kellgren–Lawrence (KL) radiographic classification was used to assess the severity of OA using joint space width. Conclusion: The mean medial joint space width decreased from 3.26 mm in both legs of the standing radiograph to 1.98 mm in the one-leg standing radiograph. Patients on both leg standing radiographs appreciated an increase in grade during the single leg radiograph. Nearly 52% of patients with both leg standing radiographs have changed the KL grading to a more severe grade when undergone a single leg standing radiograph. One-leg standing radiograph was found to be a better representation of joint space width than both-leg standing radiographs. Keywords: Knee osteoarthritis, imaging, one-leg standing radiography, both leg standing radiography.
Učestalost dojenja u ordinacijama primarne pedijatrijske zaštite u Republici Hrvatskoj tijekom trogodišnjeg razdoblja (2020.-2022.)
Authors: Čatipović Marija , Draušnik Željka , Kolarek Karakaš Mirjana , Puharić Zrinka
Published: May 2024

The goal of the research is to present data on the prevalence of breastfeeding in the Republic of Croatia for a three-year peroid. In cooperation with the Ministry of Health, the Croatian Institute of Public Health and the Department of Business Analysis of the MCS Group, data on the nutrition of children in the Republic of Croatia for years 2020, 2021 and 2022, have been extracted from the MCS Group database. In total, 63,969 records on the type of nutrition of infants and 15,871 records on the type of nutrition of children older than one year were processed, and collected from 55,042 children in total. The percentage of children exclusively breastfed for 1 month is 56.49%,  for 3 months 46.09%, and for 6 months 9.66%. When it comes to complementary feeding, 47.87% of children were breastfed for 9 months, 37.26% for 12 months, and 7.64% for 24 months. The first month of a child's life is characterized by a sudden drop in the number of breastfed children, compared to the percentage of breastfeeding represented in maternity hospitals. The rate of exclusive breastfeeding for six months is significantly below the rate recommended by WHO and UNICEF. The differences in the recommendations of WHO and UNICEF, the European Association for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), and the European Academy of Allergology and Clinical Immunology (EACCI) can be confusing for some health workers and parents. The results of total breastfeeding in months 12 and 24 are slightly below the values reported as the current rates of breastfeeding in the world by UNICEF. According to the current state of breastfeeding in the Republic of Croatia, the breastfeeding goals for 2030, set by WHO and UNICEF, will be difficult to achieve without reorganization and strengthening of the role of pediatricians in primary health care.
Kvaliteta života majki djece s poremećajem iz spektra autizma
Authors: Barišić Anamarija , Šimleša Sanja , Ivšac Pavliša Jasmina
Published: May 2024

Aim: Children with autism spectrum disorders (ASD) require additional care and different forms of support, which often affects the entire family, including mothers. The aim of this research is to determine the quality of life (QOL) of mothers of children with ASD and the factors related to the QOL of mothers.Methods: The participants were 40 mothers of children who have a diagnosis of ASD and are aged from 2 to 7 years. The questionnaire of the World Health Organization WHOQOL-BREF was used as a measuring instrument.Results: The research found that the QOL of mothers of preschool children with ASD deviated from satisfactory in all domains. Household income and mother's level of education proved to be significant factors related to QOL. Mothers of children with ASD with higher average household incomes had better mental health, were more satisfied with their environment and showed better physical health. Furthermore, mothers with a higher level of education had better mental health and were more satisfied with their environment. However, the working status of the mother and the severity of the child's symptoms did not prove to be significant factors in this study.Conclusions: Knowing the exact areas of QOL that are impaired in mothers of children with ASD and the factors that affect it contributes to better family counseling and the creation of a partnership relationship with parents, and consequently to the achievement of the goals of support and provision of social support to mothers of children with ASD.
The Latency of Auditory Event-Related Potential P300 Prolonged in School-Age Students with Unilateral Hearing Loss in a Mandarin Learning Environment
Authors: Foo Hiu Che , Tang Chenwei , Kao Yuting , Wu Hsingmei , Chang Chelun , Wu Meiyao , Lo Yuchun , Weng Shihming
Published: May 2024

Abstract: Our study investigated the differences in speech performance and neurophysiological response in groups of school-age children with unilateral hearing loss (UHL) who were otherwise typically developing (TD). We recruited a total of 16 primary school-age children for our study (UHL = 9/TD = 7), who were screened by doctors at Shin Kong Wu-Ho-Su Memorial Hospital. We used the Peabody Picture Vocabulary Test–Revised (PPVT-R) to test word comprehension, and the PPVT-R percentile rank (PR) value was proportional to the auditory memory score (by The Children's Oral Comprehension Test) in both groups. Later, we assessed the latency and amplitude of auditory ERP P300 and found that the latency of auditory ERP P300 in the UHL group was prolonged compared with that in the TD group. Although students with UHL have typical hearing in one ear, based on our results, long-term UHL might be the cause of atypical organization of brain areas responsible for auditory processing or even visual perceptions attributed to speech delay and learning difficulties.
Factors influencing maternal death in Cambodia, Laos, Myanmar, and Vietnam countries: A systematic review
Authors: Win Pyae Phyo , Hlaing Thein , Win Hla Hla
Published: May 2024

Background

A maternal mortality ratio is a sensitive indicator when comparing the overall maternal health between countries and its very high figure indicates the failure of maternal healthcare efforts. Cambodia, Laos, Myanmar, and Vietnam-CLMV countries are the low-income countries of the South-East Asia region where their maternal mortality ratios are disproportionately high. This systematic review aimed to summarize all possible factors influencing maternal mortality in CLMV countries.

Methods

This systematic review applied "The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist (2020)", Three key phrases: "Maternal Mortality and Health Outcome", "Maternal Healthcare Interventions" and "CLMV Countries" were used for the literature search. 75 full-text papers were systematically selected from three databases (PubMed, Google Scholar and Hinari). Two stages of data analysis were descriptive analysis of the general information of the included papers and qualitative analysis of key findings.

Results

Poor family income, illiteracy, low education levels, living in poor households, and agricultural and unskilled manual job types of mothers contributed to insufficient antenatal care. Maternal factors like non-marital status and sex-associated work were highly associated with induced abortions while being rural women, ethnic minorities, poor maternal knowledge and attitudes, certain social and cultural beliefs and husbands’ influences directly contributed to the limitations of maternal healthcare services. Maternal factors that made more contributions to poor maternal healthcare outcomes included lower quintiles of wealth index, maternal smoking and drinking behaviours, early and elderly age at marriage, over 35 years pregnancies, unfavourable birth history, gender-based violence experiences, multigravida and higher parity. Higher unmet needs and lower demands for maternal healthcare services occurred among women living far from healthcare facilities. Regarding the maternal healthcare workforce, the quality and number of healthcare providers, the development of healthcare infrastructures and human resource management policy appeared to be arguable. Concerning maternal healthcare service use, the provisions of mobile and outreach maternal healthcare services were inconvenient and limited.

Conclusion

Low utilization rates were due to several supply-side constraints. The results will advance knowledge about maternal healthcare and mortality and provide a valuable summary to policymakers for developing policies and strategies promoting high-quality maternal healthcare.