bluuebunny/crossref_metadata_2025 huggingface dataset:
ENDOPROSTHETIC REPLACEMENT FOR NON-ONCOLOGICAL CONDITIONS (EPRO) STUDY: A UK MULTICENTRE STUDY INTO CLINICAL OUTCOMES OF PROXIMAL FEMORAL REPLACEMENT
Authors: Wijesekera Maheshi , East Jamie , Chan Corey D , Hadfield James , As-Sultany Mohammed , Kassam Al-Amin , Petheram Tim , Jones Henry Wynn , Palan Jeya , Jain Sameer
Published: May 2024

This large UK multicentre study evaluates clinical outcomes and identifies factors associated with local complication following PFR for non-oncological conditions.

132 patients across four UK centres underwent PFR from 01/08/2004-28/03/2023 with median follow-up of 1.9 (Q10.5-Q34.2) years. 75 (56.8%) patients were female and the mean age was 74.0 (SD 11.7) years. 103 (78%) patients had Charleston Comorbidity Index â‰¥3. ASA class was III or IV in 66.6%. Indications were infected revision (39, 29.5%), periprosthetic fracture (36, 27.3%), acute trauma (30, 22.7%), aseptic revision (17, 12.9%), failed trauma (nine, 6.8%) and complex primary arthroplasty (one, 0.8%). The primary outcome was the local complication rate. Secondary outcomes were systemic complications, reoperation and mortality rates. Comparisons were made with t-tests and Chi2 tests to investigate patient and surgical factors associated with local complication. Statistical significance was p<0.05.

There were 37(28.0%) local complications. These were 18 (13.6%) dislocations, eight (6.1%) prosthetic joint infections, four (3.0%) haematomas, three (2.3%) superficial infections, one (0.8%) wound dehiscence, one (0.8%) sciatic nerve palsy and one (0.8%) femoral perforation. Dislocation mostly occurred in conventional articulations (12, 9.1%) followed by dual-mobility cups (three, 2.3%), constrained cups (two, 1.5%) and hemiarthroplasty (one, 0.8%). Median time to local complication was 30 (Q14-Q3 133) days. Seven (5.3%) patients developed a systemic complication. Thirty-three (25.0%) patients underwent reoperation. Thirty-day and one-year mortality rates were 3.8% and 12.1%, respectively. Longer surgical waiting times (7.9 \[SD 16.9) versus 2.6 \[SD 4.4\] days, p<0.001) and longer operating times (212.5 \[SD 71.8\] versus 189.4 \[SD 59.3\] mins, p=0.0450) were associated with local complication.

Due to its high complication rate, PFR should be a salvage option when performed for non-oncological indications. Conventional articulations should be avoided. PFR should be delivered in a timely manner and ideally as dual-consultant cases to reduce operating time.
ACHIEVING DISTAL FIXATION AND EARLY MOBILIZATION IN PATIENTS WITH SEVERE FEMORAL BONE LOSS USING AN INTERNAL PROXIMAL FEMORAL REPLACEMENT PROSTHESIS
Authors: Menakaya Chinyelu , Durand-Hill Matthieu , Carrington Richard , Hart Alister , Donaldson James , Miles Jonathan , Briggs Timothy , Skinner John
Published: May 2024

The management of femoral bone loss is challenging during revision hip arthroplasty. In patients with Paprosky grade IIIB and IV defects, obtaining fixation and rotational stability using traditional surgical constructs is difficult. The use of a custom-made internal proximal femoral replacement prostheses has been proposed as a solution in patients, with severe femoral bone stock loss. However, there is a paucity in the literature on their use and long-term outcomes. We report on the clinical and radiological results of our cohort.

We retrospectively reviewed all patients who underwent internal proximal femoral replacement for revision hip arthroplasty between April 1996 and April 2019. All patients had at least 2 years of follow-up time.

160 patients underwent limb salvage at our institution using internal proximal femoral replacement. The mean follow-up was 79.7 months (S.D 41.3). Indications for revision included periprosthetic fractures, aseptic loosening, and deep infection. The mean Oxford hip score increased from 13.8 (0–22) to 31.5 (18–43) (paired t-test, p < 0.001). Kaplan-Meier prosthesis survival analysis with revision as the endpoint was 87% at 5 years. None required revision of the femoral stem. There were four dislocations (5%) and there was failure to eradicate the deep infection in four.

This technique allows instant distal fixation, allowing for early mobilisation. Long-term clinical and radiological outcomes are encouraging and the complication rates are acceptable for this patient group.
A GEOMETRIC MODEL OF IMPINGEMENT DURING DISLOCATION-PRONE ACTIVITIES IN DUAL-MOBILITY AND STANDARD ACETABULAR CUPS
Authors: Williams Simon , Smeeton Mackenzie , Isaac Graham , Anderson James , Wilcox Ruth , Board Tim , Williams Sophie
Published: May 2024

Dual Mobility (DM) Total Hip Replacements (THRs), are becoming widely used but function in-vivo is not fully understood.

The aim of this study was to compare the incidence of impingement of a modular dual mobility with that of a standard cup.

A geometrical model of one subject's bony anatomy \[1\] was developed, a THR was implanted with the cup at a range of inclination and anteversion positions (Corail® stem, Pinnacle® cup (DePuy Synthes)). Two DM variants and one STD acetabular cup were modelled. Joint motions were taken from kinematic data of activities of daily living associated with dislocation \[2\] and walking. The occurrence of impingement was assessed for each component combination, orientation and activity. Implant-implant impingement can occur between the femoral neck and the metal or PE liner (DM or STD constructs respectively) or neck-PE mobile liner (DM only).

The results comprise a colour coded matrix which sums the number of impingement events for each cup position and activity and for each implant variant.

Neck-PE mobile liner impingement, occurred for both DM sizes, for all activities, and most cup placement positions indicating that the PE mobile liner is likely to move at the start of all activities including walking.

For all constructs no placement positions avoided neck-metal (DM) or neck-PE liner (STD) impingementevents in all activities. The least number of events occurred at higher inclination and anteversion component positions. In addition to implant-implant impingement, some instances of bone-bone and implant-bone impingement were also observed.

Consistent with DM philosophy, neck-PE mobile liner impingement and liner motion occurred for all activities including walking. Neck-liner impingement frequency was comparable between both DM sizes (metal liner) and a standard cup (PE liner).
OUTCOMES OF PRIMARY JOINT REPLACEMENT IN PATIENTS WHO ARE INTRAVENOUS DRUG USERS: A SYSTEMATIC REVIEW
Authors: Stedman Tobias , Hatfield Thomas , McWilliams Anthony
Published: May 2024

Arthroplasty in patients who are intravenous drug abusers presents a complex challenge, frequently requiring intervention at a younger age. The cohort suffer increased complication rates due to significant co-morbidities and poor engagement in medical services, in comparison to other patients undergoing lower limb arthroplasty. Multiple small studies show arthroplasty in this patient cohort is associated with high complication and mortality rates.

A search of electronic databases were undertaken with the assistance of the library services from the Rotherham NHS Foundation Trust, including Chocraine, SCOPUS and PubMed.

Abstracts were reviewed and relevant studies extracted for full review. Full text articles were reviewed based on strict inclusion and exclusion criteria.

Searches identified Two thousand and forty-four papers; twenty-seven studies were identified for full review of the paper based on the inclusion criteria above. From this, nine studies were deemed appropriate to for data extraction.

These nine papers present one hundred and thirty-two cases of lower limb arthroplasty, fifty nine Total Knee Arthroplasty and seventy three Total Hip Arthroplasty. From this the authors examined incidences of implant failure due to infection, revision, mortality, dislocation, aseptic loosening, peri-prosthetic fracture, or other causes. Of these, 58% of patients (n = 77) with a history of intravenous drug abuse suffered some form of significant complication; 4% of this cohort (n = 5) were lost to follow up. Infection was reported in 32% of cases and a mortality rate of 4.7%.

The rising demand of lower limb arthroplasty for intra-venous drug abusers presents a very real problem for the modern Orthopaedic surgeon. Within the studies examined, more than half report implant failure. This study synthesises the available literature regarding treatment of these patients to help facilitate decision making and informed consent.
RELIABILITY AND VALIDITY OF THE REVISION HIP COMPLEXITY CLASSIFICATION
Authors: Buadooh Kwame Junior , Holmes Benjamin , Ng Aaron
Published: May 2024

The Revision Hip Complexity Classification (RHCC) was developed by modified Delphi system in 2022 to provide a comprehensive, reproducible framework for the multidisciplinary discussion of complex revision hip surgery. The aim of this study was to assess the validity, intra-relater and inter-relater reliability of the RHCC.

Radiographs and clinical vignettes of 20 consecutive patients who had undergone revision of Total Hip Arthroplasty (THA) at our unit during the previous 12-month period were provided to observers. Five observers, comprising 3 revision hip consultants, 1 hip fellow and 1 ST3-8 registrar were familiarised with the RHCC. Each revision THA case was classified on two separate occasions by each observer, with a mean time between assessments of 42.6 days (24–57). Inter-observer reliability was assessed using the Fleiss™ Kappa statistic and percentage agreement. Intra-observer reliability was assessed using the Cohen Kappa statistic. Validity was assessed using percentage agreement and Cohen Kappa comparing observers to the RHCC web-based application result.

All observers were blinded to patient notes, operation notes and post-operative radiographs throughout the process.

Inter-observer reliability showed fair agreement in both rounds 1 and 2 of the survey (0.296 and 0.353 respectively), with a percentage agreement of 69% and 75%.

Inter-observer reliability was highest in H3-type revisions with kappa values of 0.577 and 0.441.

Mean intra-observer reliability showed moderate agreement with a kappa value of 0.446 (0.369 to 0.773).

Validity percentage agreement was 44% and 39% respectively, with mean kappa values of 0.125 and 0.046 representing only slight agreement.

This study demonstrates that classification using the RHCC without utilisation of the web-based application is unsatisfactory, showing low validity and reliability. Reliability was higher for more complex H3-type cases. The use of the RHCC web app is recommended to ensure the accurate and reliable classification of revision THA cases.
ASSOCIATION BETWEEN SURGEON AND CENTRE VOLUME AND OUTCOME OF FIRST-TIME REVISION HIP ARTHROPLASTY FOR ASEPTIC LOOSENING: A STUDY USING THE NJR DATASET
Authors: Holleyman Richard , Jameson Simon , Reed Mike , Meek Dominic , Khanduja Vikas , Judge Andy , Board Tim
Published: May 2024

This study evaluates the association between consultant and hospital volume and the risk of re-revision and 90-day mortality following first-time revision of primary hip replacement for aseptic loosening.

We conducted a cohort study of first-time, single-stage revision hip replacements (RHR) performed for aseptic loosening and recorded in the National Joint Registry (NJR) data for England, Wales, Northern Ireland, and the Isle of Man between 2003 and 2019. Patient identifiers were used to link records to national mortality data, and to NJR data to identify subsequent re-revision procedures. Multivariable Cox proportional hazard models with restricted cubic splines were used to define associations between volume and outcome.

Among 12,676 RHR there were 513 re-revisions within two years, and 95 deaths within 90 days of surgery. The risk of re-revision was highest for a consultant's first RHR (Hazard Ratio (HR) 1·58 (95%CI 1·16 to 2·15)) and remained significantly elevated for their first 26 cases (HR 1·26 (95%CI 1·00 to 1·58)). Annual consultant volumes of five/year were associated with an almost 30% greater risk of re-revision (HR 1·28 (95%CI 1·00 to 1·64)) and 80% greater risk of 90-day mortality (HR 1·81 (95%CI 1·02 to 3·21)) compared to volumes of 20/year. RHR performed at hospitals which had cumulatively undertaken fewer than 168 RHR were at up to 70% greater risk of re-revision (HR 1·70 (95% CI 1·12 to 2·60)), and those having undertaken fewer than 309 RHR were at up to three times greater risk of 90-day mortality (HR 3·06 (95% CI 1·19 to 7·86)).

This study found a significantly higher risk of re-revision and early postoperative mortality following first-time single-stage RHR for aseptic loosening when performed by lower-volume consultants and at lower-volume institutions, supporting the move towards the centralisation of such cases towards higher-volume units and surgeons.
CEPHALOMEDULLARY NAILING FOR SUBTROCHANTERIC FEMORAL SHAFT FRACTURES: A COMPARISON OF SINGLE LAG SCREW DEVICE WITH AN INTERCALATED DUAL SCREW DEVICE
Authors: McCann Conor , Ablett Andrew , Feng Tony , Macaskill Victoria , Oliver William , Keating John
Published: May 2024

Subtrochanteric femoral fractures are a subset of hip fractures generally treated with cephalomedullary nail fixation\[1\]. Single lag screw devices are most commonly-used, but integrated dual screw constructs have become increasingly popular\[2,3\]. The aim of this study was to compare outcomes of fixation of subtrochanteric femoral fractures using a single lag screw (Gamma3 nail, GN) with a dual screw device (InterTAN nail, IN). The primary outcome was mechanical failure, defined as lag screw cut-out, back-out, nail breakage or peri-implant fracture.

Consecutive adult patients (18yrs) with subtrochanteric femoral fracture treated in a single centre were retrospectively identified using electronic records. Patients that underwent surgical fixation using either a long GN (2010–2017) or IN (2017–2022) were included. Medical records and radiographs were reviewed to identify complications of fixation. Cox regression analysis was used to determine the risk of mechanical failure and secondary outcomes by implant design. Multivariable regression models were used to identify predictors of mechanical failure.

The study included 622 patients, 354 in the GN group (median age 82yrs, 72% female) and 268 in the IN group (median age 82yrs, 69% female). The risk of any mechanical failure was increased two-fold in the GN group (HR 2.44 \[95%CI 1.13 to 5.26\]; _p=0.024_). Mechanical failure comprising screw cut-out (_p=0.032_), back-out (_p=0.032_) and nail breakage (_p=0.26_) was only observed in the GN group. Technical predictors of failure included varus >5° for cut-out (OR 19.98 \[2.06 to 193.88\]; _p=0.01_), TAD;25mm for back-out (8.96 \[1.36 to 58.86\]; p=0.022) and shortening 1cm for peri-implant fracture (7.81 \[2.92 to 20.91\]; _p=<0.001_).

Our results demonstrate that an intercalated screw construct is associated with a lower risk of mechanical failure compared with the a single lag screw device. Intercalated screw designs may reduce the risk of mechanical complications for patients with subtrochanteric femoral fractures.
A Half Century of U.S. Hispanic/Latino Catholicism: Planting Seeds of Synodality
Authors: Deck Allan Figueroa
Published: May 2024

Abstract: The Encuentro processes, initiated in 1971, offer a lens to understand the growth of Hispanic/Latino presence and ministry in the United States. The Encuentros constitute the officially sanctioned vision for being church and proceeding in the pastoral care of U.S. Hispanic/Latinos. Their methodology derives from the creative reception of the spirit of Vatican II in Latin America. Many of the main features of the ecclesiology and pastoral care developed in Latin America have been adapted and replicated in U.S. Hispanic/Latino contexts. This article explores features of this symbiotic and synergistic relationship with the Latin American Church as correlated to the historical development of U.S. Hispanic/Latino Catholicism and Pope Francis’s monumental reform efforts, especially the implementation of the synodal pathway.
“San Juan is Catholic”: The Hijas de María in Puerto Rico’s Parishes and Streets, 1872–1918
Authors: Ulrickson Maria Cecilia
Published: May 2024

Abstract: The Hijas de María, a global Catholic laywomen’s organization, were active in Puerto Rico from the end of Spanish rule through North American rule. Their organizational structure and their pieties buttressed the Church’s few pastors and, after the North American invasion, its new hierarchy. In the space that the institutional Church could not fill, the Hijas’ devotions provided the laity with new, feminized paths for holiness. The devotional life of the Hijas de María developed within new global currents in the Church, including increasing Roman influence and a greater focus on children and their potential sanctity. This is also a story of how Puerto Rican Catholic women met modernity and its secular influences and claimed the island for their own and the interests of religion and the Church.
The Speech without Doors: A Genre, 1627–1769
Authors: Lowe Ruby
Published: May 2024

Abstract: In 1644 George Wither stood outside or without the doors of the House of Commons and delivered a speech to Parliament and the nation simultaneously. Not only did this “print oration” function as a prototype for  Areopagitica, A Speech of John Milton [. . .] to the Parliament of England , but it inspired a genre of print pamphlets that would extend well into the eighteenth century. This article identifies and argues for the popular consequences of the genre, detailing its contribution to England’s developing structure of political communication and representation.
“How to Become a Rock”: Non-Human Metaphors as Trans Paranarratives
Authors: Van den Bossche Sven
Published: May 2024

ABSTRACT: Non-human metaphors, including animal metaphors, are widely used to evoke trans experiences, but the blooming flowers and hatching butterflies are often reduced to mere tropes or clichés. This article investigates what a narrative approach to these non-human metaphors can offer us to reconceptualize trans existence. I employ Benjamin Biebuyck and Gunther Martens’s concept of the ‘paranarrative,’ which allows us to look at metaphors as creating an additional narrative layer where aspects of the main narrative can be deepened, nuanced, or even contested. In two case studies, I unearth hidden sides of trans experience evoked through non-human metaphors on a paranarrative level. In Marieke Lucas Rijneveld’s novel Mijn lieve gunsteling , animal metaphors ranging from otters to birds bring to the surface a view of transness not limited to gender, but one that entails feelings of isolation and even uncontrollable desires. The metaphors in the novel Wormmaan by Mariken Heitman likewise raise attention to the connectedness between human, plants, and matter that society has tried to contain in limiting categorizations, such as gender divisions. By broadening the scope of trans as an embodied experience across various boundaries, this article calls for an expansive approach to trans narratology that reaches beyond gender towards the variety of affects that trans is capable of exposing.
“Catachresis at the Origin”: Names and Power in Toni Morrison’s Fiction
Authors: Singh Amardeep
Published: May 2024

Abstract: Toni Morrison’s fiction is replete with characters who carry nicknames, who rename themselves, or are renamed by others. Some misnamings carry the stories of histories of marginalization and oppression—as with the “drunken yankee” responsible for the naming of Macon Dead in Song of Solomon . Morrison’s characters also rename themselves to resist the legacy of American slavery and institutionalized racism. What ties Morrison’s namings, misnamings, and renamings together is the sense that there is no path to the recovery of true names for many African American people. The consequence is not powerlessness; rather, the “catachresis at the origin” that Gayatri Spivak refers to is intuited organically by many Morrison characters, who embrace misnaming and rename themselves as a mode of claiming self-ownership. Catachresis may begin as rhetorical violence imposed from without, but in Toni Morrison’s fiction, it can end as an opportunity to assert power, autonomy, and a boundless creativity.
The Haunting Absence of Language: How Toni Morrison’s Spectral Formula Unlocks Marginalized Counter-Narratives in Current Gothic American Literature
Authors: Olivarez Rory
Published: May 2024

Abstract: Is Toni Morrison still here? Rather than exorcising Beloved by ordering that her story not be passed on, it appears that the author and her shade have been embraced and remain firmly rooted in current Gothic American literature. Morrison honed the spectral, liberating undocumented Black American slave counter-narratives and exposing concealed ancestral trauma. The fecundity of her contribution is celebrated in Jesmyn Ward’s Sing, Unburied, Sing and Angela Flournoy’s The Turner House , both of which employ such ghosts to engage with and enlighten their nescient descendants. In this article, I examine the gap in the scholarly conversation on the proliferation of a spectral formula established in Beloved that echoes through current literary works entailing a corporeal ghost, related to the living characters, haunted by a historically invalidated trauma, that is only released by reintegration rather than exorcism.
Multimodal analysis of traction forces and the temperature dynamics of living cells with a diamond-embedded substrate
Authors: Kołodziej Tomasz , Mrózek Mariusz , Sengottuvel Saravanan , Głowacki Maciej J. , Ficek Mateusz , Gawlik Wojciech , Rajfur Zenon , Wojciechowski Adam M.
Published: May 2024

Cells and tissues are constantly exposed to chemical and physical signals that regulate physiological and pathological processes. This study explores the integration of two biophysical methods: traction force microscopy (TFM) and optically detected magnetic resonance (ODMR) to concurrently assess cellular traction forces and the local relative temperature. We present a novel elastic substrate with embedded nitrogen-vacancy microdiamonds that facilitate ODMR-TFM measurements. Optimization efforts focused on minimizing sample illumination and experiment duration to mitigate biological perturbations. Our hybrid ODMR-TFM technique yields TFM maps and achieves approximately 1 K precision in relative temperature measurements. Our setup employs a simple wide-field fluorescence microscope with standard components, demonstrating the feasibility of the proposed technique in life science laboratories. By elucidating the physical aspects of cellular behavior beyond the existing methods, this approach opens avenues for a deeper understanding of cellular processes and may inspire the development of diverse biomedical applications.
First-order quantum phase transition in the two-qubit squeezed Rabi model
Authors: Pei Xuan-Tong , Shi Zhi-Cheng , Shen Li-Tuo , Yang Zhen-Biao
Published: May 2024

We study the ground state of the two-qubit squeezed Rabi model. Two special transformations are found to diagonalize the system Hamiltonian when each qubit’s frequency is close to the field frequency, where both the squeezing and counterrotating-wave interactions are removed, leading to an effective integrable Hamiltonian. The analytical ground state is determined and matches with numerical solutions well for a range of squeezing strengths and qubit-field detunings in the ultrastrong-coupling regime. We demonstrate that the ground state exhibits a first-order quantum phase transition at a phase boundary linearly induced by the squeezed light. We characterize the two-qubit negativity analytically and find that its two-qubit entanglement increases with the increasing squeezing strength nonlinearly. The average photon numbers of the field mode and variances of position and momentum quadratures are also analyzed and discovered to have a nonlinear relation with the squeezing strength. Finally, we discuss the experimental scheme and realization possibility of the predicted results.
Optimization of the structure, morphology and luminescent properties of NaYF4 upconversion nanoparticles
Authors: Li Yufeng , Li Xin , Zhang Wei , Zhang Dongliang , Wang Mitang
Published: May 2024

We designed and constructed rare earth doped upconversion nanoparticles β-Na(Y0.78Yb0.18Er0.04)F4, sensitizing layer encapsulated β-Na(Y0.9Er0.1)F4@β-NaYbF4 and inert layer encapsulated β-Na(Y0.9Er0.1)F4@β-NaYbF4@β-NaYF4. Compared with the mononuclear material, the luminescence intensity of the particles encapsulated with double shells in the three main bands of blue, green and red emissions increased by 346, 22, and 54 times respectively. While improving the upconversion luminescence performance, the underlying reasons for this improvement were analyzed in detail. The effects of shell coating on the fluorescence lifetime, thermal stability and energy level transition are discussed. On this basis, the composite film material was constructed by combining the shell coating strategy and the plasma resonance interaction strategy, which further improved the upconversion efficiency. In addition, by combining performance optimized upconversion particles with information coding, we explored its potential as an anti-counterfeiting material.
Coulomb-induced emission time shifts in high-order harmonic generation from H2+
Authors: Li Yangyang , Song Siqi , Han Yongkang , Yue Shengjun , Du Hongchuan
Published: May 2024

Accurate emission times of high-order harmonic generation (HHG) are vital for high-precision ultrafast detection in attosecond science, but a quantitative analysis of Coulomb effects on this time is absent in the molecular HHG. Here, we investigate the Coulomb-induced emission-time shift in HHG of H2+ with two different internuclear distances R, where the times obtained via the Gabor transform of numerical data from solving the time-dependent Schrödinger equation are used as simulation experiment results. Based on the molecular strong-field approximation, we develop a trajectory-resolved classical model that takes into account the molecular two-center structure. By selecting appropriate electron trajectories and including Coulomb interactions, the classical trajectory method can reproduce Gabor emission times well. This consistence reveals that Coulomb tails cause an emission-time shift of ∼35 as at the R = 2.0 a.u. case and of ∼40-60 as at the R = 2.6 a.u. case under the present laser parameters when compared to the Coulomb-free quantum-orbit model. Our results are of significance to probe the attosecond dynamics via two-center interference.
Twisted splitting and propagation factor of superimposed twisted Hermite-Gaussian Schell-model beams in turbulent atmosphere
Authors: Huang Qiangguo , Zhang Shaohua , Zhou Zhenglan , Xie Chen , Qu Jun
Published: May 2024

We believe this to be a new superposition twisted Hermite-Gaussian Schell-model (STHGSM) beam hat is proposed. Analytic formulas for the intensity distribution and propagation factor of the STHGSM beam in non-Kolmogorov turbulence are derived by utilizing the generalized Huygens-Fresnel principle (HFP) and the Wigner function. The evolution characteristics of STHGSM beams propagating are numerically calculated and analyzed. Our findings indicate that the light intensity of the STHGSM beam gradually undergoes splitting and rotation around the axis during propagation through non-Kolmogorov turbulence, eventually evolving into a diagonal lobe shape at a certain distance of transmission. The anti-turbulence capability of the beam strengthens with higher beam order or twist factor values.
Theory of Rayleigh-Brillouin optical activity light scattering applicable to chiral liquids
Authors: Cameron Robert P. , Alexakis Emmanouil , Arnold Aidan , McArthur Duncan
Published: May 2024

It has long been understood that dilute samples of chiral molecules such as rarefied gases should exhibit Rayleigh optical activity. We extend the existing theory by accounting for molecular dynamics and correlations, thus obtaining a more general theory of Rayleigh-Brillouin optical activity applicable to dense samples such as neat liquids.
Exploring HIV risk perception mechanisms among youth in a test-and-treat trial in Kenya and Uganda
Authors: Owino Lawrence , Johnson-Peretz Jason , Lee Joi , Getahun Monica , Coppock-Pector Dana , Maeri Irene , Onyango Anjeline , Cohen Craig R. , Bukusi Elizabeth A. , Kabami Jane , Ayieko James , Petersen Maya , Kamya Moses R. , Charlebois Edwin , Havlir Diane , Camlin Carol S.
Published: May 2024

Understanding risk perception and risk-taking among youth can inform targeted prevention efforts. Using a health beliefs model-informed framework, we analysed 8 semi-structured, gender-specific focus group discussions with 93 youth 15–24 years old (48% male, 52% female), drawn from the SEARCH trial in rural Kenya and Uganda in 2017–2018, coinciding with the widespread introduction of PrEP. Highly connected social networks and widespread uptake of antiretrovirals shaped youth HIV risk perception. Amid conflicting information about HIV prevention methods, youth felt exposed to multiple HIV risk factors like the high prevalence of HIV, belief that people with HIV(PWH) purposefully infect others, dislike of condoms, and doubts about PrEP efficacy. Young women also reported minimal sexual autonomy in the context of economic disadvantages, the ubiquity of intergenerational and transactional sex, and peer pressure from other women to have many boyfriends. Young men likewise reported vulnerability to intergenerational sex, but also adopted a sexual conquest mentality. Comprehensive sexuality education and economic empowerment, through credible and trusted sources, may moderate risk-taking. Messaging should leverage youth’s social networks to spread fact-based, gender- and age-appropriate information. PrEP should be offered alongside other reproductive health services to address both pregnancy concerns and reduce HIV risk.
Relapses of juvenile idiopathic arthritis in adulthood: A monocentric experience
Authors: Scagnellato Laura , Cozzi Giacomo , Prosepe Ilaria , Lorenzin Mariagrazia , Doria Andrea , Martini Giorgia , Zulian Francesco , Ramonda Roberta
Published: May 2024

Introduction

Our aim was to describe a monocentric cohort of young adult patients with juvenile idiopathic arthritis (JIA), assessing the risk of relapse after transition to adult care.

Methods

We conducted a retrospective study and collected clinical, serological, and demographic data of young adult patients (18–30 years old) referred to the Transition Clinic of a single Italian centre between January 2020 and March 2023. Patients with systemic-onset JIA were excluded. Primary outcome was disease relapse, defined by Wallace criteria. Risk factors were analysed by Cox proportional hazards regression.

Results

Fifty patients with age 18–30 years old were enrolled in the study and followed for a median 30 months. The median disease duration at transition was 15 years. Twenty (40%) patients were on conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and 38 (76%) were on biological DMARDs through adulthood. Twenty-three patients relapsed after transitioning to adult care for a median 9-month follow-up (IQR 0–46.5). Most relapses involved the knees (69.6%). The univariate analysis identified monoarthritis (HR 4.67, CI 1.069–20.41, p value = 0.041) as the main risk factor for relapse within the first 36 months of follow-up. Early onset, ANA positivity, past and ongoing treatment with csDMARDs or bDMARDs, therapeutic withdrawal, and disease activity within 12 months before transition did not significantly influence the risk of relapse.

Conclusion

In JIA patients, the risk of relapse after transitioning to adult care remains high, irrespective of disease subtype and treatment. The main risk factor for the early occurrence of articular activity is monoarticular involvement.
Development and evaluation of a usable blastocyst predictive model using the biomechanical properties of human oocytes
Authors: Meyer Daniel , Kort Jonathan , Chen Ching Hung , Zhao Huan , Yi Xiaoling , Lai Shin-Yu , Lu Farn , Yang Wen Jui , Hsieh I-Chiao , Chiang Chung-Li , Chen Wei-Ming , Huang Jack Yu Jen , Camarillo David , Behr Barry
Published: May 2024

Purpose

The purposes of this study were to determine whether biomechanical properties of mature oocytes could predict usable blastocyst formation better than morphological information or maternal factors, and to demonstrate the safety of the aspiration measurement procedure used to determine the biomechanical properties of oocytes.

Methods

A prospective split cohort study was conducted with patients from two IVF clinics who underwent in vitro fertilization. Each patient’s oocytes were randomly divided into a measurement group and a control group. The aspiration depth into a micropipette was measured, and the biomechanical properties were derived. Oocyte fertilization, day 3 morphology, and blastocyst development were observed and compared between measured and unmeasured cohorts. A predictive classifier was trained to predict usable blastocyst formation and compared to the predictions of four experienced embryologists.

Results

68 patients and their corresponding 1252 oocytes were included in the study. In the safety analyses, there was no significant difference between the cohorts for fertilization, while the day 3 and 5 embryo development were not negatively affected. Four embryologists predicted usable blastocyst development based on oocyte morphology with an average accuracy of 44% while the predictive classifier achieved an accuracy of 71%. Retaining the variables necessary for normal fertilization, only data from successfully fertilized oocytes were used, resulting in a classifier an accuracy of 81%.

Conclusions

To date, there is no standard guideline or technique to aid in the selection of oocytes that have a higher likelihood of developing into usable blastocysts, which are chosen for transfer or vitrification. This study provides a comprehensive workflow of extracting biomechanical properties and building a predictive classifier using these properties to predict mature oocytes’ developmental potential. The classifier has greater accuracy in predicting the formation of usable blastocysts than the predictions provided by morphological information or maternal factors. The measurement procedure did not negatively affect embryo culture outcomes. While further analysis is necessary, this study shows the potential of using biomechanical properties of oocytes to predict embryo developmental outcomes.
The prone position in COVID-19 impacts the thickness of peripapillary retinal nerve fiber layers and macular ganglion cell layers
Authors: Chirapapaisan Niphon , Eiamsamarng Akarawit , Chuenkongkaew Wanicha , Rattanathamsakul Natthapon , Ratanarat Ranistha
Published: May 2024

The prone position reduces mortality in severe cases of COVID-19 with acute respiratory distress syndrome. However, visual loss and changes to the peripapillary retinal nerve fiber layer (p-RNFL) and the macular ganglion cell layer and inner plexiform layer (m-GCIPL) have occurred in patients undergoing surgery in the prone position. Moreover, COVID-19-related eye problems have been reported. This study compared the p-RNFL and m-GCIPL thicknesses of COVID-19 patients who were placed in the prone position with patients who were not. This prospective longitudinal and case-control study investigated 15 COVID-19 patients placed in the prone position (the “Prone Group”), 23 COVID-19 patients not in the prone position (the “Non-Prone Group”), and 23 healthy, non-COVID individuals without ocular disease or systemic conditions (the “Control Group”). The p-RNFL and m-GCIPL thicknesses of the COVID-19 patients were measured at 1, 3, and 6 months and compared within and between groups. The result showed that the Prone and Non-Prone Groups had no significant differences in their p-RNFL thicknesses at the 3 follow-ups. However, the m-GCIPL analysis revealed significant differences in the inferior sector of the Non-Prone Group between months 1 and 3 (mean difference, 0.74 μm; P = 0.009). The p-RNFL analysis showed a significantly greater thickness at 6 months for the superior sector of the Non-Prone Group (131.61 ± 12.08 μm) than for the Prone Group (118.87 ± 18.21 μm; P = 0.039). The m-GCIPL analysis revealed that the inferior sector was significantly thinner in the Non-Prone Group than in the Control Group (at 1 month 80.57 ± 4.60 versus 83.87 ± 5.43 μm; P = 0.031 and at 6 months 80.48 ± 3.96 versus 83.87 ± 5.43 μm; P = 0.044). In conclusion, the prone position in COVID-19 patients can lead to early loss of p-RNFL thickness due to rising intraocular pressure, which is independent of the timing of prone positioning. Consequently, there is no increase in COVID-19 patients’ morbidity burden.
Urban-rural disparities in COVID-19 hospitalisations and mortality: A population-based study on national surveillance data from Germany and Italy
Authors: Assche Simona Bignami-Van , Ferraccioli Federico , Riccetti Nicola , Gomez-Ramirez Jaime , Ghio Daniela , Stilianakis Nikolaos I.
Published: May 2024

Purpose

Recent literature has highlighted the overlapping contribution of demographic characteristics and spatial factors to urban-rural disparities in SARS-CoV-2 transmission and outcomes. Yet the interplay between individual characteristics, hospitalisation, and spatial factors for urban-rural disparities in COVID-19 mortality have received limited attention.

Methods

To fill this gap, we use national surveillance data collected by the European Centre for Disease Prevention and Control and we fit a generalized linear model to estimate the association between COVID-19 mortality and the individuals’ age, sex, hospitalisation status, population density, share of the population over the age of 60, and pandemic wave across urban, intermediate and rural territories.

Findings

We find that in what type of territory individuals live (urban-intermediate-rural) accounts for a significant difference in their probability of dying given SARS-COV-2 infection. Hospitalisation has a large and positive effect on the probability of dying given SARS-CoV-2 infection, but with a gradient across urban, intermediate and rural territories. For those living in rural areas, the risk of dying is lower than in urban areas but only if hospitalisation was not needed; while for those who were hospitalised in rural areas the risk of dying was higher than in urban areas.

Conclusions

Together with individuals’ demographic characteristics (notably age), hospitalisation has the largest effect on urban-rural disparities in COVID-19 mortality net of other individual and regional characteristics, including population density and the share of the population over 60.
The economic burden of multimorbidity: Protocol for a systematic review
Authors: Banstola Amrit , Anokye Nana , Pokhrel Subhash
Published: May 2024

Multimorbidity, also known as multiple long-term conditions, leads to higher healthcare utilisation, including hospitalisation, readmission, and polypharmacy, as well as a financial burden to families, society, and nations. Despite some progress, the economic burden of multimorbidity remains poorly understood. This paper outlines a protocol for a systematic review that aims to identify and synthesise comprehensive evidence on the economic burden of multimorbidity, considering various definitions and measurements of multimorbidity, including their implications for future cost-of-illness analyses. The review will include studies involving people of all ages with multimorbidity without any restriction on location and setting. Cost-of-illness studies or studies that examined economic burden including model-based studies will be included, and economic evaluation studies will be excluded. Databases including Scopus (that includes PubMed/MEDLINE), Web of Science, CINAHL Plus, PsycINFO, NHS EED (including the HTA database), and the Cost-Effectiveness Analysis Registry, will be searched until March 2024. The risk of bias within included studies will be independently assessed by two authors using appropriate checklists. A narrative synthesis of the main characteristics and results, by definitions and measurements of multimorbidity, will be conducted. The total economic burden of multimorbidity will be reported as mean annual costs per patient and disaggregated based on counts of diseases, disease clusters, and weighted indices. The results of this review will provide valuable insights for researchers into the key cost components and areas that require further investigation in order to improve the rigour of future studies on the economic burden of multimorbidity. Additionally, these findings will broaden our understanding of the economic impact of multimorbidity, inform us about the costs of inaction, and guide decision-making regarding resource allocation and cost-effective interventions. The systematic review’s results will be submitted to a peer-reviewed journal, presented at conferences, and shared via an online webinar for discussion.
The influence of non-state-owned shareholder governance on the governance level of state-owned enterprises——Based on the perspective of board resolution behavior and party organization governance
Authors: Zhang Zhibin , Zhang Lishu , Xiong Aihua
Published: May 2024

With an increasing number of heterogeneous shareholders participating in corporate governance in reality, the assumption of shareholder homogeneity in agency theory is gradually relaxing in the modern field of corporate governance. The policy of mixed ownership reform in China provides empirical evidence for studying heterogeneous shareholder governance. To fully understand the governance effects of non-state shareholders, we employ the ownership proportion held by non-state shareholders among the top ten shareholders and the appointment of directors as measures for non-state shareholder governance. Using a panel fixed-effect model from the perspective of state-owned enterprises (SOEs) party organizations, we examine the impact of non-state shareholder governance on the governance level of SOEs. The study reveals that non-state shareholder governance positively affects the governance level of SOEs, with board resolutions playing a crucial role in this relationship. When party members serve as directors, the governance effect of non-state shareholders is more significant. Based on the aforementioned research findings, we recommend further refining corporate governance measures for SOEs within the context of SOE reforms. It is advisable to optimize the party organizational governance structure and leverage the synergistic effects of non-state shareholder governance and party organizational governance. Advancing reforms along the Pareto improvement path will contribute to establishing a distinctive corporate governance system for Chinese SOEs.
Stone decision engine accurately predicts stone removal and treatment complications for shock wave lithotripsy and laser ureterorenoscopy patients
Authors: Noble Peter A. , Hamilton Blake D. , Gerber Glenn
Published: May 2024

Kidney stones form when mineral salts crystallize in the urinary tract. While most stones exit the body in the urine stream, some can block the ureteropelvic junction or ureters, leading to severe lower back pain, blood in the urine, vomiting, and painful urination. Imaging technologies, such as X-rays or ureterorenoscopy (URS), are typically used to detect kidney stones. Subsequently, these stones are fragmented into smaller pieces using shock wave lithotripsy (SWL) or laser URS. Both treatments yield subtly different patient outcomes. To predict successful stone removal and complication outcomes, Artificial Neural Network models were trained on 15,126 SWL and 2,116 URS patient records. These records include patient metrics like Body Mass Index and age, as well as treatment outcomes obtained using various medical instruments and healthcare professionals. Due to the low number of outcome failures in the data (e.g., treatment complications), Nearest Neighbor and Synthetic Minority Oversampling Technique (SMOTE) models were implemented to improve prediction accuracies. To reduce noise in the predictions, ensemble modeling was employed. The average prediction accuracies based on Confusion Matrices for SWL stone removal and treatment complications were 84.8% and 95.0%, respectively, while those for URS were 89.0% and 92.2%, respectively. The average prediction accuracies for SWL based on Area-Under-the-Curve were 74.7% and 62.9%, respectively, while those for URS were 77.2% and 78.9%, respectively. Taken together, the approach yielded moderate to high accurate predictions, regardless of treatment or outcome. These models were incorporated into a Stone Decision Engine web application (http://peteranoble.com/webapps.html) that suggests the best interventions to healthcare providers based on individual patient metrics.
Population-based study of eclampsia: Lessons learnt to improve maternity care
Authors: Korb Diane , Azria Elie , Sauvegrain Priscille , Carbillon Lionel , Langer Bruno , Seco Aurélien , Chiesa-Dubruille Coralie , Bouvier-Colle Marie Hélène ,   Epimoms study group, Deneux-Tharaux Catherine
Published: May 2024

Background

Among hypertensive disorders of pregnancy (HDP), eclampsia is a rare but serious event, often considered avoidable. Detailed assessment of the adequacy of care for the women who have eclampsia can help identify opportunities for improvement and for prevention of the associated adverse maternal and neonatal outcomes.

Objective

1/ To estimate the incidence and describe the characteristics of women with eclampsia and to compare them with those of women with non-eclamptic hypertensive disorders of pregnancy (HDP)-related severe maternal morbidity (SMM) and of control women without SMM 2/ To analyse the quality of management in women who had eclampsia, at various stages of their care pathway.

Methods

It was a planned ancillary analysis of the EPIMOMS population-based study, conducted in six French regions in 2012–2013. Among the 182,309 maternities of the source population, all women with eclampsia (n = 51), with non-eclamptic HDP-related SMM (n = 351) and a 2% representative sample of women without SMM (n = 3,651) were included. Main outcome was the quality of care for eclampsia assessed by an independent expert panel at three different stages of management: antenatal care, care for pre-eclampsia and care for eclampsia.

Results

The eclampsia incidence was 2.8 per 10,000 (95%CI 2.0–4.0). Antenatal care was considered completely inadequate or substandard in 39% of women, as was pre-eclampsia care in 76%. Care for eclampsia was judged completely inadequate or substandard in 50% (21/42), mainly due to inadequate use of magnesium sulphate.

Conclusion

The high proportion of inadequate quality of care underlines the need for an evidence-based standardisation of care for HDP.
Surface roughness and cyclic fatigue resistance of a novel shaping system: An in-vitro study
Authors: Özel Beliz , Barut Güher , Baser Can Elif Delve
Published: May 2024

Recently developed Nickel-Titanium (NiTi) instruments with practical changes have resulted in safer instrumentation. In addition, topographical features on the file surface are a contributing factor to clinical durability. Therefore, this study aimed to investigate both the cyclic fatigue resistance and the roughness change of MTwo and Rotate instruments (VDW, Munich, Germany). Each instrument (n = 6/each group) was scanned with an atomic force microscopy prior to and after instrumentation. In addition, cyclic fatigue testing was conducted for each instrument (n = 11/each group) with stainless-steel blocks, including 45°-60°-90° degrees of curvature milled to the instruments’ size. The roughness parameters increased for both systems after instrumentation (p<0.05). Both systems presented an increased roughness following instrumentation (p<0.05). The cyclic fatigue resistance was lowest at 90° for both systems (p<0.05), whereas the Rotate files presented a higher resistance than that of the Mtwo files (p<0.05). Compared to the Mtwo files, Rotate files presented better resistance, while the resistance decreased as the curvature increased.