bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiolucent lines and revision risk in total knee arthroplasty using the conventional versus the Attune S+ tibial baseplate
Authors: Smolle Maria A. , Keintzel Maximilian , Staats Kevin , Böhler Christoph , Windhager Reinhard , Koutp Amir , Leithner Andreas , Donner Stefanie , Reiner Tobias , Renkawitz Tobias , Sava Manuel-Paul , Hirschmann Michael T. , Sadoghi Patrick
Published: November 2024

Aims

This multicentre retrospective observational study’s aims were to investigate whether there are differences in the occurrence of radiolucent lines (RLLs) following total knee arthroplasty (TKA) between the conventional Attune baseplate and its successor, the novel Attune S+, independent from other potentially influencing factors; and whether tibial baseplate design and presence of RLLs are associated with differing risk of revision.

Methods

A total of 780 patients (39% male; median age 70.7 years (IQR 62.0 to 77.2)) underwent cemented TKA using the Attune Knee System) at five centres, and with the latest radiograph available for the evaluation of RLL at between six and 36 months from surgery. Univariate and multivariate logistic regression models were performed to assess associations between patient and implant-associated factors on the presence of tibial and femoral RLLs. Differences in revision risk depending on RLLs and tibial baseplate design were investigated with the log-rank test.

Results

The conventional and novel Attune baseplates were used in 349 (45%) and 431 (55%) patients, respectively. At a median follow-up of 14 months (IQR 11 to 25), RLLs were present in 29% (n = 228/777) and 15% (n = 116/776) of the tibial and femoral components, respectively, and were more common in the conventional compared to the novel baseplate. The novel baseplate was independently associated with a lower incidence of tibial and femoral RLLs (both regardless of age, sex, BMI, and time to radiograph). One- and three-year revision risk was 1% (95% CI 0.4% to 1.9%)and 6% (95% CI 2.6% to 13.2%), respectively. There was no difference between baseplate design and the presence of RLLs on the the risk of revision at short-term follow-up.

Conclusion

The overall incidence of RLLs, as well as the incidence of tibial and femoral RLLs, was lower with the novel compared to the conventional tibial Attune baseplate design, but higher than in the predecessor design and other commonly used TKA systems.

Cite this article: Bone Joint J 2024;106-B(11):1240–1248.
Failed radial head arthroplasty treated by removal of the implant
Authors: Ameztoy Gallego Juan , Diez Sanchez Blanca , Vaquero-Picado Afonso , Antuña Samuel , Barco Raul
Published: November 2024

Aims

In patients with a failed radial head arthroplasty (RHA), simple removal of the implant is an option. However, there is little information in the literature about the outcome of this procedure. The aim of this study was to review the mid-term clinical and radiological results, and the rate of complications and removal of the implant, in patients whose initial RHA was undertaken acutely for trauma involving the elbow.

Methods

A total of 11 patients in whom removal of a RHA without reimplantation was undertaken as a revision procedure were reviewed at a mean follow-up of 8.4 years (6 to 11). The range of motion (ROM) and stability of the elbow were recorded. Pain was assessed using a visual analogue scale (VAS). The functional outcome was assessed using the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES), and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Radiological examination included the assessment of heterotopic ossification (HO), implant loosening, capitellar erosion, overlengthening, and osteoarthritis. Complications and the rate of further surgery were also recorded.

Results

The indications for removal of the implant were stiffness in five patients, aseptic loosening in five, and pain attributed to the RHA in three. The mean time interval between RHA for trauma to removal was ten months (7 to 21). Preoperatively, three patients had overlengthening of the implant, three had capitellar erosion, six had HO, and four had radiological evidence of loosening. At the final follow-up, the mean the flexion-extension arc improved significantly by 38.2° (95% CI 20 to 59; p = 0.002) and the mean arc of prono-supination improved significantly by 20° (95% CI 0 to 72.5; p = 0.035). The mean pain VAS score improved significantly by 3.5 (95% CI 2 to 5.5; p = 0.004). The mean MEPS improved significantly by 27.5 (95% CI 17.5 to 42.5; p = 0.002). The mean OES improved significantly by 9 (95% CI 2.5 to 14; p = 0.012), and the mean DASH score improved significantly by 23.5 (95% CI 7.5 to 31.6; p = 0.012). Ten patients (91%) had HO and osteoarthritis. Two patients underwent further surgery due to stiffness and pain, respectively.

Conclusion

Simple removal of the implant at revision surgery following a failed RHA introduced following trauma provides satisfactory mid-term results with an acceptable risk of complications. Osteoarthritis, instability, and radioulnar impingement were not problems in this series.

Cite this article: Bone Joint J 2024;106-B(11):1327–1332.
Core Outcome Domains for Elbow Replacement (CODER)
Authors: Watts Adam C. , McDaid Catriona , Hewitt Catherine
Published: November 2024

Aims

A review of the literature on elbow replacement found no consistency in the clinical outcome measures which are used to assess the effectiveness of interventions. The aim of this study was to define core outcome domains for elbow replacement.

Methods

A real-time Delphi survey was conducted over four weeks using outcomes from a scoping review of 362 studies on elbow replacement published between January 1990 and February 2021. A total of 583 outcome descriptors were rationalized to 139 unique outcomes. The survey consisted of 139 outcomes divided into 18 domains. The readability and clarity of the survey was determined by an advisory group including a patient representative. Participants were able to view aggregated responses from other participants in real time and to revisit their responses as many times as they wished during the study period. Participants were able to propose additional items for inclusion. A Patient and Public Inclusion and Engagement (PPIE) panel considered the consensus findings.

Results

A total of 45 respondents completed the survey. Nine core mandatory domains were identified: ‘return to work or normal daily role’; delivery of care was measured in the domains ‘patient satisfaction with the outcome of surgery’ and ‘would the patient have the same operation again’; ‘pain’; ‘revision’; ‘elbow function’; ‘independence in activities of daily living’; ‘health-related quality of life’; and ‘adverse events’. ‘Elbow range of motion’ was identified as important by consensus but was felt to be less relevant by the PPIE panel. The PPIE panel unanimously stated that pain should be used as the primary outcome domain.

Conclusion

This study defined core domains for the clinical outcomes of elbow replacement obtained by consensus from patients, carers, and healthcare professionals. Pain may be used as the primary outcome in future studies, where appropriate. Further work is required to define the instruments that should be used.

Cite this article: Bone Joint J 2024;106-B(11):xxx–xxx.
Management of the infected total elbow arthroplasty
Authors: Sanchez-Sotelo Joaquin
Published: November 2024

Periprosthetic joint infection represents a devastating complication after total elbow arthroplasty. Several measures can be implemented before, during, and after surgery to decrease infection rates, which exceed 5%. Debridement with antibiotics and implant retention has been reported to be successful in less than one-third of acute infections, but still plays a role. For elbows with well-fixed implants, staged retention seems to be equally successful as the more commonly performed two-stage reimplantation, both with a success rate of 70% to 80%. Permanent resection or even amputation are occasionally considered. Not uncommonly, a second-stage reimplantation requires complex reconstruction of the skeleton with allografts, and the extensor mechanism may also be deficient. Further developments are needed to improve our management of infection after elbow arthroplasty.

Cite this article: Bone Joint J 2024;106-B(11):1321–1326.
Efficacy of a saline wash plus vancomycin/tobramycin-doped PVA composite (PVA-VAN/TOB-P) in a mouse pouch infection model implanted with 3D-printed porous titanium cylinders
Authors: Markel David C. , Bou-Akl Therese , Wu Bin , Pawlitz Paula , Ren Weiping
Published: November 2024

Aims

The efficacy of saline irrigation for treatment of implant-associated infections is limited in the presence of porous metallic implants. This study evaluated the therapeutic efficacy of antibiotic doped bioceramic (vancomycin/tobramycin-doped polyvinyl alcohol composite (PVA-VAN/TOB-P)) after saline wash in a mouse infection model implanted with titanium cylinders.

Methods

Air pouches created in female BalBc mice by subcutaneous injection of air. In the first of two independent studies, pouches were implanted with titanium cylinders (400, 700, and 100 µm pore sizes) and inoculated with Staphylococcus aureus (1 × 103 or 1 × 106 colony-forming units (CFU)/pouch) to establish infection and biofilm formation. Mice were killed after one week for microbiological analysis. In the second study, pouches were implanted with 400 µm titanium cylinders and inoculated with S. aureus (1 × 103 or 1 × 106 CFU/pouch). Four groups were tested: 1) no bacteria; 2) bacteria without saline wash; 3) saline wash only; and 4) saline wash plus PVA-VAN/TOB-P. After seven days, the pouches were opened and washed with saline alone, or had an additional injection of PVA-VAN/TOB-P. Mice were killed 14 days after pouch wash.

Results

The first part of the study showed that low-grade infection was more significant in 400 µm cylinders than cylinders with larger pore sizes (p < 0.05). The second part of the study showed that saline wash alone was ineffective in eradicating both low- and high-grade infections. Saline plus PVA-VAN/TOB-P eradicated the titanium cylinder-associated infections, as manifested by negative cultures of the washouts and supported by scanning electron microscopy and histology.

Conclusion

Porous titanium cylinders were vulnerable to bacterial infection and biofilm formation that could not be treated by saline irrigation alone. Application of PVA-VAN/TOB-P directly into the surgical site alone or after saline wash represents a feasible approach for prevention and/or treatment of porous implant-related infections.

Cite this article: Bone Joint Res 2024;13(11):622–631.
Enlightened or ‘blinded by the light’?
Authors: Dobbs Tom
Published: November 2024

Used properly, technology has the power to transform surgery.
Predicting the future: using AI for clinical support in kidney transplantation
Authors: Knight S
Published: November 2024

Can machine learning help clinicians with decision making and improve outcomes?
State of the art for prosthetic reconstruction of the upper limb
Authors: Kang NV
Published: November 2024

We look at the advancements in prosthetics and how they could improve patient outcomes in the future.
Robots in surgery: what have we got ourselves into?
Authors: Rockall TA
Published: November 2024

Can robotic surgery lead the way to a more efficent and effective surgical industry?
The IDEAL framework and its applications: balancing innovation with safety
Authors: McCulloch P , Marcus HJ , Hanrahan JG
Published: November 2024

We must ensure that we do not sacrifice patient safety and proper training when exploring technological advancements in surgery.
Lead gloves and the deadly danger of early x-rays
Authors: Watkinson-Deane Alice
Published: November 2024

We take a look at how healthcare practitioners developed protections against the damage of x-rays.
Somos un pueblo sin fronteras : Contending with INS Terror during Chicago’s Chicano Movement
Authors: García Myrna
Published: November 2024

Abstract: This essay illustrates how, and under what circumstances, the Chicago chapter of Centro de Acción Social Autónoma (CASA) was created. CASA was one of the most important immigrant rights organizations that flourished during the Chicano movement. The political slogan Somos un pueblo sin fronteras or Sin fronteras was used as a tool to agitate for immigrant rights by uniting ethnic Mexicans (and Latinxs) as one community regardless of juridical citizenship. It was a strategy to denounce racialized immigration terror. A sin fronteras politics also served as a framework to fight for rights that resonated well beyond the Chicano movement.
Stomping Ground: Living Against Gentrification in Humboldt Park
Authors: Mumm Jesse
Published: November 2024

Abstract: This ethnographic portrait, rather than covering debates from the voluminous gentrification literature, centers two Puerto Rican residents who are experiencing the threat of erasure as everyday life. The lives of Rosalyn Velásquez and Rafael Lugo span the struggles of early migration, racial segregation, intense poverty, gang violence, the drug economy, and legacies of community building in the aftermath, as outsider investment and white newcomer buyers transform their blocks. Although they do not see themselves as heroes, victims, or full-time activists, they deliver—without academic jargon—personally and historically informed analyses of their neighborhood, revealing economic survival strategies, self-affirmations of dignity, and profound local knowledge. They describe sights, sounds, smells, and conversations out in the streets, but also webs of reciprocity and mutual aid that link them to multigenerational extended family and to grassroots community agencies and education programs, whose efforts signify safety, uplift, and improvement. They reveal the welcomes they have themselves extended toward white newcomers—despite knowing their effect on local property values and taxes—whose racialized fears and isolation from the Latino community mean they rarely reciprocate. These two life course interviews counter multiple myths upon which gentrification depends and affirm the critical consciousness of so many people across the United States today who are living against gentrification.
“Thanks to San Juan de los Lagos”: The Evolution of La fé sanjuanera in Chicago
Authors: Kanter Deborah
Published: November 2024

Abstract: While the Virgin of Guadalupe represents Mexican Catholicism to many, the Virgin of San Juan de los Lagos has a long presence among Mexican migrants. Early arrivals in Chicago brought the Virgin of San Juan in their hearts: making promesas and requesting special Masses far from home. They sought to publicize their fé sanjuanera in the Chicago churches and streets that became their new home. Today, this devotion is less linked to a miraculous space in Jalisco and has laid roots on sacralized ground in Illinois. The Virgin’s people made places to express their devotion, often collectively, where they live: Chicago.
Camila v. Peru: Standards Set by CRC on Sexual and Reproductive Rights
Authors: Guerra Elida
Published: November 2024

ABSTRACT: This article seeks to analyze the case of Camila v. Peru , the first decision of the Committee on the Rights of the Child that establishes standards on sexual and reproductive rights. It also briefly develops the context of sexual and reproductive rights in Peru and discusses the challenges to the implementation of reparations.
Identitarian Hatreds and Disloyalty Propaganda: Revisiting the Eurocentrism of Human Rights
Authors: Heinze Eric
Published: November 2024

ABSTRACT: Human rights law has been dismissed as Eurocentric in situations where it has been invoked to justify neo-liberal power relations. Yet Eurocentrism also works in other ways. Human rights experts have adopted notions of “hatred” patterned on Western-dominated histories, then have subsequently reproduced these notions in the form of identity -based categories such as race, religion, gender, or sexuality. However, these same experts have overlooked millions of victims of government-orchestrated, loyalty -based hostilities. Despite ongoing disagreements about whether or how to penalize individual citizens for extreme speech acts, human rights bodies should expand their conceptions of hatred to include abuses rooted in histories other than those modeled on Western violations.
Gun Violence Against Children in the U.S
Authors: Yost Mark , Fernandez Kasey , Nelson Etoile , Dicker Rochelle , Farzanegan Maryam
Published: November 2024

ABSTRACT: Gun violence against children in the United States (U.S.) is a public health crisis which violates the human rights of its victims, resulting in lasting morbidity and death. Firearm-related injury is the leading cause of death for children under eighteen years old in the U.S. We use the United Nations (UN) Universal Declaration of Human Rights, UN Convention on the Rights of the Child, and UN Sustainable Development Goals to analyze gun violence against children in the U.S. from a human rights perspective. We recommend to 1) ratify the UN Convention on the Rights of the Child, establishing a framework for comprehensive gun law reform, 2) partner with the UN Special Representative for the Secretary-General on Violence Against Children to draft policy, 3) increase gun violence research funding, and 4) implement evidence-based community violence prevention programs.
“So Many Friends!”: Gregariousness and Its Discontents in Jane Austen
Authors: Greaney Michael
Published: November 2024

Abstract: This article provides a new reading of the question of friendship as it is interrogated by Jane Austen’s major fiction. In a discussion that ranges from Northanger Abbey to Persuasion , it argues that her fiction is characterized by escalating skepticism about the authenticity and durability of what passes for friendship in its social worlds. With recourse to work by Jacques Derrida and Irving Goh, it argues that friend in her work is a category that is undermined or vacated by its very excess. Austen emerges from this discussion as a novelist of amity who harbors an anti-gregarious streak and whose works are drawn to a fantasy of friendship without friends.
Improving data sampling with rapid statistical convergence in digital Fourier microscopy analysis
Authors: Zuccolotto-Bernez A. B. , Rojas-Ochoa L. F. , Egelhaaf S. U. , Escobedo-Sánchez M. A.
Published: November 2024

Soft matter research often involves studying correlation functions such as the intermediate scattering function. Wave scattering experiments or digital Fourier microscopy are usually used to obtain this function, generating large amounts of data that must be analyzed to obtain reliable information. However, this process can be time-consuming and requires an optimized data analysis procedure to minimize calculations while ensuring statistical validity. To address this issue, we have developed an algorithm that uses an efficient sampling technique to reduce the number of calculations needed for fast statistical convergence in digital Fourier microscopy. Our algorithm provides information equivalent to traditional analysis but in a much shorter time frame, up to 2 orders of magnitude faster.
Improvement of noise performance in the phase locking laser Doppler vibrometer with a low carrier frequency via harmonic locking
Authors: Gao Chunlin , Rembe Christian
Published: November 2024

A heterodyne laser Doppler vibrometer (LDV) with a Bragg cell has a stationary signal carrier at a frequency of at least 35 MHz. The expensive Bragg cell with the restricted shift frequency is not an optimal solution to meet the requirements for many measurement scenarios. For vibrations with low frequencies and small amplitudes, a tens-of-megahertz carrier frequency not only wastes bandwidth at the photodetector but also requires a fast and expensive analog-to-digital converter (ADC). Compared to the Bragg-cell-based LDVs, LDVs with an optical phase-locked loop (OPLL) enable a selectable carrier and thus can provide a low carrier frequency. However, problems arise when the carrier frequency is smaller than the laser linewidth and the OPLL bandwidth. We accidentally were able to offset-lock the OPLL on the harmonic component of the heterodyne oscillator signal and explored this phenomenon, which enables carrier frequencies much smaller than the laser linewidth of the locked lasers at a smaller noise level. In this paper, we demonstrate a carrier frequency down to 3 MHz with a 3.3 dB better signal-to-noise-ratio (SNR) compared to the traditional locking technology. Our findings may enable very cost-efficient LDVs.
Spin wave measurements in FeCo with a virtually imaged phase array spectrometer
Authors: Jean-Ruel Hubert , Chagnon-Lessard Sophie , Newburger Michael , Wolf Michael , Kawakami Roland , Wardle Gregory , Miller Ian , Hunter John
Published: November 2024

We demonstrate for the first time the efficient acquisition of spin wave Brillouin spectra with a virtually imaged phase array-based spectrometer and an etalon-based notch filter. Thermally excited magnons in a 5 nm crystalline Fe75Co25 film are detectable in 100 ms and a signal-to-noise ratio greater than 100 is reached in 10 seconds with a spectral resolution of 0.45 GHz and a pump power of 23 mW. The dependence of the Brillouin shift on the externally applied magnetic field is characterized for fields ranging from 29 to 370 mT and the effective magnetization is estimated to be 1.6±0.1 MA/m. A 2D map of the spatial variation of the Brillouin shift obtained in a non-uniform magnetic field demonstrates the suitability of VIPA-based instrumentation for imaging spin wave propagation in magnonic devices.
A digital dashboard for reporting mental, neurological and substance use disorders in Nairobi, Kenya: Implementing an open source data technology for improving data capture
Authors: Mwanga Daniel M. , Waruingi Stella , Manolova Gergana , Wekesah Frederick M. , Kadengye Damazo T. , Otieno Peter O. , Bitta Mary , Omwom Ibrahim , Iddi Samuel , Odero Paul , Kinuthia Joan W. , Dua Tarun , Chowdhary Neerja , Ouma Frank O. , Kipchirchir Isaac C. , Muhua George O. , Sander Josemir W. , Newton Charles R. , Asiki Gershim ,   on behalf of the EPInA Study Team
Published: November 2024

The availability of quality and timely data for routine monitoring of mental, neurological and substance use (MNS) disorders is a challenge, particularly in Africa. We assessed the feasibility of using an open-source data science technology (R Shiny) to improve health data reporting in Nairobi City County, Kenya. Based on a previously used manual tool, in June 2022, we developed a digital online data capture and reporting tool using the open-source Kobo toolbox. Primary mental health care providers (nurses and physicians) working in primary healthcare facilities in Nairobi were trained to use the tool to report cases of MNS disorders diagnosed in their facilities in real-time. The digital tool covered MNS disorders listed in the World Health Organization’s (WHO) Mental Health Gap Action Program Intervention Guide (mhGAP-IG). In the digital system, data were disaggregated as new or repeat visits. We linked the data to a live dynamic reproducible dashboard created using R Shiny, summarising the data in tables and figures. Between January and August 2023, 9064 cases of MNS disorders (4454 newly diagnosed, 4591 revisits and 19 referrals) were reported using the digital system compared to 5321 using the manual system in a similar period in 2022. Reporting in the digital system was real-time compared to the manual system, where reports were aggregated and submitted monthly. The system improved data quality by providing timely and complete reports. Open-source applications to report health data is feasible and acceptable to primary health care providers. The technology improved real-time data capture, reporting, and monitoring, providing invaluable information on the burden of MNS disorders and which services can be planned and used for advocacy. The fast and efficient system can be scaled up and integrated with national and sub-national health information systems to reduce manual data reporting and decrease the likelihood of errors and inconsistencies.
“How I wish we could manage such things”: A qualitative assessment of barriers to postpartum hemorrhage management and referral in Kenya
Authors: Miller Nora , Henry Junita , Opondo Kennedy , Garg Lorraine F. , Calvert Madison , Clarke-Deedler Emma , Dulo Liddy , Achieng Emmaculate , Oguttu Monica , McConnell Margaret , Cohen Jessica L. , Burke Thomas
Published: November 2024

Maternal mortality rates in Kenya have remained high, with the country reporting 342 deaths per 100,000 live births. A major contributor to this is postpartum hemorrhage (PPH), responsible for 40% of maternal deaths in Kenya and the leading cause globally, particularly in low- and middle-income countries. Timely and effective PPH care is crucial; however, challenges arise when referrals between facilities become necessary. Although Primary health care facilities (PHCs) in Kenya oversee many births and are crucial in PPH risk detection and management, they often fall short due to ill-equipped facilities and inefficient referral systems. This study traced PPH patients from tertiary institutions to their initial PHCs. Through qualitative interviews with healthcare providers, we aimed to examine the primary challenges in PPH management and referral decision-making. We found that, in addition to structural gaps, challenges in collaboration and communication between providers from different health facilities, which may also stem from inadequate training, greatly influenced referral efficacy. Our findings are pivotal for maternal health discourse and policy. Importantly, while many solutions focus on structural inputs, our study underscores the importance of communication between facilities in ensuring timely care. Our findings suggest a need for bolstered emergency preparedness, informed clinical decision-making, and strategic interventions where they are most impactful.
Do government innovation preferences enhance ecological resilience in resource-based cities?—Based on mediating effect and threshold effect perspectives
Authors: Zhang Jie , Yang Jiahui , Zhao Feng
Published: November 2024

The ecological resilience of resource-based cities reflects the resilience of the ecological environment in resource-based areas to recover after resource development activities, and good ecological resilience holds great significance for the sustainability of the development of resource-based cities. Government innovation preferences are a solid foundation for implementing an innovation-driven strategy and an important guarantee for realizing an efficient production mode. (the purpose of the study) Therefore, to investigate whether government innovation preferences can promote the level of ecological resilience in resource-based cities. (sample information and empirical methods) This paper establishes a mediating effect model and a threshold effect model and empirically analyzes 2009–2020 panel data covering 113 resource-based cities in China as an example. (main findings) The results show the following: (1) the primary term of government innovation preferences has a positive effect on the ecological resilience of resource-based cities, and the secondary term has a negative effect, with a decreasing marginal effect. Additionally, the educational level has a mediating effect on the mechanism of the impact of government innovation preferences on the ecological resilience of resource-based cities. (2) The role of government innovation preferences in the ecological resilience of resource-based cities is heterogeneous: The impact of government innovation preferences on the ecological resilience of resource-based cities in the western region is stronger than that in the central region, and the impact of government innovation preferences on the ecological resilience of medium-sized resource-based cities is stronger than that of large resource-based cities. (3) The role of environmental decentralization produces a single threshold effect with a threshold value of 2.3993 in the impact of the mechanism of government innovation preferences on the ecological resilience of resource-based cities. (contributions and policy implications) The results of this paper can provide theoretical support for the government to set a reasonable innovation preference intensity, and they provide a practical guarantee for the central government to give more environmental governance power to local governments.
Within-subject variation of C-reactive protein and high-sensitivity C-reactive protein: A systematic review and meta-analysis
Authors: Gough Alex , Sitch Alice , Ferris Erica , Marshall Tom
Published: November 2024

Background

C-reactive protein (CRP) and high-sensitivity C-reactive protein (hsCRP) are measures of inflammation used in diagnosis, to guide treatment decisions, and in disease prediction. Variability in measured CRP and hsCRP may affect their clinical utility but estimates of within-subject variability are based on limited data.

Methods

A systematic review and meta-analysis was performed to estimate longitudinal within-subject variability of CRP and hsCRP over any time period. Follow-up studies of any design in adults or children, with repeated measures of CRP or hsCRP were sought. Multiple databases were searched from inception to November 2022. Titles and abstracts were screened in duplicate. Full text screening and data extraction were performed by one reviewer and verified by a second. Risk of bias was assessed with a modified Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) tool. Intraclass correlation coefficient (ICC) results were pooled with a meta-analysis and coefficient of variation (CV) results were described by median and range.

Results

Of 2675 studies identified, 60 met the inclusion criteria: 34 reported CRP and 26 reported hsCRP. For CRP, median CV was 0.41 (range 0.11 to 0.89), and the pooled estimate of ICC was 0.55 (95% CI 0.35 to 0.74). For hsCRP, median CV was 0.44 (range 0.27 to 0.76) and the pooled estimate of ICC was 0.62 (95% CI 0.58 to 0.67).

Limitations

Assessment of variability was not the main aim of many of the included papers, and it is possible that some relevant papers have been missed. Many of the papers included had low numbers of participants and/or low numbers of repeated measurements.

Conclusions

Estimated within-subject variability is high for both CRP and hsCRP, but estimates are based on small numbers of participants and measurements. There is a need for better estimates of within-subject variability from analysis of larger numbers of repeated measurements in larger numbers of subjects.
Frequency of limitations statements in original research articles of United States leading medical journals: A meta-research protocol
Authors: Hsu Nin-Chieh , Tsai Hung-Bin , Hsu Chia-Hao , Tsai Ming-Yan , Liao Charles , Tokuda Yasuharu
Published: November 2024

Background

Limitation declarations are commonly deemed essential to uphold intellectual humility for scientific research, but little has been reported about the limitation statements in published original research articles. This meta-research study aims to investigate the trends of limitation statements among three leading general medical journals in the US.

Methods

This cross-sectional study will compile a data set of full-length original research articles published in the New England Journal of Medicine, Journal of the American Medical Association, and Annals of Internal Medicine between 2002 and 2022. Limitation statement will be recognized by two investigators, and a predefined set of sensitive keywords is used for sensitivity analysis. Frequency of limitation statements within the main text of research articles and trends for different study designs, including their association with the corresponding reporting guidelines, are the main measurements. We employ the Cochran-Armitage test for trend analysis.

Conclusion

The findings of this study will provide an overview of the limitation statements in leading general medical journals in the US. The results may contribute to future research to identify factors that are associated with the presence of limitation statements.
Trends in hepatocellular carcinoma and viral hepatitis treatment in older Americans
Authors: Jiang Joy , Shiels Meredith S. , Rivera Donna , Ghany Marc G. , Engels Eric A. , O’Brien Thomas R.
Published: November 2024

Background

Incidence of hepatocellular carcinoma (HCC) had been increasing steadily among older Americans but plateaued in 2015–2017. Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) are important causes of HCC. The impact of improved treatments for these infections on recent trends in HCC incidence is unclear.

Aims

To examine the relationship between use of antiviral therapy for chronic viral hepatis and HCC incidence in older Americans.

Methods

We used 2007–2017 data from the Surveillance, Epidemiology, and End Results—Medicare database to estimate age-standardized incidence rates and average annual percent changes (AAPCs) for viral hepatitis-attributable HCC among individuals ≥66 years. We analyzed data from Medicare Part D to determine the frequency of HBV and HCV treatment utilization in this population.

Results

Overall HCC incidence increased 10.5%, from 22.2/100,000 in 2007 to 24.5/100,000 in 2017 (AAPC, 1.3%). During that time, HBV-attributable HCC rates decreased from 2.5 to 2.0/100,000 (AAPC, -1.6%), while HCV-attributable HCC rose from 6.6 to 8.0/100,000 (AAPC, 2.0%). HBV treatment among patients with HBV infection increased by 66% (2007, 7.4%; 2015, 12.3%). Treatment for HCV was stable at <2% during 2006–2013 but rose to 6.9% in 2014 and 12.7% in 2015, coinciding with the introduction of direct acting antiviral agents for HCV.

Conclusions

A decreased incidence of HBV-attributable HCC corresponded with an increased uptake in treatment for that infection. Despite a marked increase in the effectiveness and frequency of HCV treatment in 2014 and 2015, HCV-attributable HCC had not begun to fall as of 2017.
Drug repurposing against fucosyltransferase-2 via docking, STD-NMR, and molecular dynamic simulation studies
Authors: Atif Muhammad , Zafar Humaira , Wahab Atia-tul- , Choudhary M. Iqbal
Published: November 2024

Aberrant fucosylation is the hallmark of malignant cell transformation, leading to many cellular events, such as uncontrolled cell proliferation, angiogenesis, tumor cell invasion, and metastasis. This increased fucosylation is caused due to the over-expression of fucosyltransferases (FUTs) that catalyzes the transfer of the fucose (Fuc) residue from GDP-fucose (donor substrate) to various oligosaccharides, glycoproteins, and glycolipids (acceptor substrates). Hence, fucosyltransferases (FUTs) are considered as validated target for the drug discovery against on cancers. In the current study, a drug repurposing approach was deployed to identify new hits against fucosyltransferase 2 (FUT2), using computational and biophysical techniques. A library of 500 US-FDA approved drugs were screened in-silico against fucosyltransferase 2 (FUT2) donor and acceptor sites. Five drugs were predicted as hits, based on their significant docking scores (-5.8 to -8.2), and binding energies (-43 to -51.19 Kcal/mol). Furthermore, STD-NMR highlighted the epitope of these drugs in the binding site of fucosyltransferase 2 (FUT2). Simulation studies provided insights about the binding site of these drugs, and 4 of them, acarbose, ascorbic acid, ibuprofen, and enalaprilat dihydrate, were found as significant binders at the donor binding site of fucosyltransferase 2 (FUT2). Hence, the current study reports the repurposed drugs as potential hits against fucosyltransferase 2 (FUT2). These may be further studied through in-vitro and in-vivo inhibitory and mechanistic studies.
Regression analysis of topological indices for predicting efficacy of Alzheimer’s drugs
Authors: Ashraf Tahreem , Idrees Nazeran , Belay Melaku Berhe
Published: November 2024

Alzheimer’s Disease(AD) is the most common type of dementia. It is a progressive disease beginning with mild memory loss and possibly leading to loss of the ability to carry on a conversation and respond to the environment. This study investigates the relationship between the chemical structure of potential AD drugs and their therapeutic efficacy using Multi-Criteria Decision-Making (MCDM) techniques including The approach for Order Preference by Similarity to Ideal Solution (TOPSIS) and Simple Additive Weighting (SAW) method. A comprehensive dataset comprising molecular descriptors and corresponding pharmacological properties, i.e., melting point, boiling point, molecular weight and density of AD drugs was compiled from diverse sources. Topological indices were calculated to capture the structural characteristics of these compounds. Application of TOPSIS and SAW through Entropy method helps obtain optimal drugs for curing AD. Quantitative Structure Property Relationships (QSPR) analysis has been done between properties and topological indices of AD’s drug structures. Results revealed significant relations between specific topological indices and drug efficacy, providing insights into the structural features crucial for AD treatment efficacy. This approach offers a promising avenue for rational drug design and optimization in the quest for novel AD therapeutics.
Psychological flow and mental immunity as predictors of job performance for mental health care practitioners during COVID-19
Authors: Al Eid Nawal A. , Arnout Boshra A. , Al-Qahtani Thabit A. , Farhan Neamah D. , Al Madawi Abeer M.
Published: November 2024

Background

Numerous studies indicated that workers in the health sector suffer from work stress, hassles, and mental health problems associated with COVID-19, which negatively affect the completion of their job tasks. These studies pointed out the need to search for mechanisms that enable workers to cope with job stress effectively.

Objectives

This study investigated psychological flow, mental immunity, and job performance levels among the mental health workforce in Saudi Arabia. It also tried to reveal the psychological flow (PF) and mental immunity (MI) predictability of job performance (JP).

Method

A correlational survey design was employed. The study sample consisted of 120 mental health care practitioners (therapists, psychologists, counselors)who lived in Saudi Arabia. Sixty-four were men, 56 were women, and their ages ranged between 27 and 48 (36.32±6.43). The researchers developed three measurements of psychological flow, mental immunity, and job performance. After testing their validity and reliability, these measures were applied to the study participants.

Results

The results found median levels of psychological flow, mental immunity, and job performance among mental health care practitioners. Also, the results revealed that psychological flow and mental immunity were statistically significant predictors of job performance. The psychological flow variable contributed (38.70%) and mental immunity (54.80%) to the variance in job performance of mental health care practitioners.

Conclusion

The current study indicated that psychological flow and mental immunity significantly influenced the job performance of mental health care practitioners. These findings pointed out that human resource management in mental health care institutions in Saudi Arabia must search for procedures that achieve a state of flow and mental immunity for workers to make their jobs more meaningful. Also, these findings indicated the importance of planning interventions to enhance mental health care practitioners’ psychological flow, mental immunity, and job performance to help them cope with work stress effectively and protect them from symptoms of burnout.
The effects of a 6-week intervention with Limosilactobacillus reuteri ATCC PTA 6475 alone and in combination with L. reuteri DSM 17938 on gut barrier function, immune markers, and symptoms in patients with IBS-D—An exploratory RCT
Authors: König Julia , Roca Rubio María Fernanda , Forsgård Richard A. , Rode Julia , Axelsson Jakob , Grompone Gianfranco , Brummer Robert J.
Published: November 2024

Background

An increased intestinal permeability is a common feature in patients with diarrhoea-predominant irritable bowel syndrome (IBS-D). Probiotics have shown to improve IBS symptoms and might also affect intestinal barrier function.

Aim

The aim of this study was to investigate the effects of a 6-week intervention with Limosilactobacillus reuteri ATCC PTA 6475 alone (single strain) or in combination with Limosilactobacillus reuteri DSM 17938 (dual strain) on gut barrier function, immune markers, and symptoms in IBS-D patients (ClinicalTrials.gov registration number: NCT03986476).

Methods

65 IBS-D patients were randomised into three groups (placebo, single strain, dual strain). Small and large intestinal permeability were assessed using a multi-sugar urinary recovery test. Blood, saliva, faecal samples, and several symptom scales were collected before, and after three and six weeks of intervention.

Results

Small and large intestinal permeability as well as other markers of gut barrier function were not significantly affected by the probiotic interventions. Serum IL-6 levels showed a tendency to be reduced in the single strain group (descriptive p = 0.052). In addition, high-sensitivity C-reactive protein was significantly reduced in the dual strain group (p = 0.041). The participants in both treatment groups reported less gastrointestinal symptoms after three weeks, but this reached significance only in the dual strain group (total score: p = 0.032, pain subscore: p = 0.028). After six weeks, none of the assessed symptoms were significantly different from the placebo.

Conclusion

The probiotic compounds investigated in this study did not seem to affect IBS-D patients’ gut barrier function, but showed potential anti-inflammatory and symptom-improving properties, which need to be confirmed in larger study cohorts.
Insights from qualitative and bifurcation analysis of COVID-19 vaccination model in Bangladesh
Authors: Kuddus Md Abdul , Mohiuddin M. , Paul Anip Kumar , Rahman Azizur
Published: November 2024

The unprecedented global impact of the 2019 coronavirus disease (COVID-19) has necessitated a comprehensive understanding of its transmission dynamics and control measures. In this study, we present a detailed analysis of a COVID-19 vaccination model tailored to the context of Bangladesh, incorporating dual-dose vaccination strategies. By employing qualitative and bifurcation analysis techniques, we investigate the equilibrium points, effective reproduction number (R0), and critical thresholds that influence the prevalence and control of COVID-19 in the region. Our findings reveal insights into the effectiveness of vaccination programs and provide a framework for developing targeted control plans. Through a rigorous examination of model parameters and sensitivity analysis, we identify key factors driving COVID-19 transmission dynamics, emphasizing the significance of vaccination rates and other critical parameters. The validation of our model against real-world data underscores its utility in informing evidence-based decision-making for managing the COVID-19 pandemic in Bangladesh and beyond.
Definition of clinically relevant intraoperative hypotension: A data-driven approach
Authors: Maleczek Mathias , Laxar Daniel , Geroldinger Angelika , Gleiss Andreas , Lichtenegger Paul , Kimberger Oliver
Published: November 2024

Background

Associations between intraoperative hypotension (IOH) and various postoperative outcomes were shown in retrospective trials using a variety of different definitions of IOH. This complicates the comparability of these trials and makes clinical application difficult. Information about the best performing definitions of IOH regarding 30-day mortality, hospital length of stay (hLOS), and postanesthesia care unit length of stay (PACU-LOS) is missing.

Methods

A retrospective cohort trial was conducted using data from patients undergoing noncardiothoracic surgery. We split the obtained dataset into two subsets. First, we used one subset to choose the best fitting definitions of IOH for the outcomes 30-day mortality, hLOS, and PACU-LOS. The other subset was used to independently assess the performance of the chosen definitions of IOH.

Results

The final cohort consisted of 65,454 patients. In the shaping subset, nearly all tested definitions of IOH showed associations with the three outcomes, where the risk of adverse outcomes often increased continuously with decreasing MAP. The best fitting definitions were relative time with a MAP (mean arterial pressure) of <80 mmHg for 30-day mortality, lowest MAP for one minute for hLOS, and lowest MAP for one cumulative minute for PACU-LOS. Testing these three definitions of IOH in the independent second subset confirmed the associations of IOH with 30-day mortality, hLOS, and PACU-LOS.

Conclusions

Using a data-driven approach, we identified the best fitting definitions of IOH for 30-day mortality, hLOS, and PACU-LOS. Our results demonstrate the need for careful selection of IOH definitions.

Clinical trial number: n/a, EC #2245/2020
Women suffering from chronic rhinosinusitis in Norway are more likely to take sick leave
Authors: Clarhed Ulrika K. E. , Schiöler Linus , Torén Kjell , Fell Anne Kristin M. , Hellgren Johan
Published: November 2024

Background

Chronic rhinosinusitis (CRS) decreases the quality of life and affects the working life of sufferers. There is a scarcity of studies of how CRS affects sick leave at the population level, particularly for women.

Materials and methods

Data from questionnaires were collected in Telemark, Norway in 2013 (N = 15,484) and again in 2018 (N = 13,966). Odds ratios with 95% confidence intervals (CI) for having sick leave in the last 12 months, adjusted for sex, asthma, smoking and age, were calculated, as well as the relationship to occupational groups. Comparisons were made between women and men.

Results

Subjects with CRS had 64% increased odds for taking sick leave compared to subjects without CRS (OR 1.64, 95% CI 1.45–1.85) in 2013, with similar results in 2018 (OR 1.60, 95% CI 1.41–1.81). Women with CRS were almost twice as likely to take sick leave than men with CRS (OR 1.96, 95% CI 1.56–2.46) in 2013. Sick leave was more common in subjects with CRS in some occupational groups.

Conclusion

CRS is a chronic and debilitating disease that appears to affect sick leave on a population level, with women being more affected than men. Optimised treatment for CRS might reduce sick leave and associated costs.