bluuebunny/crossref_metadata_2025 huggingface dataset:
The future of sickle cell disease therapeutics rests in genomics
Authors: Wonkam Ambroise
Published: February 2023

Sickle cell disease (SCD) is the most-common monogenic recessive disease in humans, annually affecting almost 300,000 newborns worldwide, 75% of whom live in Africa. Genomics research can accelerate the development of curative therapies for SCD in three ways. First, research should explore the missing heritability of foetal haemoglobin (HbF) – the strongest known modifier of SCD clinical expression – among highly genetically heterogenous and understudied African populations, to provide novel therapeutics targets for HbF induction. Second, SCD research should invest in RNA therapies, either by using microRNA to target the production of HbF proteins by binding to the transcription machinery in a cell, or by directly mediating production of HbF or adult haemoglobin through injection of messenger RNA. Third, investigators should aim to identify currently unknown genetic risk factors for SCD cardiovascular complications, which will address mortality, particularly in adults. Now is the time for global research programs to uncover genomic keys to unlock SCD therapeutics.
Interactions of natural and synthetic self-assembling peptides with phospholipid monolayer
Authors: Πρωτοπαπά Ελισάβετ
Published: February 2023

Τα ορθολογικά σχεδιασμένα αυτοσυναρμολογούμενα πεπτίδια που σχηματίζουν β-φύλλο έχουν προηγουμένως αποδειχθεί ότι υφίστανται πυρηνοκίνητη μονοδιάστατη αυτοσυναρμολόγηση πάνω από μια κρίσιμη συγκέντρωση σε διάλυμα, από μονομερή τυχαία σπείρα σε μια ιεραρχία καλά καθορισμένων νανοταινιών, κορδελών και ινιδίων β-φύλλου. Το ενδιαφέρον για την εφαρμογή των αυτοσυναρμολογούμενων πεπτιδίων στην ιατρική, π.χ. στη μηχανική των ιστών, και στους βιοαισθητήρες υπαγορεύει την ανάγκη συσχέτισης της μοριακής δομής των πεπτιδίων με τη νανοτοξικότητα των μεμβρανών. Εδώ εξετάζεται μια σειρά παραμέτρων που θα μπορούσαν να επηρεάσουν τις αλληλεπιδράσεις των πεπτιδίων με μονοστιβάδες φωσφολιπιδίων με τη χρήση ηλεκτροχημικών τεχνικών σε ένα πρότυπο σύστημα με φορέα DOPC-Hg. Οι παράμετροι αυτές είναι συγκεκριμένα η κατάσταση συσσωμάτωσης του πεπτιδίου, η πολικότητα, το καθαρό φορτίο, η εφαρμοζόμενη τάση και η αμφίφιλοτητα. Για την παρούσα μελέτη χρησιμοποιήθηκαν συνολικά 16 συστηματικά τροποποιημένα πεπτίδια που σχηματίζουν ταινίες αυτοσυναρμολόγησης. Αποδεικνύεται ότι, απουσία εφαρμοζόμενης τάσης, τα αμφίφιλα πεπτίδια, με αρωματικά αμινοξέα, μηδενικό καθαρό φορτίο και σε μονομερή και όχι συσσωρευμένη κατάσταση στο διάλυμα, έχουν τη μεγαλύτερη τάση να δεσμεύονται σε μονοστρώματα DOPC και να δημιουργούν διακριτές αγώγιμες δομές. Τα θετικά φορτισμένα αμφίφιλα πεπτίδια αλληλεπιδρούν ισχυρότερα με την DOPC από ό,τι τα αρνητικά φορτισμένα, ενώ τα πολικά πεπτίδια παρουσιάζουν μικρή αλληλεπίδραση με την DOPC. Η εφαρμοζόμενη αρνητική τάση κατά μήκος του λιπιδικού στρώματος οδηγεί στη δέσμευση των αμφίφιλων και των πολικών θετικά φορτισμένων πεπτιδίων στο λιπιδικό στρώμα, ωστόσο τα πεπτίδια αυτά είναι λιγότερο ικανά να υποστούν αυτοσυγκρότηση σε δομές που μοιάζουν με πόρους στο λιπιδικό περιβάλλον. Η εισαγωγή αμινοξέος σερίνης από την επιλογή των διαθέσιμων πολικών αμινοξέων στην πρωταρχική αλληλουχία του πεπτιδίου διευκολύνει σημαντικά την αλληλεπίδραση πεπτιδίου-DOPC. Αυτή η κατηγορία πεπτιδίων αποδεικνύεται ότι είναι σημαντικά λιγότερο διαταραγμένη στη μεμβράνη σε σύγκριση με τα αντιμικροβιακά πεπτίδια. Η έρευνα αυτή παρέχει όχι μόνο μια καλύτερη εικόνα για τον ορθολογικό σχεδιασμό νέων βιοϋλικών με βάση πεπτίδια, αλλά και μια περαιτέρω κατανόηση των αλληλεπιδράσεων των φυσικών αντιμικροβιακών και αμυλοειδικών πεπτιδίων με τις βιολογικές μεμβράνες.
Γονιδιωματική
Authors: Μαρκαντώνη Μαρία
Published: February 2023

Η υπογονιμότητα πλήττει πλέον το 15% των ζευγαριών παγκοσμίως, με τον ανδρικό παράγοντα να ευθύνεται για το 50% των περιπτώσεων. Η ανδρική υπογονιμότητα περιλαμβάνει περιπτώσεις ολιγοζωοσπερμίας, ασθενοζωοσπερμίας, τερατοζωοσπερμίας, συνδυασμός τους αλλά και την αζωοσπερμία που χωρίζεται σε δύο κατηγορίες, η μη αποφρακτική αζωοσπερμία και η αποφρακτική αζωοσπερμία. Η υπογονιμότητα, είναι μια πάθηση που επηρεάζει μεγάλο ποσοστό πληθυσμού, έχει διερευνηθεί διεξοδικά μαζί με όλες τις παραμέτρους που συμβάλλουν στην εκδήλωση της πάθησης, όπως οι περιβαλλοντικές επιπτώσεις, η γήρανση, οι καθημερινές συνήθειες και το γενετικό τοπίο του κάθε ατόμου. Όσον αφορά συγκεκριμένα το γενετικό τοπίο, έχουν υπάρξει πολυάριθμες μελέτες που χρησιμοποίησαν τεχνικές όπως η ανάλυση μικροελλειμάτων χρωμοσώματος Υ σε περιοχές AZF, η αλληλούχιση εξωνιόματος με σκοπό την διερεύνηση των κωδικών περιοχών του γονιδιώματος αλλά και την αλληλούχιση μορίων RNA, τόσο miRNAs όσο και lncRNAs, μορίων των οποίων ο ρόλος στην εμφάνιση της ανδρικής υπογονιμότητας αποτελεί ευρύ επιστημονικό πεδίο. Η ραγδαία ανάπτυξη των τεχνικών νέας γενιάς επέτρεψε την ακόμη πιο διεισδυτική ματιά στην εξερεύνηση των γενετικών αιτιών της ανδρικής υπογονιμότητας, με την χρήση των μελετών συσχέτισης ολόκληρου του γονιδιώματος (Genome wide association studies). Οι GWAS, συνέβαλαν στην ανακάλυψη νέων δεικτών, υπεύθυνων για πλήθος ασθενειών που μέχρι τώρα δεν είχαν αναλυθεί μέσω της ανάλυσης των συχνοτήτων εμφάνισης πολυμορφισμών σε δυο ομάδες ατόμων. Η παρούσα μελέτη αποτελεί την πρώτη απόπειρα πραγματοποίησης μιας μελέτης συσχέτισης ολόκληρου του γονιδιώματος με τη χρήση της τεχνικής της γονοτύπησης , σε δείγματα γόνιμων και υπογόνιμων ανδρών στον Ελληνικό πληθυσμό. Οι δείκτες, καθώς και όσοι βρίσκονται σε ανισορροπία σύνδεσης με αυτούς, κατηγοριοποιήθηκαν με βάση τον λειτουργικό τους ρόλο, αναδεικνύοντας έτσι την ύπαρξη πολλών EQTLs, επηρεάζοντας έτσι αποδεδειγμένα την ρύθμιση της έκφρασης κοντινών (cis- EQTL) ή μακρινών (trans-EQTL) γονιδίων. Η συλλογή όλων των γονιδίων τα οποία τα EQTL επηρεάζουν, ανέδειξαν πλήθος μορίων lncRNAs των οποίων η έκφραση ρυθμίζεται από αυτά. Ο ρόλος των lncRNAs στην γονιμότητα εξετάζεται πολλαπλώς καθώς είναι γνωστό πως αλληλεπιδρά με τα miRNAs τα οποία με τη σειρά τους επηρεάζουν την έκφραση πολλών mRNA, αποσιωπώντας τα. Η συλλογή της πλήρους λίστας των αλληλεπιδράσεων μεταξύ lncRNAs-miRNAs-mRNAs, οδηγεί στην κατανόηση των μηχανισμών μέσω των οποίων τα μόρια RNA μπορούν να οδηγήσουν στην εκδήλωση της ανδρικής υπογονιμότητας αλλά και την ανακάλυψη νέων δεικτών. Συνολικά η διατριβή συγκεντρώνει ένα αρκετά σημαντικό δείγμα για τον Ελληνικό πληθυσμό και δημιουργεί μια βάση γενετικών και επιδημιολογικών δεδομένων, η οποία αποτελεί το θεμέλιο για επόμενες μελέτες, με ακόμη μεγαλύτερο αριθμό ατόμων και περισσότερη δύναμη ανάλυσης.
Exercise
Authors: Κουκόλη Ελένη
Published: February 2023

Αυτή η έρευνα προτείνει τη «μετάφραση», σε αντίθεση με άλλες στρατηγικές οικειοποίησης, ως μια θεωρία και πρακτική που προσκαλεί τη δυνατότητα της επιτελεστικής μεταπαραγωγής κατά τη διάρκεια της παραγωγής, της εκτέλεσης και της παρακολούθησης ενός χορευτικού έργου. Η θεωρία της μετάφρασης προτείνεται ως μοντέλο για την ανάγνωση χορευτικών έργων καθώς και ως εργαλείο χορογραφίας για τη δημιουργία έργων μεταπαραγωγής που χρησιμοποιούν ιστορικές παραπομπές ή/και είναι υβριδικά χορογραφικά έργα μεταξύ μορφών και μέσων. Σε αυτή τη διατριβή, η θεωρία της μετάφρασης χρησιμοποιείται για να συζητήσει το Les Noces (1923) της Bronislava Nijinska ως ένα χορογραφικό έργο του μοντερνισμού που ανανεώνει τις έννοιες του χορού και της κίνησης μέσα από την εξέταση του έργου της ρωσικής πρωτοπορίας. Στη συνέχεια, η θεωρία της μετάφρασης διαμορφώνει τη χορογραφική μέθοδο μέσω της οποίας μπορώ να μεταφράσω το Les Noces στο Άσκηση: Les Noces (2017). Το έργο Άσκηση: Το Les Noces δεν μία απλώς μία ιστορική έρευνα, και επομένως, δεν είναι μια ανακατασκευή, αναβίωση ή διασκευή του αρχικού μπαλέτου. Το Άσκηση: Το Les Noces δεν είναι ούτε μία εγκατάσταση σε γκαλερί που προσαρμόζει ένα έργο μπαλέτου σε μια πλατφόρμα εικαστικών τεχνών. Αυτή η διατριβή προτείνει την Άσκηση: Les Noces ωςμία «χορογραφική τοποθεσία». Ως τον τόπο όπου διαφορετικές συγγραφικές φωνές, διαφορετικές χρονικότητες, διαφορετικά μέσα και κείμενα καλούνται να συνυπάρξουν στην ένταση μεταξύ δύο άκρων: την πλήρη παρουσία και την πλήρη απουσία τους και ως εκ τούτου να διαπραγματευτούν και ενδεχομένως να αλλάξουν τη μορφή και το νόημά τους. Έτσι, η μετάφραση προτείνεται ως μια διιστορική και διεπιστημονική χορογραφική θεωρία, μέθοδος και πρακτική που εργάζεται προς την επέκταση των μέσων που εμπλέκονται με σκοπό την εμπλοκή τους σε ένα νέο πολιτιστικό και ιστορικό περιβάλλον.
The Hurwitz and Lipschitz integers and some applications
Authors: Τσοπανίδης Νικόλαος
Published: February 2023

Σε αυτή τη διατριβή εξετάζουμε τους δακτυλίους των ακεραίων Lipschitz και Hurwitz, περιγράφουμεορισμένες από τις ιδιότητές τους, και τις εφαρμόζουμε για να λύσουμε ορισμένα συστήματα απόΔιοφαντικές εξισώσεις. Ειδικότερα, επεξηγούμε τα μέρη απο τα έργα των Hurwitz και Pall στους ακέραιους αυτους αριθμούς που είναι πιο σχετικά με το δικό μαςσκοπό.Το κύριο αποτέλεσμα αυτής της διατριβής είναι η απόδειξη της «Εικασίας 1-3-5» του Zhi-Wei Sun.Αυτή η εικασία δηλώνει ότι οποιοσδήποτε ακέραιος μπορεί να γραφτεί ως άθροισματεσσάρων τετραγώνων, x^2 +y^2 +z^2 +t^2 (x, y, z, t ∈ N), με τέτοιο τρόπο ώστε x+3y +5z να είναι επίσης ένα τετράγωνο. Παρουσιάζουμε μια απόδειξη που χρησιμοποιεί βασική αριθμητική του δαχτύλιο τωνΑκέραιων του Lipschitz, μαζί με μια ιδέα που συνδυάζει τη μέτα-μεταθετικότητακαι τη σύζευξη με πρώτους αριθμούς Lipschitz με νόρμες 3, 5 και 7.Επιπλέον, αποδεικνύουμε ενα παρόμοιο αποτέλεσμα για πολλά συστήματα εξισώσεων με μορφή ανάλογη με την εικασία 1-3-5. Παρουσιάζουμε επίσης ένα αποτέλεσμα σχετικά με τηκυκλικη δομή της μετάθεσης που προκαλείται από την συνάρτηση της μέτα-μεταθετικότητας γιαπρωτεύοντα τετραδόνια, και παρουσιάζουμε μια γενίκευση αυτης της συνάρτησης για ημιπρώιματετραδονια. Τέλος, προτείνουμε έναν τρόπο αντιμετώπισης παρόμοιων ανοιχτών προβλήμάτων χρησιμοποιώντας μια μέθοδο που χρησιμοποιεί αυτή τη γενίκευση και δείχνει πώς μπορεί κανείς, χρησιμοποιώντας αυτή τη μέθοδο, να αποδείξει κάποια μέρη αυτών των ανοιχτών προβλημάτων.
In poetry, if meter has to help memory, it takes its time
Authors: Andreetta Sara , Soldatkina Oleksandra , Boboeva Vezha , Treves Alessandro
Published: February 2023

To test the idea that poetic meter emerged as a cognitive schema to aid verbal memory, we focused on classical Italian poetry and on three components of meter: rhyme, accent, and verse length. Meaningless poems were generated by introducing prosody-invariant non-words into passages from Dante’s Divina Commedia and Ariosto’s Orlando Furioso. We then ablated rhymes, modified accent patterns, or altered the number of syllables. The resulting versions of each non-poem were presented to Italian native speakers, who were then asked to retrieve three target non-words. Surprisingly, we found that the integrity of Dante’s meter has no significant effect on memory performance. With Ariosto, instead, removing each component downgrades memory proportionally to its contribution to perceived metric plausibility. Counterintuitively, the fully metric versions required longer reaction times, implying that activating metric schemata involves a cognitive cost. Within schema theories, this finding provides evidence for high-level interactions between procedural and episodic memory.
Open Science Training in TRIPLE
Authors: Provost Lottie , Di Donato Francesca , Tóth-Czifra Erzsébet , Dumouchel Suzanne , Blotière Emilie , Chen Yin
Published: February 2023

This case study focuses on the online training activities on Open Science delivered within the H2020 project Transforming Research through Innovative Practices for Linked Interdisciplinary Exploration (TRIPLE, Grant Agreement 863420). The project is dedicated to building a discovery platform for the Social Sciences and Humanities (SSH) and is committed to promoting and supporting the uptake of Open Science within research practices.

In order to address SSH research and training communities’ needs for enhanced competencies on Open Science and for stronger support in the Findable, Accessible, Interoperable, Reusable (FAIR) management of digital training materials, two reusable outputs were produced. The work carried out is presented as a novel approach to tackle the issues related to FAIRifying research and training practices and to create training resources whose reusability and relevance reaches beyond the project lifetime and framework. The case study presents the methods by which the results were produced so as to encourage and enable their future adaptation and reuse.

The TRIPLE Open Science training series (result 1) targets SSH researchers, research support personnel and infrastructure developers in need of practical tools and specific skills to integrate Open Science practices in their workflows. The training series provides 12 competence-oriented online training events in Open Access whose training materials are available as Open Educational Resources (OER).

The TRIPLE Training Toolkit (result 2) targets training organisers and research performing organisations who wish to design and manage training events as OERs and increase the impact of their training following good practice. The Toolkit is an easily reproducible workflow designed to help trainers minimise the time they spend in managing training events following FAIR practice. The workflow follows a FAIR-by-design method to address the frequent findability and reusability issues related to the management of digital training resources.
A protocol for linking participants’ retailer ‘loyalty card’ records into the Avon Longitudinal Study of Parents and Children (ALSPAC)
Authors: Skatova Anya , Boyd Andy
Published: February 2023

Longitudinal population studies (LPS) have a long history of providing insights into how individual consumption patterns and other lifestyle choices affect health and socio-economic outcomes. LPS typically operate as research databanks, integrating rich and deep phenotypic data - covering diverse aspects of individual, family and household status - with genomic data and linked records on health and socio-economic outcomes. However, individual consumption and behavioural choices are traditionally studied solely using self-report methods which are prone to known biases. We propose to enrich LPS databanks with a new form of digital footprint data – individual shopping history records. These are collected by supermarkets through “loyalty” card schemes and can provide a new perspective on real world behaviours and history of consumption. However, as a novel class of data in the context of longitudinal research, our ability to assess the quality and completeness of the data is unknown, as is our ability to effectively triangulate between self-reported and linked data. This paper describes a protocol for linking individual level shopping history data into a LPS using Avon Longitudinal Study of Parents and Children (ALSPAC) as a testbed. The protocol covers the process of establishing participant fair processing, an ethical and legal basis for the linkage framework itself, and how these data will be integrated into the ALSPAC databank. It does not cover the subsequent research use of these data. The protocol was built on an extensive participant engagement and acceptability work and has been approved by the ALSPAC Law and Ethics committee.
The genome sequence of the Common Snout Hoverfly, Rhingia campestris (Meigen, 1822)
Authors: Crowley Liam M. , Mitchell Ryan ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective, Doyle Toby , Wotton Karl R. ,   Darwin Tree of Life Consortium
Published: February 2023

We present a genome assembly from an individual male Rhingia campestris (the Common Snout Hoverfly; Arthropoda; Insecta; Diptera; Syrphidae). The genome sequence is 720 megabases in span. Most of the assembly is scaffolded into five chromosomal pseudomolecules, including the assembled X sex chromosome. The mitochondrial genome has also been assembled and is 16.7 kilobases in length. Gene annotation of this assembly on Ensembl has identified 22,748 protein coding genes.
Las movilidades transfronterizas de hogares de migrantes bajo el COVID-19 en Argentina.
Authors: Diaz Mariela Paula
Published: February 2023

El objetivo principal es analizar los vínculos de los hogares de migrantes bolivianos residentes en la Villa 20 de la Ciudad de Buenos Aires (Argentina) con su país de origen. Concretamente indagar las características de las prácticas plurilocales y el impacto del cierre de fronteras en el contexto global de la pandemia del COVID-19. Para llevar a cabo este trabajo se utilizó una estrategia metodológica multimétodo que combina procedimientos cualitativos y cuantitativos. Entre los principales resultados se destaca la práctica de la plurilocalidad como parte de las estrategias de reproducción familiar en una escala que supera los límites del barrio. La medida gubernamental de cierre de fronteras frente a la pandemia generó una merma de este tipo de movilidad transfronteriza, pero acrecentó otras de manera informal.
Driving Growth in the New Manufacturing Age
Authors: Roberts Max
Published: February 2023

The digital manufacturing revolution is encouraging companies to turn to innovative business models in order to engage with their customers
Employment Law SOS
Authors: Marsden Tracey
Published: February 2023

This month, our legal expert explains the law surrounding staff gambing during working hours, fitness provisions that benefit certain workers over others, and what to do when industrial action on the railways prevents staff getting to site
The Generation Game
Authors: Beck Chris
Published: February 2023

Young workers are putting themselves at risk because of a blasé attitude to health and safety, experts warn. Could technology be the secret to engaging them with the risks?
Unlocking Potential for Machine Builders
Authors: Hague Tony
Published: February 2023

UK manufacturing is strong and machine builders are reporting full order books. However, this demand may be causing unforeseen problems, says Tony Hague, managing director of West Midlands manufacturer, PP Control & Automation
Where Are All The Women?
Authors: Beck Chris
Published: February 2023

It’s a shocking statistic that fewer than 10% of the manufacturing workforce are female. What’s putting them off considering a career in the industry, and what can be done to help bring the numbers up?
Size Matters?
Authors: Beck Chris
Published: February 2023

Small companies make up the backbone of the UK’s manufacturing sector. So why is there so little acknowledgement of their value to the economy?
It’s about Hearts and Minds
Authors: Wood Mike
Published: February 2023

The new ISO 45001 safety standard should reinforce the message to manufacturers that a safe workplace begins with good culture
A Growing Concern
Authors: Beck Chris
Published: February 2023

Energy is increasingly on the agenda in manufacturing boardrooms across the UK, a survey conducted by MM in association with E.ON has found
Deep Breaths
Authors: Horsey John
Published: February 2023

Fumes and dust are the enemies of manufacturing work environments, and controlling workers’ exposure to them should be a primary concern
Canine urinary incontinence: diagnosis and treatment
Authors: Whittleton Tara , Munro Olivia , Barker Victoria , Tappin Simon
Published: February 2023

Canine urinary incontinence is a common presentation in small animal practice. The care required by the owners at home should not be underestimated as a number of these dogs are presented by owners with a request for euthanasia. Many of the causes of incontinence are treatable, so the veterinarian and veterinary nurse should perform a thorough investigation in order to obtain a diagnosis and instigate appropriate therapy. This article outlines the initial approach to an incontinent dog and discusses the specific diagnostics and treatment options available and nursing care required.
Clinical features of hepatozoonosis in dogs and cats
Authors: Colombo Mariasole , Traversa Donato
Published: February 2023

Canine and feline vector-borne diseases are emerging diseases caused by a multitude of worldwide distributed pathogens (bacteria, viruses, protozoa and helminths) and transmitted by ectoparasites (ticks, fleas, sandflies and mosquitoes). They are important because of their increasing prevalence and distribution, great pathogenic potential in companion animals and the zoonotic potential of some of them. Among vector-borne diseases, hepatozoonosis is a neglected but emerging tick-borne disease of dogs and cats. It is caused by different protozoa species belonging to the genus Hepatozoon and is characterized by variable clinical pictures, from subclinical and subtle to potentially life-threatening signs. Data on the biology, epidemiology, clinical features and treatment of canine and feline hepatozoonosis are still limited and the disease is often overlooked in clinical settings. This article discusses the current literature on clinical aspects of canine and feline hepatozoonosis, to increase awareness of this disease.
DEVELOPMENT OF A PREDICTION MODEL (NZSPINE) FOR SIGNIFICANT ADVERSE OUTCOME AFTER SPINE SURGERY
Authors: Coia Jadresic M. , Baker J.
Published: February 2023

Numerous prediction tools are available for estimating postoperative risk following spine surgery. External validation studies have shown mixed results. We present the development, validation, and comparative evaluation of novel tool (NZSpine) for modelling risk of complications within 30 days of spine surgery.

Data was gathered retrospectively from medical records of patients who underwent spine surgery at Waikato Hospital between January 2019 and December 2020 (n = 488). Variables were selected a priori based on previous evidence and clinical judgement. Postoperative adverse events were classified objectively using the Comprehensive Complication Index. Models were constructed for the occurrence of any complication and significant complications (based on CCI >26). Performance and clinical utility of the novel model was compared against SpineSage (https://depts.washington.edu/spinersk/), an extant online tool which we have shown in unpublished work to be valid in our local population.

Overall complication rate was 34%. In the multivariate model, higher age, increased surgical invasiveness and the presence of preoperative anemia were most strongly predictive of any postoperative complication (OR = 1.03, 1.09, 2.1 respectively, p <0.001), whereas the occurrence of a major postoperative complication (CCI >26) was most strongly associated with the presence of respiratory disease (OR = 2.82, p <0.001).

Internal validation using the bootstrapped models showed the model was robust, with an AUC of 0.73. Using sensitivity analysis, 80% of the model's predictions were correct. By comparison SpineSage had an AUC of 0.71, and in decision curve analysis the novel model showed greater expected benefit at all thresholds of risk.

NZSpine is a novel risk assessment tool for patients undergoing acute and elective spine surgery and may help inform clinicians and patients of their prognosis. Use of an objective tool may help to provide uniformity between DHBs when completing the “clinician assessment of risk” section of the national prioritization tool.
DOES PATIENT AGE INFLUENCE FUNCTIONAL OUTCOMES TWO YEARS AFTER PERIACETABULAR OSTEOTOMY?
Authors: Koo Y.E. , Lightfoot N.J. , Boyle M.J.
Published: February 2023

The influence of patient age on functional outcomes after periacetabular osteotomy (PAO) for acetabular dysplasia remains unclear, with previous studies utilising scores developed for older, arthritic patients. The purpose of this study is to assess the influence of patient age on International Hip Outcome Tool (iHOT-12) scores, two years after PAO.

Eighty-six patients (72 female, 14 male; mean age 26.9 years) who underwent PAO by a single surgeon and had completed a minimum of two years follow up were identified. Patients were categorised into three groups according to age at the time of surgery: adolescent (11-20 years; n=29), young adult (21–30 years; n=29), and mature (≥31 years; n=28). The three groups were compared with respect to baseline variables and functional outcomes (iHOT-12, EQ-5D quality of life score, University of California Los Angeles (UCLA) activity score, pain visual analogue score (VAS)). Multivariate regression was undertaken to assess for independent predictors of two-year iHOT-12 score.

The adolescent group demonstrated a lower BMI (p=0.004) while the mature group had a greater American Society of Anaesthesiology (ASA) score (p=0.049). There were otherwise no significant differences in baseline variables between the three groups (all p>0.05).

The three groups demonstrated significant post-operative improvements across all functional outcome measures. There were no significant differences in two-year iHOT-12, EQ-5D, UCLA score or pain VAS between the three groups (all p>0.05). Regression modelling found that patient age at the time of surgery did not have an independent effect on two-year iHOT-12 score (p=0.878).

We found that patient age at the time of surgery did not influence functional outcomes two years after PAO. Our results suggest that patient age should not be considered in isolation as an indication or contraindication for PAO.
“RULES-BASED MOTION” REANIMATION OF THE CARPUS
Authors: Sandow MJ , Howard C , Cheng ZX
Published: February 2023

Using a reverse engineering capability to quantify the factors that control the rigid body mechanics of the wrist, a mathematical forward animation capability and model of wrist motion that allows the carpus to move under its own rules is being developed. This characterises the isometric connections, from which was developed the Stable Central Column Theory of Carpal Mechanics - which incorporates the Law of Rules Based Motion.

This work has now advanced to the ability to reapply the extracted rules to allow rules-based rigid body reanimation of an individual wrist. As each wrist is unique, there is a given reality that each reanimation must be based on an individual wrist's unique rules, and the aspiration to create a standard or normal wrist is unrealistic.

Using True Life Anatomy (Adelaide, Aust) analysis software, the specific rules (morphology / connectivity / interaction / loading) of individual wrists have been characterised, and then reapplied in a rigid body reanimation environment using Adams (MSC Software, U.S.) software.

In the preliminary application of this biomechanics environment, by using the reverse engineering / forward reanimation process, wrist motion can be recreated - based purely on the unique rules, extracted from individual wrists. Instability of the proximal scaphoid was evident in several of the animations, and there was confirmation that the spatial attachment points of the isometric constraints are very exacting. The actual attachment and specific morphology of the carpal bones varied between individual wrists.

Using a reverse engineering and then forward reanimation process, we have been able to recreate wrist motion using the rigid body mechanics based on the Law of Rules Based Motion. Further work is required, but the potential to apply “what if” virtual surgery options to an individual injured wrist and more precisely characterise and test solutions to wrist dysfunction are becoming realised.
AVASCULAR NECROSIS RATES IN MODERATE TO SEVERE UNSTABLE SLIPPED CAPITAL FEMORAL EPIPHYSIS: ANTERIOR OPEN REDUCTION VERSUS THE MODIFIED DUNN PROCEDURE
Authors: St George J. , Norquay M. , Birke O. , Gibbons P. , Little D.
Published: February 2023

The risk of AVN is high in Unstable Slipped Capital Femoral Epiphysis (SCFE) and the optimal surgical treatment remains controversial. Our AVN rates in severe, unstable SCFE remained unchanged following the introduction of the Modified Dunn Procedure (MDP) and as a result, our practice evolved towards performing an Anterior Open Reduction and Decompression (AOR) in an attempt to potentially reduce the “second hit” phenomenon that may contribute. The aim of this study was to determine the early surgical outcomes in Unstable SCFE following AOR compared to the MDP.

All moderate to severe, Loder unstable SCFEs between 2008 and 2022 undergoing either an AOR or MDP were included. AVN was defined as a non-viable post-operative SPECT-CT scan.

Eighteen patients who underwent AOR and 100 who underwent MPD were included. There was no significant difference in severity (mean PSA 64 vs 66 degrees, p = 0.641), or delay to surgery (p = 0.973) between each group. There was no significant difference in the AVN rate at 27.8% compared to 24% in the AOR and MDP groups respectively (p = 0.732). The mean operative time in the AOR group was 24 minutes less, however this was not statistically significant (p = 0.084). The post-reduction PSA was 26 degrees (range, 13-39) in the AOR group and 9 degrees (range, −7 to 29) in the MDP group (p<0.001). Intra-operative femoral head monitoring had a lower positive predictive value in the AOR group (71% compared to 90%).

Preliminary results suggest the AVN rate is not significantly different following AOR. There is less of an associated learning curve with the AOR, but as anticipated, a less anatomical reduction was achieved in this group. We still feel that there is a role for the MDP in unstable slips with a larger remodelling component.
EFFECT OF PERIOPERATIVE VITAMIN C ON THE INCIDENCE OF COMPLEX REGIONAL PAIN SYNDROME: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Seth I. , Bulloch G. , Seth N. , Siu A. , Clayton S. , Lower K. , Roshan S. , Nara N.
Published: February 2023

Complex regional pain syndrome type 1 (CRPS-I) is a devastating complication that can occur after limb extremity injuries. The effectiveness of vitamin C in preventing CRPS-I incidence is debatable. Therefore, we conducted a systematic review and meta-analysis to assess the role of vitamin C in CRPS-I prevention and its effect on pain score, functional outcomes and complications rate after wrist, ankle, and foot fractures.

We searched Medline, Embase, the Cochrane Library, Clinicaltrial.gov, and Google Scholar from infinity to May 2021 for relevant studies comparing the incidence of CRPS-I with administration of perioperative vitamin C versus placebo after wrist, ankle, and foot fractures. Continuous data such as functional outcomes and pain scores were pooled as mean differences (MD), whist dichotomous variables such as the incidence of CRPS-I and complications were pooled as odds ratios (OR), with 95% confidence interval (CI). Data analyses was done using R software (meta package, version 4.9-0) for Windows.

Eight studies, including two quasi-experimental studies, were included. The timeframe for vitamin C administration ranged from 42 to 50 days post-injury and/or surgical fixation and the dosage was either 500 mg or 1000 mg. The results showed that vitamin C was associated with a lower rate of CRPS-I relative to a placebo (OR 0.33, 95% CI [0.17, 0.63]). No significant difference was found between vitamin C and placebo in terms of complications (OR 1.90, 95% CI [0.99, 3.65]), functional outcomes (MD 6.37, 95% CI [-1.40, 14.15]), and pain scores (MD −0.14, 95% CI [-1.07, 0.79]).

The findings demonstrate that when compared to placebo, at least 42 days of vitamin C prophylaxis is associated with prevention of CRPS-I following wrist, ankle, and foot fractures, irrespective of vitamin C dosage or fracture type. No significant differences were found with secondary outcomes.
FIRST RIB FRACTURE: STILL A MARKER OF TRAUMA SEVERITY?
Authors: Flaaten N. , Dyke G.
Published: February 2023

First rib fractures (FRFs) have historically been a marker for severe trauma and poor outcomes. The aim of this study was to assess whether an association still exists between a fractured first rib and global trauma scores suffered by the patient, examine mortality rate and identify other commonly associated injuries.

This study examined patients who presented to the Rockhampton Hospital with a traumatic FRF between the dates of July 2015 to June 2020. Patient demographics, mortality rate and additional injuries sustained by the patients were collected. The Injury Severity Score (ISS) was utilised and calculated for each patient. Analysis was conducted to determine associations between trauma scores and FRFs, mortality rate and other injuries sustained at the time of rib fracture.

In total, 545 patients had a rib fracture with 48 patients identified as having an FRF. Median age was 50 years. Thirty-seven (77%) were male. The most common mechanism of FRF was motor vehicle/motorbike accidents (71%). Fifty percent of patients with an observed FRF had the highest global ISS of very severe, with 13% severe, 22% moderate and 15% mild. No patients died from their injuries. Of those with an FRF, 79% experienced fractures other than ribs, 75% had other rib fractures and 52% had chest injuries.

A larger than expected proportion of FRFs were not associated with severe trauma scores or high mortality. These findings suggest that patients with an FRF may have a greater chance of surviving their traumatic FRF than previously reported. Clinicians should be aware of the potential for severity and other associated injuries, such as chest wall fractures and thoracic injuries, when treating a patient with a fracture of their first rib.
TIBIAL PLATEAU FRACTURE CHARACTERISTICS: RELIABILITY AND DIAGNOSTIC ACCURACY OF 3D-PRINTED MODELS
Authors: van der Gaast N. , Huitema J.M. , Brouwers L. , Edwards M.J.R. , Hermans E. , Doornberg J.N. , Jaarsma R.L.
Published: February 2023

Classification systems for tibial plateau fractures suffer from poor interobserver agreement, and their value in preoperative assessment to guide surgical fixation strategies is limited. For tibial plateau fractures four major characteristics are identified: lateral split fragment, posteromedial fragment, anterior tubercle fragment, and central zone of comminution. These fracture characteristics support preoperative assessment of fractures and guide surgical decision-making as each specific component requires a respective fixation strategy. We aimed to evaluate the additional value of 3D-printed models for the identification of tibial plateau fracture characteristics in terms of the interobserver agreement on different fracture characteristics.

Preoperative images of 40 patients were randomly selected. Nine trauma surgeons, eight senior and eight junior registrars indicated the presence or absence of four fracture characteristics with and without 3D-printed models. The Fleiss kappa was used to determine interobserver agreement for fracture classification and for interpretation, the Landis and Koch criteria were used.

3D-printed models lead to a categorical improvement in interobserver agreement for three of four fracture characteristics: lateral split (Kconv = 0.445 versus K3Dprint = 0.620; P < 0.001), anterior tubercle fragment (Kconv = 0.288 versus K3Dprint = 0.449; P < 0.001) and zone of comminution (Kconv = 0.535 versus K3Dprint = 0.652; P < 0.001).

The overall interobserver agreement improved for three of four fracture characteristics after the addition of 3D printed models. For two fracture characteristics, lateral split and zone of comminution, a substantial interobserver agreement was achieved.

Fracture characteristics seem to be a more reliable way to assess tibial plateau fractures and one should consider including these in the preoperative assessment of tibial plateau fractures compared to the commonly used classification systems.
CLINICAL AND RADIOLOGICAL OUTCOMES FOLLOWING GLENOID BONE GRAFTING IN PRIMARY REVERSE TOTAL SHOULDER ARTHROPLASTY
Authors: Critchley O.C. , Guest C. , Warby S. , Hoy G. , Page R.S.
Published: February 2023

Glenoid bone grafting in reverse total shoulder arthroplasty (RTSA) has emerged as an effective method of restoring bone stock in the presence of complex glenoid bone loss, yet there is limited published evidence on efficacy. The aim of this study was to conduct an analysis of clinical and radiographic outcomes associated with glenoid bone grafting in primary RTSA.

Patients who underwent a primary RTSA with glenoid bone grafting were retrospectively identified from the databases of two senior shoulder surgeons. Inclusion criteria included minimum of 12 months clinical and/or radiographical follow up. Patients underwent preoperative clinical and radiographic assessment. Graft characteristics (source, type, preparation), range of movement (ROM), patient-reported outcome measures (Oxford Shoulder Scores [OSS]), and complications were recorded. Radiographic imaging was used to analyse implant stability, graft incorporation, and notching by two independent reviewers.

Between 2013 and 2021, a total of 53 primary RTSA procedures (48 patients) with glenoid bone grafting were identified. Humeral head autograft was used in 51 (96%) of cases. Femoral head allograft was utilised in two cases. Depending on the morphology of glenoid bone loss, a combination of structural (corticocancellous) and non-structural (cancellous) grafts were used to restore glenoid bone stock and the joint line. All grafts were incorporated at review. The mean post-operative OSS was significantly higher than the pre-operative OSS (40 vs. 22, p < 0.001). ROM was significantly improved post-operatively. One patient is being investigated for residual activity-related shoulder pain. This patient also experienced scapular notching resulting in the fracturing of the inferior screw. One patient experienced recurrent dislocations but was not revised.

Overall, at short term follow up, glenoid bone grafting was effective in addressing glenoid bone loss with excellent functional and clinical outcomes when used for complex bone loss in primary RTSA. The graft incorporation rate was high, with an associated low complication rate.
ACROMIAL MORPHOLOGY IS A RISK FACTOR FOR UNIDIRECTIONAL POSTERIOR SHOULDER INSTABILITY
Authors: Bekhit P. , Saffi M. , Hong N. , Hong T.
Published: February 2023

Acromial morphology has been implicated as a risk factor for unidirectional posterior shoulder instability. Studies utilising plain film radiographic landmarks have identified an increased risk of posterior shoulder dislocation in patients with higher acromion positioning. The aims of this study were to develop a reproducible method of measuring this relationship on cross sectional imaging and to evaluate acromial morphology in patients with and without unidirectional posterior shoulder instability.

We analysed 24 patients with unidirectional posterior instability. These were sex and age matched with 61 patients with unidirectional anterior instability, as well as a control group of 76 patients with no instability. Sagittal T1 weighted MRI sequences were used to measure posterior acromial height relative to the scapular body axis (SBA) and long head of triceps insertion axis (LTI). Two observers measured each method for inter-observer reliability, and the intraclass correlation coefficient (ICC) calculated.

LTI method showed good inter-observer reliability with an ICC of 0.79. The SBA method was not reproducible due suboptimal MRI sequences. Mean posterior acromial height was significantly greater in the posterior instability group (14.2mm) compared to the anterior instability group (7.7mm, p=0.0002) as well when compared with the control group (7.0mm, p<0.0001). A threshold of 7.5mm demonstrated a significant increase in the incidence of posterior shoulder instability (RR = 9.4).

We conclude that increased posterior acromial height is significantly associated with posterior shoulder instability. This suggests that the acromion has a role as an osseous restraint to posterior shoulder instability.
SARCOPENIA AS A PREDICTOR OF MORTALITY IN PATIENTS WITH METASTATIC TUMOURS IN THE SPINAL COLUMN
Authors: Bekhit P. , Ou C. , Baker J.
Published: February 2023

Sarcopenia has been observed to be a predictor of mortality in international studies of patients with metastatic disease of the spine. This study aimed to validate sarcopenia as a prognostic tool in a New Zealand setting. A secondary aim of this study was to assess the intra-observer reliability of measurements of psoas and vertebral body cross sectional areas on computed tomography imaging.

A cohort of patients who had presented to Waikato Hospital with secondary neoplasia in the spinal column from 2014 to 2018 was selected. Cross sectional psoas and vertebral body areas were measured at the mid-pedicle L3 level, followed by calculation of the psoas to vertebral body cross sectional area ratio. Psoas to vertebral body cross sectional area ratio was compared with survivorship. The strength of the correlation between sarcopenia and survivorship was compared with the correlation between serum albumin and survivorship, as well as the correlation between the Metastatic Spine Risk Index (MSRI) and survivorship.

A total of 110 patients who received operative (34) and non-operative (76) were included. The results demonstrate that psoas to vertebral body cross sectional area ratio is not statistically significantly correlated with survivorship (p=0.53). Serum albumin is significantly correlated with survivorship (p<0.0001), as was the MSRI. There is good intra-observer and inter-observer reliability for measurements of psoas to vertebral body cross sectional area.

This study failed to demonstrate the utility for the psoas to vertebral body cross sectional area ratio that other studies have demonstrated in estimating survivorship. Serum albumin levels remain a useful prognostic indicator in patients with secondary tumours in the vertebral column.
EVALUATION OF THE PATIENT’S KNEE IMPLANT PERFORMANCE (PKIP) SCORE IN REVISION KNEE ARTHROPLASTY
Authors: Abdul N.M. , Haywood Z. , Edmondston S.J. , Yates P.J.
Published: February 2023

Patient reported outcome measures (PROMs) after total knee arthroplasty (TKA) are typically used to assess longitudinal change in pain and function after total knee arthroplasty (TKA). The Patient's Knee Implant Performance (PKIP) score was developed to evaluate outcomes more broadly including function, stability, confidence, and satisfaction. Although validated in patients having a primary TKA, the PKIP has not been evaluated as an outcome measure for patients having revision TKA. This study examined patient outcomes at one year following primary and revision TKA measured using the PKIP, compared to Oxford Knee Scores.

A retrospective analysis of pre-operative and one-year post-operative outcomes was completed for 39 patients (21 female) who had primary (n=27) or revision (n=12) TKA with a single surgeon between 2017 and 2020. The mean age was 69.2±7.4 years, and mean weight 87.4± 5.1kg. The change over time and correlation between the self-reported outcome measures was evaluated.

There was a significant improvement in the PKIP overall score at the 12-month follow-up (32± 13 v 69± 15, p= <0.001), with no significant difference between groups (3.3 points, p=0.50). Among the PKIP sub-scores, there was a significant improvement in knee confidence (3.5±2 vs 7.7±2; p<0.001), stability (3.4±2 vs 7.4±3; p<0.001) and satisfaction (2.5±1.7 vs 6.6±3, p<0.001). Between group differences in PKIP sub-scores one year after surgery were small and non-significant. For all patients, the OKS and PKIP scores were moderately correlated before surgery (r=0.64, p=<0.05), and at 1 year after surgery (r=0.61, p= <0.001).

Significant improvements in knee confidence, stability, and satisfaction one year after TKA were identified from the PKIP responses, with no significant difference between primary and revision surgery. The moderate correlation with the OKS suggests these questionnaires measure difference constructs and may provide complementary outcome information in this patient cohort.
HIP ULTRASOUND-GUIDED HAEMATOMA (HUSH) BLOCK FOR INTRACAPSULAR NECK OF FEMUR FRACTURES OUTPERFORMS FASCIA-ILIACA BLOCK
Authors: Patel R. , Elliott R.
Published: February 2023

Regional anaesthesia is integral to best practice analgesia for patients with neck of femur fractures (NOFFs). These patients are generally frail and are vulnerable to side effects of opioid analgesia. Femoral nerve block (FNB) or fascia-iliaca block (FIB) can reduce opioid requirement. Literature supports good efficacy for extra-capsular NOFFs however it is acknowledged to be suboptimal for intracapsular fractures.

We present a novel technique, using point of care ultrasound guidance to perform hip ultrasound guided haematoma (HUSH) aspiration, and injection of local anaesthetic (block) for intracapsular NOFFs.

This a case control series. A consecutive series of cognitively intact patients, with an isolated intra-capsular NOFF, received a HUSH block using 10mls of 0.75% Ropivicaine. Haematoma was aspirated and volume recorded. This was performed in addition to standard NOFF pathway analgesia that includes a FIB and multimodal analgesia including opioids. Visual Analogue Scale (VAS)pain scores at rest and on movement were recorded pre and post procedure as well as combined morphine equivalent units administered post HUSH block. The control arm was a retrospective group of similar patients who followed the routine care pathway including a FIB. VAS pain scores from observation charts and usage of morphine equivalent units were calculated.

Ten patients consented to receive HUSH blocks and we included thirty-eight patients in our control series. The HUSH block group showed mean VAS pain score of 4.2/10 at rest and 8.6 on movement prior to block. In the time after the block, VAS pain scores reduced to 1.5 at rest (p=0.007) and 3.1 on movement (p=0.0001) with a mean total morphine equivalent use of 8.75mg. This is significantly different from the control group's mean VAS pain at rest score 6.9 (p=0.0001) and 24.1mg total morphine equivalent (p=0.07).

HUSH Block in addition to fascia iliaca block appears to significantly better pain relief in intracapsular neck of femur fracture patients when compared to fascia iliaca block alone. We believe it is relatively easy to perform with readily available ultrasound scanners in emergency departments.
TEN-YEAR FOLLOW-UP ANALYSIS OF A LARGE SERIES OF THE LATEST GENERATION OF DM CUPS
Authors: Philippot R.
Published: February 2023

Dual mobility is a French concept that appeared in the 1970s and was initially intended to reduce dislocation rates.

In recent years, this concept has evolved with new HA titanium spray coatings, new external macrostructures, and better-quality polyethylene. This has allowed to extend the indications to younger and therefore active populations.

The objective of our work is to analyze at least 10 years a homogeneous and continuous series of 170 primary total hip replacements associating a latest generation Novae Sunfit® dual mobility cup with a straight femoral stem. Only primary arthroplasties for osteoarthritis or necrosis were included. Total hip arthroplasty was always performed through a posterolateral approach. All patients had regular clinical and radiological follow-up. The average follow-up in our series was 11.5 years. The average age of the population is 71 years.

At the last follow-up, there were 17 deaths, 6 losses to follow up and 9 adverse events, including 1 cup change for psoas impingement and 1 dislocation. The low rate of dislocation at 11 years confirms the high stability of the dual mobility, which should be recommended for primary procedure for patients at high risk of postoperative instability. The lack of intraprosthetic dislocation due to wear at 11 years of follow-up highlights the good quality of the latest generation of polyethylene, and the need to combine high-polished surfaces and a refined femoral neck with a dual mobility cup. Finally, the lack of aseptic loosening confirms the quality of the secondary fixation of these implants and justifies their wider use in all patients.