bluuebunny/crossref_metadata_2025 huggingface dataset:
A collaborative approach to exercise provision for people with Parkinson’s – a feasibility and acceptability study of the PDConnect programme
Authors: Jones Julie , Alexander Lyndsay , Hancock Elizabeth , Cooper Kay
Published: April 2021

Background: Exercise has been shown to be beneficial for people with Parkinson’s (PwP), slowing the rate of decline of motor and non-motor symptoms, with emerging evidence associating exercise with a neuroprotective effect. Current exercise provision is time-limited, and delivered in the absence of strategies to support long-term adherence to exercise. With a growing Parkinson’s population, there is a need to develop long-term sustainable approaches to exercise delivery. The primary aim of this study is to assess the feasibility and acceptability of a multicomponent intervention (PDConnect) aimed at promoting physical activity, and self-management for PwP.

Methods: A convergent fixed parallel mixed methods design study will be undertaken. The study aims to recruit 30 PwP, who will be randomly allocated into two groups: (i) the usual care group will receive physiotherapy once a week for six weeks delivered via Microsoft Teams. (ii) The PDConnect group will receive physiotherapy once a week for six weeks which combines exercise, education and behaviour change interventions delivered by NHS Parkinson’s specialist physiotherapists via Microsoft Teams. This will be followed by 12 weekly sessions of group exercise delivered on Microsoft Teams by fitness instructors specially trained in Parkinson’s. Participants will be then contacted by the fitness instructors once per month for three months by video conferencing to support exercise engagement. Primary feasibility data will be collected during the study, with acceptability assessed via semi-structured interviews at the end. Secondary outcomes encompassing motor, non-motor and health and well-being measures will be assessed at baseline, at six, 18, and 30 weeks.

Discussion: This pilot study will establish whether PDConnect is feasible and acceptable to PwP. This will provide a platform for a larger evaluation to assess the effectiveness of PDConnect at increasing exercise participation and self-management within the Parkinson’s Community.

Trial registration: Registered on ISRCTN (ISRCTN11672329, 4th June 2020).
In vitro evaluation of the anti-diabetic potential of Helichrysum petiolare Hilliard & B.L. Burtt using HepG2 (C3A) and L6 cell lines
Authors: Aladejana Adebowale Emmanuel , Bradley Graeme , Afolayan Anthony Jide
Published: April 2021

Background: Helichrysum petiolare Hilliard & B.L. Burtt has been listed in a survey of plants used in traditional medicine for the treatment of type 2 diabetes in the Eastern Cape of South Africa. In this study, the antidiabetic potentials of ethanol, cold aqueous (CAQ) and boiled aqueous (BAQ) extracts of H. petiolare were investigated.

Methods: The cytotoxic and glucose utilization effects of the extracts were evaluated using L6 myocytes and HepG2 (C3A) hepatocytes. α-amylase, α-glucosidase and lipase inhibition assays were also carried out.

Results: The ethanol extract showed significant cytotoxic effects in the treated cells. Both BAQ and CAQ extracts significantly increased glucose uptake in L6 and C3A cell lines. The CAQ extract enhanced glucose uptake more in the L6 myocytes than in the C3A cell-lines hepatocytes. The BAQ extract showed higher levels of inhibition on α–amylase and α-glucosidase than CAQ. The activities were not significantly different from acarbose. However, BAQ showed lower lipase inhibition than acarbose (p<0.05).

Conclusions: The BAQ and CAQ extracts of H. petiolare may, therefore, contain pharmacologically active and relatively non-toxic hypoglycaemic chemicals, which may be effective substitutes in the treatment of diabetes mellitus.
Recommendations for the FAIRification of genomic track metadata
Authors: Gundersen Sveinung , Boddu Sanjay , Capella-Gutierrez Salvador , Drabløs Finn , Fernández José M. , Kompova Radmila , Taylor Kieron , Titov Dmytro , Zerbino Daniel , Hovig Eivind
Published: April 2021

Background: Many types of data from genomic analyses can be represented as genomic tracks, i.e. features linked to the genomic coordinates of a reference genome. Examples of such data are epigenetic DNA methylation data, ChIP-seq peaks, germline or somatic DNA variants, as well as RNA-seq expression levels. Researchers often face difficulties in locating, accessing and combining relevant tracks from external sources, as well as locating the raw data, reducing the value of the generated information.

Description of work: We propose to advance the application of FAIR data principles (Findable, Accessible, Interoperable, and Reusable) to produce searchable metadata for genomic tracks. Findability and Accessibility of metadata can then be ensured by a track search service that integrates globally identifiable metadata from various track hubs in the Track Hub Registry and other relevant repositories. Interoperability and Reusability need to be ensured by the specification and implementation of a basic set of recommendations for metadata. We have tested this concept by developing such a specification in a JSON Schema, called FAIRtracks, and have integrated it into a novel track search service, called TrackFind. We demonstrate practical usage by importing datasets through TrackFind into existing examples of relevant analytical tools for genomic tracks: EPICO and the GSuite HyperBrowser.

Conclusion: We here provide a first iteration of a draft standard for genomic track metadata, as well as the accompanying software ecosystem. It can easily be adapted or extended to future needs of the research community regarding data, methods and tools, balancing the requirements of both data submitters and analytical end-users.
The Analysis of Total Quality Management Critical Success Factors
Authors: Kulenović Mirza , Folta Martin , Veselinović Ljiljan
Published: April 2021

Purpose: The primary purpose of this paper is to identify the most important factors related to the successful implementation of TQM in the literature and to compare the identified factors with the existing research.
Methodology/Approach: By conducting a systematic literature review in three main stages, this research analyzes 13 empirical papers published between 1995 and 2017. Three main stages included: formulation of the problem to be solved by the systematic literature review; definition of inclusion criteria and exclusion of articles; and article search and selection.
Findings: Analysing previous research and conducting a literature review, we identify six main critical success factors (CSF): top management leadership and commitment, customer focus, training (employees), procurement management (suppliers), information and analysis, and process management.
Research Limitation/Implication: In this paper, we focused solely on the influence of TQM practices on the financial performance of a company. As such, the non-financial performance indicators were not considered.
Originality/Value of paper: This paper adds value to the existing literature as it focuses on critical factors of TQM implementation examined in relation to the financial performance of the company and provides a good basis for understanding and developing more complex models.
Business Process Risk Modelling in Theory and Practice
Authors: Špaček Miroslav
Published: April 2021

Purpose: The purpose of the paper is to introduce SW based decision-making tool that helps managers cope with risks and uncertainties of selected industrial processes. The solution is substantiated by the theoretical background.
Methodology/Approach: The research is based on combination of contextual interviews with process management experts and Business Process Modelling Notion (BPMN). The former is aimed at the identification of industrial processes with highest risk exposure the latter is conducive to the design of processes to be subjected to stochastic simulation.
Findings: The findings show that the risks and uncertainties in the management of industrial processes can be kept under control when using advanced tools of risk analysis as simulation approaches. The solution proposed comes in handy to risk analysts or process managers.
Research Limitation/Implication: The library of process models which were included into stochastic simulation includes selected processes as investments, service providing or economic value-added engineering. Additional processes are being included on ongoing basis.
Originality/Value of paper: The paper offers the solution to industrial process risk management which goes far beyond academic sphere and provides industrial practitioners SW tool that facilitates process risk management.
Study on Likelihood-Ratio-Based Multivariate EWMA Control Chart Using Lasso
Authors: Saruhashi Takumi , Ohkubo Masato , Nagata Yasushi
Published: April 2021

Purpose: When applying exponentially weighted moving average (EWMA) multivariate control charts to multivariate statistical process control, in many cases, only some elements of the controlled parameters change. In such situations, control charts applying Lasso are useful. This study proposes a novel multivariate control chart that assumes that only a few elements of the controlled parameters change.
Methodology/Approach: We applied Lasso to the conventional likelihood ratio-based EWMA chart; specifically, we considered a multivariate control chart based on a log-likelihood ratio with sparse estimators of the mean vector and variance-covariance matrix.
Findings: The results show that 1) it is possible to identify which elements have changed by confirming each sparse estimated parameter, and 2) the proposed procedure outperforms the conventional likelihood ratio-based EWMA chart regardless of the number of parameter elements that change.
Research Limitation/Implication: We perform sparse estimation under the assumption that the regularization parameters are known. However, the regularization parameters are often unknown in real life; therefore, it is necessary to discuss how to determine them.
Originality/Value of paper: The study provides a natural extension of the conventional likelihood ratio-based EWMA chart to improve interpretability and detection accuracy. Our procedure is expected to solve challenges created by changes in a few elements of the population mean vector and population variance-covariance matrix.
Sociodemographic factors associated with postnatal maternal complications in public hospitals in Nairobi City County, Kenya
Authors: Mukhwana Raheli Misiko , Keraka Margaret N , Onyambu Meshack
Published: April 2021

Introduction/Aims

Focused antenatal care provides individualised counselling, targeted assessment and safe, cost effective, evidence-based intervention. It has been implemented in developing countries as a strategy to improve maternal health. This study aimed to investigate sociodemographic factors associated with maternal complications in selected public county hospitals in Nairobi City County, Kenya.

Methods

This was a cross-sectional study using a sample of 397 postnatal women who were given a questionnaire, with sections on their sociodemographic and health characteristics. Data analysis was done using the Chi Square test to determine the association between study variables, with P<0.05 considered statistically significant.

Results

The study found that 30% of respondents reported a maternal complication during their current delivery outcome. Sociodemographic factors significantly associated with maternal complications were age (P=0.002), occupation (P=0.001) and income (P=0.011). The health factors associated with occurrence of maternal complications were number of deliveries (P=0.001) and mode of delivery (P=0.001).

Conclusions

A number of factors were found to be significantly associated with maternal outcomes, including age and occupation. Further studies to determine why young women do not use focused antenatal care are necessary, as this would help reduce the incidence of birth-associated complications.
Determinants of male involvement in maternal healthcare services in southwest Nigeria
Authors: Olajubu Aanuoluwapo O , Ayamolowo Sunday J , Okiti Oluwatosin A , Olajubu Temitope O , Adeyeye Olajumoke , Olowokere Adekemi E
Published: April 2021

Background/Aims

In Nigeria, women's partners are often excluded from taking part in maternal healthcare, as a result of sociocultural norms. However, the involvement of male partners in maternal healthcare services has the potential to improve maternal health outcomes. This study examined factors associated with male involvement in maternal healthcare services in Ife Central, Osun State, Nigeria.

Methods

A cross-sectional study was conducted, involving 265 men living in Ife Central who were married with at least one child, selected by multistage sampling. A structured questionnaire was used to assess men's knowledge of their expected roles in maternal healthcare, their perception of male involvement, and their current level of involvement in their spouse's healthcare. Descriptive and inferential statistical analyses were carried out to identify predictors of active male involvement in maternal healthcare, at a significance of P<0.05.

Results

Approximately half (55.6%) of the respondents had good knowledge of the expected role of men in maternal healthcare services and 76.6% had a positive perception of this role. Overall, less than half (47.6%) of the participants were actively involved in maternal healthcare services. The participants most frequently reported that men's involvement was influenced by their degree of knowledge (92.4%), job schedule (92.0%), and clinic waiting time (86.4%), among others. Age (odds ratio=2.33, P=0.038), educational status (odds ratio=2.42, P=0.004) religion (odds ratio=2.34, P=0.012), occupation (odds ratio=2.81, P<0.001) and level of knowledge (odds ratio=2.34, P=0.001) were found to be significantly associated with men's level of involvement in maternal healthcare services. However, only good level of knowledge (adjusted odds ratio=2.32, P=0.004) emerged as an independent predictor of men's level of involvement in maternal healthcare services.

Conclusions

The study concluded that men's involvement in maternal healthcare services was low, despite their positive perception towards it. Less than half of the participants had good knowledge regarding men's role in maternal healthcare, and this factor was identified as a significant predictor of level of involvement. Programmes and policies should aim to enhance men's knowledge of their role in maternal healthcare, and it may be necessary to restructure the healthcare delivery system to be more male friendly.
Comparing the effectiveness of mime therapy and neuromuscular re-education in improving facial symmetry and function in acute Bell's palsy: a pilot randomised clinical trial
Authors: D'Souza Arnold Fredrick , Rebello Sydney Roshan
Published: April 2021

Background/aims

Untreated Bell's palsy may lead to disability and reduced quality of life, while early intervention can improve prognosis. This pilot randomised clinical trial aims to compare the effectiveness of mime therapy and neuromuscular re-education in improving facial symmetry and function in patients with acute Bell's palsy.

Methods

A total of 20 patients diagnosed with Bell's palsy were included in this study after meeting the inclusion criteria. Patients were randomly divided into two groups of ten. Group A received mime therapy while group B received neuromuscular re-education. Each participant received 12 sessions of the respective treatment over 2 weeks and was assessed for facial symmetry and function using the Sunnybrook Facial Grading System and the Facial Clinimetric Evaluation Scale respectively.

Results

Although both mime therapy and neuromuscular re-education showed highly significant improvements within each group for both the Sunnybrook Facial Grading System (P=0.005) and Facial Clinimetric Evaluation Scale (P=0.005); they showed no difference between each group for the Sunnybrook Facial Grading System (P=0.212) and Facial Clinimetric Evaluation Scale (P=0.97).

Conclusions

Mime therapy and neuromuscular re-education are equally effective in the recovery of facial symmetry and function in acute Bell's palsy. Physiotherapists can choose between either technique based on their skills and preference or based on patient comfort and expectation.
Effect of shockwave therapy on kinematic gait parameters in children with spastic diplegic cerebral palsy
Authors: Allam Hatem H , Almalki Abdulrahman J , Elsayyad Lamiaa K
Published: April 2021

Background/aims

Extracorporeal shockwave therapy might be a considerable substitute to present treatment alternatives to reduce spasticity and improve range of motion in patients with cerebral palsy, which could improve their quality of life and gait pattern. The aim of this study was to investigate the effect of extracorporeal shockwave therapy on gait parameters in children with spastic diplegic cerebral palsy.

Methods

A total of 34 children with spastic diplegia (19 boys and 15 girls) participated in the study. Their ages ranged from 5–7 years (mean 5.8 ± standard deviation 1.2 years). They were randomly assigned into two equal groups, the study and the control group. Both groups received the traditional physiotherapy programme, three sessions a week consecutively for 3 months. Children in the study group also received extracorporeal shockwave therapy one session a week for 3 months.

Results

There was a significant improvement of spasticity, step length and stride width in the control group (P=0.017, 0.015, 0.033 respectively). Walking speed did not show a significant change in the control group (P=0.1). In the study group, there was a significant improvement in spasticity, stride length, stride width, and walking speed (P=0.0001, 0.005, 0.029, 0.014 respectively). Comparing the gained improvement in the study and the control group, the results showed that the improvement in the study group significantly exceeded that of the control group in spasticity, stride length, stride width and walking speed (P=0.0003, 0.011, 0.043, 0.002 respectively).

Conclusions

Extracorporeal shockwave therapy is effective in reducing spasticity and improving gait patterns in children with spastic diplegia cerebral palsy.
Cardiovascular outcome in patients with high risk cardiovascular events in Nakornping Hospital
Authors:   Department of Internal Medicine, Nakornping Hospital, Chiang Mai, Thailand, Siriwattana K , Siriaree K ,   Department of Internal Medicine, Nakornping Hospital, Chiang Mai, Thailand, Hinmali K ,   Registered Nurse, Nursing Department, Nakornping Hospital, Chiang Mai, Thailand
Published: April 2021

Objectives Patients with atherosclerosis are at different levels of elevated risk of ischemic events depending on the specific manifestation of the disease and may have varying degrees of future risk for ischemic events. This study evaluated the incidence of composite cardiovascular outcomes of patients with high risk cardiovascular events in Nakornping Hospital. Methods This prospective observational non-interventional cohort study enrolled patients age 45 years or more who met the inclusion criteria of the Outpatient Department of Medicine, Nakornping Hospital, between January 2008 and December 2009. The follow-up period for each patient was 60 months. The composite cardiovascular outcome of cardiovascular deaths, non-fatal myocardial infarctions, non-fatal strokes and hospitalizations for heart failure was determined. Results Of the 387 patients in the Outpatient Department of Medicine of Nakornping Hospital, 103 were in the established atherosclerotic disease group and 284 were in the multiple risk factors group. The rate of overall composite cardiovascular events (cardiovascular death, non-fatal MI, non-fatal stroke, and hospitalization for heart failure) was 3.83%. The rate was higher in the established atherosclerotic disease group than in the multiple risk factors group 6.79% vs. 1.41% (HR = 14.28; 95% CI, 2.26-90.02, p = 0.005) which was driven by hospitalization for heart failure, but the established atherosclerotic disease group had a lower rate of medical treatment for diabetes than the multiple risk factors group. The rate of receipt of anti-diabetic drugs was statistically significantly lower in the established atherosclerotic disease group than in the multiple risk factors group. Conclusions Patients with established atherosclerotic disease have a higher rate of composite cardiovascular outcomes than patients with multiple risk factors, but they have a lower rate of medical treatment for diabetes.
Mental health literacy and quality of life among patients with stroke
Authors:   Nursing Department, Sanpasithiprasong Hospital, Posai V , Boonchoo R ,   Nursing Department, Sanpasithiprasong Hospital, Watradul D ,   Adult and Geriatric Nursing Branch, Srisavarindhira Thai Red Cross Institute of Nursing, Makkabphalanon K ,   Department of Adult and Gerontological Nursing, Boromarajonani College of Nursing Chonburi, Thangkratok P ,   Community Health Nursing Branch, Srisavarindhira Thai Red Cross Institute of Nursing
Published: April 2021

Objectives To study the level of mental health literacy and quality of life among patients with stroke and to investigate the relationship between mental health literacy and quality of life. Methods A cross-sectional descriptive study was conducted with 150 purposively selected stroke patients at Sanpasithiprasong Hospital, Ubon Ratchathani, Thailand. Data were collected from October 2019 to March 2020. The research tool consisted of 3 parts: general and clinical data, a mental health literacy questionnaire, and the Thai version of the stroke-specific quality of life scale. Data were analyzed using descriptive statistics and Spearman’s rank correlation coefficient. Results The mean age of participants was 51.80 years (SD 8.62); most were female (65.33%). The level of mental health literacy among patients with stroke was moderate (mean = 3.05, SD = 0.21). The quality of life among patients with stroke was moderate (mean = 3.06, SD = 0.66). The mental health literacy questionnaire yielded a Cronbach’s alpha coefficient of 0.92, and the Thai version of the stroke-specific quality of life scale yielded a Cronbach’s alpha coefficient of 0.96. Mental health literacy was statistically significantly associated with quality of life among patients with stroke (r = 0.484, p < .001). Conclusions The mental health literacy among patients with stroke was moderate as was their quality of life. Mental health literacy was significantly associated with quality of life among patients with stroke. This suggests that emphasizing and promoting mental health literacy among patients with stroke can improve and increase their quality of life. Chiang Mai Medical Journal 2021;60(1):63-74. doi 10.12982/CMUMEDJ.2021.06
Development controller and feedback of Chiang Mai automated external defibrillation trainer and manikin for basic life support training
Authors:   Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Laosuksri W , Chenthanakij B ,   Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Sutham K ,   Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Rangsri W ,   Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Pongvuthitham R ,   Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Rungsiyakull C ,   Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Sucharitakul T ,   Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Khunlertgit N ,   Department of Computer Engineering, Faculty of Engineering, Chiang Mai University, Wittayachamnankul B ,   Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University
Published: April 2021

Objectives Basic Life Support (BLS) should be taught to everyone; however, there is a lack of Automated External Defibrillation (AED) trainers in Thailand due to the cost of the imported equipment. An AED trainer, manikin, and manikin controller system was locally developed which can display training results to help reduce the cost. Methods This is a descriptive study of a locally developed controller and feedback system, the Chiang Mai AED trainer and manikin. The controller was examined by 5 BLS instructors using a 10-point scale questionnaire consisting of 3 questions to evaluate the efficacy of the device. Correlation among BLS instructors was also calculated. Results The controller and feedback system for the Chiang Mai AED trainer and manikin worked appropriately as intended. The instructor set up either a ‘shock advised’ or a ‘no shock advised’ scenario for 2 two-minute chest compressions. The AED trainer responded promptly when the electrode pads were attached to the manikin. The controller was also able to display compression depth, compression speed, chest recoils, rescue breaths, and time to first defibrillation. Evaluation of the controller using a 10-point scale resulted in a median of 27 (interquartile range 26-29) out of 30. Intraclass correlation was 0.97 (95% confidence interval 0.90-0.99, p < 0.001). Conclusions The controller for the Chiang Mai AED trainer and manikin is effective for use in BLS training. Chiang Mai Medical Journal 2021;60(1):87-98. doi 10.12982/CMUMEDJ.2021.08
Effects of the participatory learning program for student leaders on food management knowledge and practice in school
Authors:   Pediatric Nursing Section, Nursing Department, Faculty of Medicine, Chiang Mai University, Nakam N , Aungwattana S ,   Faculty of Nursing, Chiang Mai University, Tuanrat W ,   Faculty of Nursing, Chiang Mai University
Published: April 2021

Objectives This study aimed to compare students’ knowledge and practices related to managing school meals before and after a participatory learning program. Methods The study used a one group pretest–posttest quasi-experimental design with assessment conducted before and after a participatory learning program. The study included 34 student leaders who participated in the program during February to March 2020. The data were analyzed using descriptive statistics, t-test, and the Wilcoxon Matched Pairs Signed-Ranks test. Results The 34 student leaders (64.7% female and 35.3% male, average age 16.91 years) scored 15.26 before the knowledge segment of the program and 19.35 after that program. They received an average score of 9.0 before the practices segment of the program which improved to 20.00 after the program. The increase in both knowledge and practice scores were statistically significant (p < 0.001, p < 0.001). Conclusion Food management in schools is essential to the nutritional status of students. A participatory learning program can significantly improve student leaders’ knowledge and practices related to school food management. Student leaders can conduct these programs and exchange ideas with other students. School food management policies can then be adjusted accordingly. Chiang Mai Medical Journal 2021;60(1):113-24. doi 10.12982/CMUMEDJ.2021.10
Patient-reported outcomes and function after reinsertion of the triangular fibrocartilage complex by open surgery
Authors: Feitz Reinier , van der Oest Mark J. W. , van der Heijden Elisabeth P. A. , Slijper Harm P. , Selles Ruud W. , Hovius Steven E. R. ,   On behalf of the Hand-Wrist Study Group
Published: April 2021

Aims

Patients with a triangular fibrocartilage complex (TFCC) injury report ulnar-sided wrist pain and impaired function. The surgical procedure of TFCC reinsertion aims to improve function in patients with this injury in whom conservative treatment has failed. The purpose of this study was to investigate the outcomes of open TFCC reinsertion.

Methods

The study involved 274 patients who underwent open repair of the TFCC between December 2013 and December 2018. The patients completed the Patient-Rated Wrist Evaluation (PRWE) questionnaire, and scored pain and function using a visual analogue scale (VAS). Range of motion (ROM) was assessed by experienced hand therapists.

Results

Clinically significant improvements were reported in pain, function, and grip strength in 220 patients (80%) three and 12 months postoperatively.

Conclusion

These data will help surgeons to make decisions about the outcomes of open repair of the TFCC and to counsel patients appropriately. Level of evidence: III Cite this article: Bone Joint J 2021;103-B(4):711–717.
Limb-salvage reconstruction following resection of pelvic bone sarcomas involving the acetabulum
Authors: Fujiwara Tomohiro , Medellin Rincon Manuel Ricardo , Sambri Andrea , Tsuda Yusuke , Clark Rhys , Stevenson Jonathan , Parry Michael C. , Grimer Robert J. , Jeys Lee
Published: April 2021

Aims

Limb salvage for pelvic sarcomas involving the acetabulum is a major surgical challenge. There remains no consensus about what is the optimum type of reconstruction after resection of the tumour. The aim of this study was to evaluate the surgical outcomes in these patients according to the methods of periacetabular reconstruction.

Methods

The study involved a consecutive series of 122 patients with a periacetabular bone sarcoma who underwent limb-salvage surgery involving a custom-made prosthesis in 65 (53%), an ice-cream cone prosthesis in 21 (17%), an extracorporeal irradiated autograft in 18 (15%), and nonskeletal reconstruction in 18 (15%).

Results

The rates of major complications necessitating further surgery were 62%, 24%, 56%, and 17% for custom-made prostheses, ice-cream cone prostheses, irradiated autografts and nonskeletal reconstructions, respectively (p = 0.001). The ten-year cumulative incidence of failure of the reconstruction was 19%, 9%, 33%, and 0%, respectively. The major cause of failure was deep infection (11%), followed by local recurrence (6%). The mean functional Musculoskeletal Tumour Society (MSTS) scores were 59%, 74%, 64%, and 72%, respectively. The scores were significantly lower in patients with major complications than in those without complications (mean 52% (SD 20%) vs 74% (SD 19%); p < 0.001). For periacetabular resections involving the ilium, the mean score was the highest with custom-made prostheses (82% (SD 10%)) in patients without any major complication; however, nonskeletal reconstruction resulted in the highest mean scores (78% (SD 12%)) in patients who had major complications. For periacetabular resections not involving the ilium, significantly higher mean scores were obtained with ice-cream cone prostheses (79% (SD 17%); p = 0.031).

Conclusion

Functional outcome following periacetabular reconstruction is closely associated with the occurrence of complications requiring further surgery. For tumours treated with periacetabular and iliac resection, skeletal reconstruction may result in the best outcomes in the absence of complications, whereas nonskeletal reconstruction is a reasonable option if the risk of complications is high. For tumours requiring periacetabular resection without the ilium, reconstruction using an ice-cream cone prosthesis supported by antibiotic-laden cement is a reliable option. Cite this article: Bone Joint J 2021;103-B(4):795–803.
Long-term outcomes of curved intertrochanteric varus osteotomy combined with bone impaction grafting for non-traumatic osteonecrosis of the femoral head
Authors: Osawa Yusuke , Seki Taisuke , Okura Toshiaki , Takegami Yasuhiko , Ishiguro Naoki , Hasegawa Yukiharu
Published: April 2021

Aims

We compared the clinical outcomes of curved intertrochanteric varus osteotomy (CVO) with bone impaction grafting (BIG) with CVO alone for the treatment of osteonecrosis of the femoral head (ONFH).

Methods

This retrospective comparative study included 81 patients with ONFH; 37 patients (40 hips) underwent CVO with BIG (BIG group) and 44 patients (47 hips) underwent CVO alone (CVO group). Patients in the BIG group were followed-up for a mean of 12.2 years (10.0 to 16.5). Patients in the CVO group were followed-up for a mean of 14.5 years (10.0 to 21.0). Assessment parameters included the Harris Hip Score (HHS), Oxford Hip Score (OHS), Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), complication rates, and survival rates, with conversion to total hip arthroplasty (THA) and radiological failure as the endpoints.

Results

There were no significant differences in preoperative and postoperative HHS or postoperative OHS and JHEQ between the BIG group and the CVO group. Complication rates were comparable between groups. Ten-year survival rates with conversion to THA and radiological failure as the endpoints were not significantly different between groups. Successful CVO (postoperative coverage ratio of more than one-third) exhibited better ten-year survival rates with radiological failure as the endpoint in the BIG group (91.4%) than in the CVO group (77.7%), but this difference was not significant (p = 0.079).

Conclusion

Long-term outcomes of CVO with BIG were favourable when proper patient selection and accurate surgery are performed. However, this study did not show improvements in treatment results with the concomitant use of BIG. Cite this article: Bone Joint J 2021;103-B(4):665–671.
Vascular impulse technology versus elevation for the reduction of swelling of lower extremity joint fractures: results of a prospective randomized controlled study
Authors: Schnetzke Marc , El Barbari Jan , Schüler Svenja , Swartman Benedict , Keil Holger , Vetter Sven , Gruetzner Paul Alfred , Franke Jochen
Published: April 2021

Aims

Complex joint fractures of the lower extremity are often accompanied by soft-tissue swelling and are associated with prolonged hospitalization and soft-tissue complications. The aim of the study was to evaluate the effect of vascular impulse technology (VIT) on soft-tissue conditioning in comparison with conventional elevation.

Methods

A total of 100 patients were included in this prospective, randomized, controlled monocentre study allocated to the three subgroups of dislocated ankle fracture (n = 40), pilon fracture (n = 20), and intra-articular calcaneal fracture (n = 40). Patients were randomized to the two study groups in a 1:1 ratio. The effectiveness of VIT (intervention) compared with elevation (control) was analyzed separately for the whole study population and for the three subgroups. The primary endpoint was the time from admission until operability (in days).

Results

The mean length of time until operability was 8.2 days (SD 3.0) in the intervention group and 10.2 days (SD 3.7) in the control group across all three fractures groups combined (p = 0.004). An analysis of the subgroups revealed that a significant reduction in the time to operability was achieved in two of the three: with 8.6 days (SD 2.2) versus 10.6 days (SD 3.6) in ankle fractures (p = 0.043), 9.8 days (SD 4.1) versus 12.5 days (SD 5.1) in pilon fractures (p = 0.205), and 7.0 days (SD 2.6) versus 8.4 days (SD 1.5) in calcaneal fractures (p = 0.043). A lower length of stay (p = 0.007), a reduction in pain (ppreop= 0.05; pdischarge< 0.001) and need for narcotics (ppreop= 0.064; ppostop= 0.072), an increased reduction in swelling (p < 0.001), and a lower revision rate (p = 0.044) could also be seen, and a trend towards fewer complications (p = 0.216) became apparent.

Conclusion

Compared with elevation, VIT results in a significant reduction in the time to achieve operability in complex joint fractures of the lower limb. Cite this article: Bone Joint J 2021;103-B(4):746–754.
Management of tenosynovial giant cell tumour of the foot and ankle
Authors: Spierenburg Geert , Lancaster Sarah Tamar , van der Heijden Lizz , Mastboom Monique J. L. , Gelderblom Hans , Pratap Sarah , van de Sande Michiel A. J. , Gibbons C. L. Max H.
Published: April 2021

Aims

Tenosynovial giant cell tumour (TGCT) is one of the most common soft-tissue tumours of the foot and ankle and can behave in a locally aggressive manner. Tumour control can be difficult, despite the various methods of treatment available. Since treatment guidelines are lacking, the aim of this study was to review the multidisciplinary management by presenting the largest series of TGCT of the foot and ankle to date from two specialized sarcoma centres.

Methods

The Oxford Tumour Registry and the Leiden University Medical Centre Sarcoma Registry were retrospectively reviewed for patients with histologically proven foot and ankle TGCT diagnosed between January 2002 and August 2019.

Results

A total of 84 patients were included. There were 39 men and 45 women with a mean age at primary treatment of 38.3 years (9 to 72). The median follow-up was 46.5 months (interquartile range (IQR) 21.3 to 82.3). Localized-type TGCT (n = 15) predominantly affected forefoot, whereas diffuse-type TGCT (Dt-TGCT) (n = 9) tended to panarticular involvement. TGCT was not included in the radiological differential diagnosis in 20% (n = 15/75). Most patients had open rather than arthroscopic surgery (76 vs 17). The highest recurrence rates were seen with Dt-TGCT (61%; n = 23/38), panarticular involvement (83%; n = 5/8), and after arthroscopy (47%; n = 8/17). Three (4%) fusions were carried out for osteochondral destruction by Dt-TGCT. There were 14 (16%) patients with Dt-TGCT who underwent systemic treatment, mostly in refractory cases (79%; n = 11). TGCT initially decreased or stabilized in 12 patients (86%), but progressed in five (36%) during follow-up; all five underwent subsequent surgery. Side effects were reported in 12 patients (86%).

Conclusion

We recommend open surgical excision as the primary treatment for TGCT of the foot and ankle, particularly in patients with Dt-TGCT with extra-articular involvement. Severe osteochondral destruction may justify salvage procedures, although these are not often undertaken. Systemic treatment is indicated for unresectable or refractory cases. However, side effects are commonly experienced, and relapses may occur once treatment has ceased. Cite this article: Bone Joint J 2021;103-B(4):788–794.
Primary stability of a proximally coated and tapered stem
Authors: Alsousou Joseph , Oragui Emeka , Martin Alexander , Strickland Louise , Newman Simon , Kendrick Ben , Taylor Adrian , Glyn-Jones Siôn
Published: April 2021

Aims

The aim of this prospective cohort study was to evaluate the early migration of the TriFit cementless proximally coated tapered femoral stem using radiostereometric analysis (RSA).

Methods

A total of 21 patients (eight men and 13 women) undergoing primary total hip arthroplasty (THA) for osteoarthritis of the hip were recruited in this study and followed up for two years. Two patients were lost to follow-up. All patients received a TriFit stem and Trinity Cup with a vitamin E-infused highly cross-linked ultra-high molecular weight polyethylene liner. Radiographs for RSA were taken postoperatively and then at three, 12, and 24 months. Oxford Hip Score (OHS), EuroQol five-dimension questionnaire (EQ-5D), and adverse events were reported.

Results

At two years, the mean subsidence of the head and tip for the TriFit stem was 0.38 mm (SD 0.32) and 0.52 mm (SD 0.36), respectively. The total migration of the head and tip was 0.55 mm (SD 0.32) and 0.71 mm (SD 0.38), respectively. There were no statistically significant differences between the three to 12 months' migration (p = 0.105) and 12 to 24 months' migration (p = 0.694). The OHS and EQ-5D showed significant improvements at two years.

Conclusion

The results of this study suggest that the TriFit femoral stem achieves initial stability and is likely to be stable in the mid and long term. A long-term outcome study is required to assess late mechanisms of failure and the effects of bone mineral density (BMD) related changes. Cite this article: Bone Joint J 2021;103-B(4):644–649.
The profile of the spinal column in subjects with lumbar developmental spinal stenosis
Authors: Lai Marcus Kin Long , Cheung Prudence Wing Hang , Samartzis Dino , Karppinen Jaro , Cheung Kenneth M. C. , Cheung Jason Pui Yin
Published: April 2021

Aims

The aim of this study was to determine the differences in spinal imaging characteristics between subjects with or without lumbar developmental spinal stenosis (DSS) in a population-based cohort.

Methods

This was a radiological analysis of 2,387 participants who underwent L1-S1 MRI. Means and ranges were calculated for age, sex, BMI, and MRI measurements. Anteroposterior (AP) vertebral canal diameters were used to differentiate those with DSS from controls. Other imaging parameters included vertebral body dimensions, spinal canal dimensions, disc degeneration scores, and facet joint orientation. Mann-Whitney U and chi-squared tests were conducted to search for measurement differences between those with DSS and controls. In order to identify possible associations between DSS and MRI parameters, those who were statistically significant in the univariate binary logistic regression were included in a multivariate stepwise logistic regression after adjusting for demographics. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported where appropriate.

Results

Axial AP vertebral canal diameter (p < 0.001), interpedicular distance (p < 0.001), AP dural sac diameter (p < 0.001), lamina angle (p < 0.001), and sagittal mid-vertebral body height (p < 0.001) were significantly different between those identified as having DSS and controls. Narrower interpedicular distance (OR 0.745 (95% CI 0.618 to 0.900); p = 0.002) and AP dural sac diameter (OR 0.506 (95% CI 0.400 to 0.641); p < 0.001) were associated with DSS. Lamina angle (OR 1.127 (95% CI 1.045 to 1.214); p = 0.002) and right facet joint angulation (OR 0.022 (95% CI 0.002 to 0.247); p = 0.002) were also associated with DSS. No association was observed between disc parameters and DSS.

Conclusion

From this large-scale cohort, the canal size is found to be independent of body stature. Other than spinal canal dimensions, abnormal orientations of lamina angle and facet joint angulation may also be a result of developmental variations, leading to increased likelihood of DSS. Other skeletal parameters are spared. There was no relationship between DSS and soft tissue changes of the spinal column, which suggests that DSS is a unique result of bony maldevelopment. These findings require validation in other ethnicities and populations. Level of Evidence: I (diagnostic study) Cite this article: Bone Joint J 2021;103-B(4):725–733.
LY3023414 inhibits both osteogenesis and osteoclastogenesis through the PI3K/Akt/GSK3 signalling pathway
Authors: Chen Xiaojun , Chen Wei , Aung Zin Mar , Han Wenqing , Zhang Yan , Chai Gang
Published: April 2021

Aims

LY3023414 is a novel oral phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) dual inhibitor designed for advanced cancers, for which a phase II clinical study was completed in March 2020; however, little is known about its effect on bone modelling/remodelling. In this study, we aimed to explore the function of LY3023414 in bone modelling/remodelling.

Methods

The function of LY3023414 was explored in the context of osteogenesis (bone formation by osteoblasts) and osteoclastogenesis (osteoclast formation and bone resorption). Murine preosteoblast MC3T3-E1 cell line and murine bone marrow-derived macrophage cells (BMMs) were subjected to different treatments. An MTS cell proliferation assay was used to examine the cytotoxicity. Thereafter, different induction conditions were applied, such as MCSF and RANKL for osteoclastogenesis and osteogenic media for osteogenesis. Specific staining, a bone resorption assay, and quantitative real-time polymerase chain reaction (qRT-PCR) were subsequently used to evaluate the effect of LY3023414. Moreover, small interfering RNA (siRNA) was applied to knockdown Akt1 or Akt2 for further validation. Lastly, western blot was used to examine the exact mechanism of action.

Results

LY3023414 attenuated PI3K/protein kinase B (Akt)/GSK3-dependent activation of β-catenin and nuclear factor-activated T cell 1 (NFATc1) during osteogenesis and osteoclastogenesis, respectively. LY3023414 mainly inhibited osteoclast formation instead of mature osteoclast function. Moreover, it suppressed osteogenesis both in the early stage of differentiation and late stage of calcification. Similarly, gene knockdown of Akt isoforms by siRNA downregulated osteogenic and osteoclastogenic processes, indicating that Akt1 and Akt2 acted synergistically.

Conclusion

LY3023414 can suppress osteogenesis and osteoclastogenesis through inhibition of the PI3K/Akt/GSK3 signalling pathway, which highlights the potential benefits and side effects of LY3023414 for future clinical applications. Cite this article: Bone Joint Res 2021;10(4):237–249.
The current state of robotics in total knee arthroplasty
Authors: St Mart Jean-Pierre , Goh En Lin
Published: April 2021

Robotic total knee arthroplasty (TKA) has demonstrated improved component positioning and a reduction of alignment outliers with regard to pre-operative planning. Early robotic TKA technologies were mainly active systems associated with significant technical and surgical complications. Current robotic TKA systems are predominantly semi-active with additional haptic feedback which minimizes iatrogenic soft tissue injury compared to conventional arthroplasty and older systems. Semi-active systems demonstrate advantages in terms of early functional recovery and hospital discharge compared to conventional arthroplasty. Limitations with current robotic technology include high upfront costs, learning curves and lack of long-term outcomes. The short-term gains and greater technical reliability associated with current systems may justify the ongoing investment in robotic technology. Further long-term data are required to fully ascertain the cost-effectiveness of newer robotic systems.

Cite this article: EFORT Open Rev 2021;6:270-279. DOI: 10.1302/2058-5241.6.200052
Magnetosensibility and Magnetic Properties of Ectatomma brunneun Smith, F. 1858 Ants
Authors: Pereira Márlon César , Pereira-Bomfim Maria da Graça Cardoso , Guimarães Ingrid de Carvaho , Rodrigues Candida Anitta Pereira , Serna Jilder Peña , Acosta-Avalo Daniel , Antonialli-Junior William Fernando
Published: April 2021

The aim of the present paper is to study magnetosensibility and to seek for magnetic nanoparticles in ants. The social insects, by living in colonies, developed very efficient methods of nestmate recognition, being less tolerant towards individuals from other colonies. Therefore, any kind of strange behavior between nestmates and/or conspecifics, besides those present in their own behavioral repertoire, is not expected. The behavior study in the present paper analyze whether changes in the intensity of applied magnetic fields on Ectatomma brunneun (Smith) ants can cause changes in the normal pattern of interaction between conspecifics. A pair of coils generating a magnetic field was used to change the whole local geomagnetic field. Magnetometry studies were done on abdomens and head + antennae using a SQUID magnetometer. The results show that changes in the geomagnetic field affect the usual pattern of interactions between workers from different colonies. The magnetometry results show that abdomens present superparamagnetic nanoparticles and heads present magnetic single domain nanoparticles. Behavior experiments show for the first time that Ectatomma brunneun ants are magnetosensible. The change in nestmate recognition of Ectatomma ants observed while a magnetic field is applied can be associated to some kind of disturbance in a magnetosensor presented in the body based on magnetic nanoparticles.