bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of COVID-19 on morbidity and mortality in neck of femur fracture patients
Authors: Ward Alex E. , Tadross Daniel , Wells Fiona , Majkowski Lawrence , Naveed Umna , Jeyapalan Rathan , Partridge David G. , Madan Suvira , Blundell Chris M. 
Published: November 2020

Aims Within the UK, around 70,000 patients suffer neck of femur (NOF) fractures annually. Patients presenting with this injury are often frail, leading to increased morbidity and a 30-day mortality rate of 6.1%. COVID-19 infection has a broad spectrum of clinical presentations with the elderly, and those with pre-existing comorbidities are at a higher risk of severe respiratory compromise and death. Further increased risk has been observed in the postoperative period. The aim of this study was to assess the impact of COVID-19 infection on the complication and mortality rates of NOF fracture patients. Methods All NOF fracture patients presenting between March 2020 and May 2020 were included. Patients were divided into two subgroup: those with or without clinical and/or laboratory diagnosis of COVID-19. Data were collected on patient demographics, pattern of injury, complications, length of stay, and mortality. Results Overall, 132 patients were included. Of these, 34.8% (n = 46) were diagnosed with COVID-19. Bacterial pneumonia was observed at a significantly higher rate in those patients with COVID-19 (56.5% vs 15.1%; p =< 0.000). Non respiratory complications such as acute kidney injury (30.4% vs 9.3%; p =0.002) and urinary tract infection (10.9% vs 3.5%; p =0.126) were also more common in those patients with COVID-19. Length of stay was increased by a median of 21.5 days in patients diagnosed with COVID-19 (p < 0.000). 30-day mortality was significantly higher in patients with COVID-19 (37.0%) when compared to those without (10.5%; p <0.000). Conclusion This study has shown that patients with a neck of femur fracture have a high rate of mortality and complications such as bacterial pneumonia and acute kidney injury when diagnosed with COVID-19 within the perioperative period. We have demonstrated the high risk of in hospital transmission of COVID-19 and the association between the infection and an increased length of stay for the patients affected. Cite this article: Bone Joint Open 2020;1-11:669–675.
The impact of COVID-19 on elective and trauma spine service in a district general hospital
Authors: Zahra Wajiha , Karia Monil , Rolton Daniel 
Published: November 2020

Aims The aim of this paper is to describe the impact of COVID-19 on spine surgery services in a district general hospital in England in order to understand the spinal service provisions that may be required during a pandemic. Methods A prospective cohort study was undertaken between 17 March 2020 and 30 April 2020 and compared with retrospective data from same time period in 2019. We compared the number of patients requiring acute hospital admission or orthopaedic referrals and indications of referrals from our admission sheets and obtained operative data from our theatre software. Results Between 17 March to 30 April 2020, there were 48 acute spine referrals as compared to 68 acute referrals during the same time period last year. In the 2019 period, 69% (47/68) of cases referred to the on-call team presented with back pain, radiculopathy or myelopathy compared to 43% (21/48) in the 2020 period. Almost 20% (14/68) of spine referrals consisted of spine trauma as compared to 35% (17/48) this year. There were no confirmed cases of cauda equine last year during this time. Overall, 150 spine cases were carried out during this time period last year, and 261 spine elective cases were cancelled since 17 March 2020. Recommendations We recommend following steps can be helpful to deal with similar situations or new pandemics in future: 24 hours on-call spine service during the pandemic. Clinical criteria in place to prioritize urgent spinal cases. Pre-screening spine patients before elective operating. Start of separate specialist trauma list for patients needing urgent surgeries. Conclusion This paper highlights the impact of COVID-19 pandemic in a district general hospital of England. We demonstrate a decrease in hospital attendances of spine pathologies, despite an increase in emergency spine operations. Cite this article: Bone Joint Open 2020;1-6:281–286.
Providing a paediatric trauma and orthopaedics service during the peak of the COVID-19 pandemic
Authors: Iliadis Alexis D , Eastwood Deborah M , Bayliss Lee , Cooper Michael , Gibson Alexander , Hargunani Rikin , Calder Peter ,   Royal National Orthopaedic Hospital Paediatric COVID-19 Collaborative
Published: November 2020

Introduction In response to the COVID-19 pandemic, there was a rapidly implemented restructuring of UK healthcare services. The The Royal National Orthopaedic Hospital, Stanmore, became a central hub for the provision of trauma services for North Central/East London (NCEL) while providing a musculoskeletal tumour service for the south of England, the Midlands, and Wales and an urgent spinal service for London. This study reviews our paediatric practice over this period in order to share our experience and lessons learned. Our hospital admission pathways are described and the safety of surgical and interventional radiological procedures performed under general anaesthesia (GA) with regards to COVID-19 in a paediatric population are evaluated. Methods All paediatric patients (≤ 16 years) treated in our institution during the six-week peak period of the pandemic were included. Prospective data for all paediatric trauma and urgent elective admissions and retrospective data for all sarcoma admissions were collected. Telephone interviews were conducted with all patients and families to assess COVID-19 related morbidity at 14 days post-discharge. Results Overall, 100 children underwent surgery or interventional radiological procedures under GA between 20 March and 8 May 2020. There were 35 trauma cases, 20 urgent elective orthopaedic cases, two spinal emergency cases, 25 admissions for interventional radiology procedures, and 18 tumour cases. 78% of trauma cases were performed within 24 hours of referral. In the 97% who responded at two weeks following discharge, there were no cases of symptomatic COVID-19 in any patient or member of their households. Conclusion Despite the extensive restructuring of services and the widespread concerns over the surgical and anaesthetic management of paediatric patients during this period, we treated 100 asymptomatic patients across different orthopaedic subspecialties without apparent COVID-19 or unexpected respiratory complications in the early postoperative period. The data provides assurance for health care professionals and families and informs the consenting process. Cite this article: Bone Joint Open 2020;1-6:287–292.
Dealing with the COVID-19 pandemic in orthopaedics: experiences and procedure in Germany
Authors: Mueller Michael , Boettner Friedrich , Karczewski Daniel , Janz Viktor , Felix Stephan , Kramer Axel , Wassilew Georgi I 
Published: November 2020

AimsThe worldwide COVID-19 pandemic is directly impacting the field of orthopaedic surgery and traumatology with postponed operations, changed status of planned elective surgeries and acute emergencies in patients with unknown infection status. To this point, Germany's COVID-19 infection numbers and death rate have been lower than those of many other nations.MethodsThis article summarizes the current regimen used in the field of orthopaedics in Germany during the COVID-19 pandemic. Internal university clinic guidelines, latest research results, expert consensus, and clinical experiences were combined in this article guideline.ResultsEvery patient, with and without symptoms, should be screened for COVID-19 before hospital admission. Patients should be assigned to three groups (infection status unknown, confirmed, or negative). Patients with unknown infection status should be considered as infectious. Dependent of the infection status and acuity of the symptoms, patients are assigned to a COVID-19-free or affected zone of the hospital. Isolation, hand hygiene, and personal protective equipment is essential. Hospital personnel directly involved in the care of COVID-19 patients should be tested on a weekly basis independently of the presence of clinical symptoms, staff in the COVID-19-free zone on a biweekly basis. Class 1a operation rooms with laminar air flow and negative pressure are preferred for surgery in COVID-19 patients. Electrocautery should only be utilized with a smoke suction system. In cases of unavoidable elective surgery, a self-imposed quarantine of 14 days is recommended prior to hospital admission.ConclusionDuring the current COVID-19 pandemic, orthopaedic patients admitted to the hospital should be treated based on an interdisciplinary algorithm, strictly separating infectious and non-infectious cases. Cite this article: Bone Joint Open 2020;1-6:309–315.
Dynamic deformation of the femoral head occurs on weightbearing in Legg-Calves-Perthes disease
Authors: Aarvold Alexander , Lohre Ryan , Chhina Harpreet , Mulpuri Kishore , Cooper Anthony 
Published: November 2020

Aims Though the pathogenesis of Legg-Calve-Perthes disease (LCPD) is unknown, repetitive microtrauma resulting in deformity has been postulated. The purpose of this study is to trial a novel upright MRI scanner, to determine whether any deformation occurs in femoral heads affected by LCPD with weightbearing. Methods Children affected by LCPD were recruited for analysis. Children received both standing weightbearing and supine scans in the MROpen upright MRI scanner, for coronal T1 GFE sequences, both hips in field of view. Parameters of femoral head height, width, and lateral extrusion of affected and unaffected hips were assessed by two independent raters, repeated at a one month interval. Inter- and intraclass correlation coefficients were determined. Standing and supine measurements were compared for each femoral head. Results Following rigorous protocol development in healthy age-matched volunteers, successful scanning was performed in 11 LCPD-affected hips in nine children, with seven unaffected hips therefore available for comparison. Five hips were in early stage (1 and 2) and six were in late stage (3 and 4). The mean age was 5.3 years. All hips in early-stage LCPD demonstrated dynamic deformity on weightbearing. Femoral head height decreased (mean 1.2 mm, 12.4% decrease), width increased (mean 2.5 mm, 7.2% increase), and lateral extrusion increased (median 2.5 mm, 23% increase) on standing weightbearing MRI compared to supine scans. Negligible deformation was observed in contra-lateral unaffected hips, with less deformation observed in late-stage hips. Inter- and intraclass reliability for all measured parameters was good to excellent. Conclusion This pilot study has described an effective novel research investigation for children with LCPD. Femoral heads in early-stage LCPD demonstrated dynamic deformity on weightbearing not previously seen, while unaffected hips did not. Expansion of this protocol will allow further translational study into the effects of loading hips with LCPD. Cite this article: Bone Joint Open 2020;1-7:364–369.
Foot function during gait and parental perceived outcome in older children with symptomatic club foot deformity
Authors: McCahill Jennifer Leigh , Stebbins Julie , Harlaar Jaap , Prescott Robin , Theologis Tim , Lavy Christopher 
Published: November 2020

Aims To assess if older symptomatic children with club foot deformity differ in perceived disability and foot function during gait, depending on initial treatment with Ponseti or surgery, compared to a control group. Second aim was to investigate correlations between foot function during gait and perceived disability in this population. Methods In all, 73 children with idiopathic club foot were included: 31 children treated with the Ponseti method (mean age 8.3 years; 24 male; 20 bilaterally affected, 13 left and 18 right sides analyzed), and 42 treated with primary surgical correction (mean age 11.6 years; 28 male; 23 bilaterally affected, 18 left and 24 right sides analyzed). Foot function data was collected during walking gait and included Oxford Foot Model kinematics (Foot Profile Score and the range of movement and average position of each part of the foot) and plantar pressure (peak pressure in five areas of the foot). Oxford Ankle Foot Questionnaire, Disease Specific Index for club foot, Paediatric Quality of Life Inventory 4.0 were also collected. The gait data were compared between the two club foot groups and compared to control data. The gait data were also correlated with the data extracted from the questionnaires. Results Our findings suggest that symptomatic children with club foot deformity present with similar degrees of gait deviations and perceived disability regardless of whether they had previously been treated with the Ponseti Method or surgery. The presence of sagittal and coronal plane hindfoot deformity and coronal plane forefoot deformity were associated with higher levels of perceived disability, regardless of their initial treatment. Conclusion This is the first paper to compare outcomes between Ponseti and surgery in a symptomatic older club foot population seeking further treatment. It is also the first paper to correlate foot function during gait and perceived disability to establish a link between deformity and subjective outcomes Cite this article: Bone Joint Open 2020;1-7:384–391.
Partial resection of the posterior wall for hip dislocation in severe acetabular protrusio
Authors: Rodriguez Hugo A. , Viña Felipe , Muskus Meilyn A. 
Published: November 2020

AimsIn elderly patients with osteoarthritis and protrusio who require arthroplasty, dislocation of the hip is difficult due to migration of the femoral head. Traditionally, neck osteotomy is performed in situ, so this is not always achieved. Therefore, the purpose of this study is to describe a partial resection of the posterior wall in severe protrusio.MethodsThis is a descriptive observational study, which describes the surgical technique of the partial resection of the posterior wall during hip arthroplasty in patients with severe acetabular protrusio operated on between January 2007 and February 2017.ResultsIn all, 49 hip arthroplasties were performed. The average age of patients was 60 years, and idiopathic was the most frequent aetiology of protrusio. All patients were treated with femoral head autograft and no intra- or postoperative complications were reported. No patients required revision surgery.ConclusionPartial resection of the posterior wall demonstrated to be a safe surgical technique with 100% survival in a follow-up to ten years in total hip arthroplasty due to severe acetabular protrusio. Cite this article: Bone Joint Open 2020;1-7:431–437.
40 days and 40 nights: Clinical characteristics of major trauma and orthopaedic injury comparing the incubation and lockdown phases of COVID-19 infection
Authors: Ajayi Bisola , Trompeter Alex , Arnander Magnus , Sedgwick Philip , Lui Darren F. 
Published: November 2020

Aims The first death in the UK caused by COVID-19 occurred on 5 March 2020. We aim to describe the clinical characteristics and outcomes of major trauma and orthopaedic patients admitted in the early COVID-19 era. Methods A prospective trauma registry was reviewed at a Level 1 Major Trauma Centre. We divided patients into Group A, 40 days prior to 5 March 2020, and into Group B, 40 days after. Results A total of 657 consecutive trauma and orthopaedic patients were identified with a mean age of 55 years (8 to 98; standard deviation (SD) 22.52) and 393 (59.8%) were males. In all, 344 (approximately 50%) of admissions were major trauma. Group A had 421 patients, decreasing to 236 patients in Group B (36%). Mechanism of injury (MOI) was commonly a fall in 351 (52.4%) patients, but road traffic accidents (RTAs) increased from 56 (13.3%) in group A to 51 (21.6%) in group B (p = 0.030). ICU admissions decreased from 26 (6.2%) in group A to 5 (2.1%) in group B. Overall, 39 patients tested positive for COVID-19 with mean age of 73 years (28 to 98; SD 17.99) and 22 (56.4%) males. Common symptoms were dyspnoea, dry cough, and pyrexia. Of these patients, 27 (69.2%) were nosocomial infections and two (5.1%) of these patients required intensive care unit (ICU) admission with 8/39 mortality (20.5%). Of the patients who died, 50% were older and had underlying comorbidities (hypertension and cardiovascular disease, dementia, arthritis). Conclusion Trauma admissions decreased in the lockdown phase with an increased incidence of RTAs. Nosocomial infection was common in 27 (69.2%) of those with COVID-19. Symptoms and comorbidities were consistent with previous reports with noted inclusion of dementia and arthritis. The mortality rate of trauma and COVID-19 was 20.5%, mainly in octogenarians, and COVID-19 surgical mortality was 15.4%. Cite this article: Bone Joint Open 2020;1-7:330–338.
The impact of COVID-19 on trauma and orthopaedic surgery in the United Kingdom
Authors: Wallace Charles N. , Kontoghiorghe Christina , Kayani Barbar , Chang Justin S. , Haddad Fares S. 
Published: November 2020

The coronavirus 2019 (COVID-19) global pandemic has had a significant impact on trauma and orthopaedic (T&O) departments worldwide. To manage the peak of the epidemic, orthopaedic staff were redeployed to frontline medical care; these roles included managing minor injury units, forming a “proning” team, and assisting in the intensive care unit (ICU). In addition, outpatient clinics were restructured to facilitate virtual consultations, elective procedures were cancelled, and inpatient hospital admissions minimized to reduce nosocomial COVID-19 infections. Urgent operations for fractures, infection and tumours went ahead but required strict planning to ensure patient safety. Orthopaedic training has also been significantly impacted during this period. This article discusses the impact of COVID-19 on T&O in the UK and highlights key lessons learned that may help to proactively prepare for the next global pandemic. Cite this article: Bone Joint Open 2020;1-7:420–423.
Confocal air-coupled ultrasonic optical coherence elastography probe for quantitative biomechanics
Authors: Zvietcovich Fernando , Nair Achuth , Ambekar Yogeshwari S. , Singh Manmohan , Aglyamov Salavat R. , Twa Michael D. , Larin Kirill V. 
Published: November 2020

We present an air-coupled ultrasonic radiation force probe co-focused with a phase-sensitive optical coherence tomography (OCT) system for quantitative wave-based elastography. A custom-made 1 MHz spherically focused piezoelectric transducer with a concentric 10 mm wide circular opening allowed for confocal micro-excitation of waves and phase-sensitive OCT imaging. Phantom studies demonstrated the capabilities of this probe to produce quasi-harmonic excitation up to 4 kHz for generation of elastic waves. Experimental results in ocular tissues showed highly detailed 2D and 3D elasticity mapping using this approach with great potential for clinical translation.
Udržitelná spotřeba a životní styl jako vzdělávací téma
Authors: Dlouhá Jana , Henderson Laura , Kroufek Roman , Jančaříková Kateřina , Neprašová Simona 
Published: November 2020

Odpovědná spotřeba je zahrnuta v jednom z Cílů udržitelného rozvoje (SDG 12), a tento cíl hraje důležitou roli i v rovině vzdělávací: UNESCO pro jeho naplnění stanovilo sadu vzdělávacích cílů pro různé úrovně vzdělávání. Je jimi soubor klíčových kompetencí pro SDG12, a jak je patrné z jejich analýzy, jsou tyto vzdělávací cíle rozloženy víceméně rovnoměrně mezi kognitivní, emocionální/sociální a behaviorální doménou učení, což je i znakem vzdělávání pro udržitelnost obecně. Vzdělávání vycházející z těchto cílů tak může přinést nejen potřebné znalosti, ale též působit na proměnu zažitých vzorců myšlení a chování, což je pro změnu spotřebitelských zvyklostí a životního stylu obecně důležité. Článek nejen předvádí, jak si vzdělávací cíle tohoto typu stanovit (tak, aby působily na všechny složky osobnosti a byly součástí transformativního učení), ukazuje také, jak konkrétně mohou vypadat ve zde popisovaném programu vzdělávání pro odpovědnou spotřebu navrženém pro různé typy škol. Cílem programu je dovést děti/žáky/studenty k poznání, že jsou aktivní součástí ekonomiky, a mohou prostřednictvím svého každodenního rozhodování formovat podobu ekonomického systému.
DTM-based analysis of the spatial distribution of topolineaments
Authors: Kamiński Mirosław 
Published: November 2020

Abstract
The research area is located on the boundary between two Paleozoic structural units: the Radom–Kraśnik Block and the Mazovian–Lublin Basin in the southeastern Poland. The tectonic structures are separated by the Ursynów–Kazimierz Dolny fault zone. The digital terrain model obtained by the ALS (Airborne Laser Scanning) method was used. Classification and filtration of an elevation point cloud were performed. Then, from the elevation points representing only surfaces, a digital terrain model was generated. The model was used to visually interpret the course of topolineaments and their automatic extraction from DTM. Two topolineament systems, trending NE–SW and NW–SE, were interpreted. Using the kernel density algorithm, topolineament density models were generated. Using the Empirical Bayesian Kriging, a thickness model of quaternary deposits was generated. A relationship was observed between the course of topolineaments and the distribution and thickness of Quaternary formations. The topolineaments were compared with fault directions marked on tectonic maps of the Paleozoic and Mesozoic. Data validation showed consistency between topolineaments and tectonic faults. The obtained results are encouraging for further research.
Ice-crevasse sedimentation in the eastern part of the Głubczyce Plateau (S Poland) during the final stage of the Drenthian Glaciation
Authors: Salamon Tomasz 
Published: November 2020

AbstractGlacial sediments in the eastern part of the Głubczyce Plateau, at the Krowiarki site, were studied. Two units were distinguished within the sedimentary succession. The lower unit is composed of mainly sandy sediments with diamicton interbeds, the upper unit of very fine silt and clay sediments that exhibit rhythmic lamination in parts. Based on the textural and structural features of deposits, local deformations and palaeoflow directions, it was found that the sediments had been deposited within an ice crevasse, which was initially open and functioned as an ablation flow artery. The sediments were deposited in the form of a small fan dominated by sheetflows. Glacial tills were also redeposited on its surface. In a later phase, the crevasse was blocked. As a result, it was filled with water, leading to the development of a crevasse lake in which low-energy deposition dominated. The crevasse style of deposition indicates that, in the final stage of glaciation, the marginal part of the ice sheet was in a stagnant phase. This conclusion applies to the part located on the southern side of the watershed of the eastern Głubczyce Plateau. The probable reason for the stagnation of the ice sheet was the distinct loss of ice supply above the local topography barrier due to the decreasing thickness of the ice sheet in the studied area.