bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AimsWe 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).MethodsThis 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.ResultsThere 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).ConclusionLong-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

AimsComplex 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.MethodsA 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).ResultsThe 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.ConclusionCompared 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

AimsThe 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).MethodsA 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.ResultsAt 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.ConclusionThe 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

AimsThe 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.MethodsThis 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.ResultsAxial 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.ConclusionFrom 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
April 2021 Critical Care Case of the Month: Abnormal Acid-Base Balance in a Post-Partum Woman
Authors:   Emanuel Medical Center, Turlock, CA USA, Mahmoud Mohammad 
Published: April 2021

No abstract available. Article truncated after first page. History of Present Illness: A 29-year-old healthy woman, who is 8 weeks postpartum, presented to the emergency department with severe shortness of breath, fast shallow breathing, nausea, several episodes of nonbloody nonbilious emesis, abdominal pain and malaise for 1 week. The patient delivered a healthy boy at full-term by spontaneous vaginal delivery. Her pregnancy was uneventful. She denied smoking or use of alcohol. Physical Exam: On presentation to the emergency department her blood pressure was found to be 121/71, temperature 36.8°C, pulse 110 beats per minute, respiratory rate 20 breaths per minute and SpO2 saturation of 99% while breathing ambient air. Physical exam was remarkable except for dry mucous membranes, sinus tachycardia, and tachypnea with mild epigastric tenderness with light palpation. Which of the following should be done? 1.	Complete blood count (CBC) 2.	Metabolic panel 3.	Chest x-ray 4.	Arterial blood gases (ABGs) 5.	All of the above …
Examining Association Between Reported High Cholesterol and Risk Factors in Adults With Intellectual and Developmental Disabilities (IDD): A Five-Year Follow-Up
Authors: Murthy Sumithra , Hsieh Kelly 
Published: April 2021

Abstract
Adults with intellectual and developmental disabilities (IDD) are at a greater risk of developing high cholesterol and cardiovascular disease. We examined whether physical inactivity, obesity, and diabetes were predictive of reported high cholesterol and whether there were any mediating effects of diabetes on the relationship between obesity and high cholesterol in 1,618 adults with IDD across five years. Results suggest that obesity and diabetes were significantly associated with high cholesterol after adjusting for age, sex, and residence type with a partial mediator effect of diabetes in the relationship between obesity and high cholesterol across all time points. Further research is needed to explore the causal mechanisms behind the relationships between obesity, diabetes, and high cholesterol.
STOP model development and analysis of an optical collimation system for a tactical high-energy laser weapon
Authors: Lyu Chenyang , Zhan Renjun 
Published: April 2021

To effectively avoid the bottleneck of optical collimation system distortion in the use of tactical high-energy laser weapons (THELWs), this paper proposes and realizes an optical–multiphysics–finite-element coupling analysis method. Combined with dynamic physical parameters, we construct and verify a structure–thermal–optical-performance (STOP) model and accurately restore the multiphysics coupling phenomenon in the THELW lens. Finally, we conclude that the limiting output power of THELW assembled with the doublet lens is 1155.6 W. Then, we draw a series of conclusions from different physical fields and make a comprehensive analysis of the optical collimation system performance. The analysis methods and conclusions described in the paper are of great significance for the R & D of future laser weapons and other optical systems.
Micro-opto-electro-mechanical gyroscope based on the Talbot effect of a single-layer near-field diffraction grating
Authors: Xie Kunyang , Zhang Rui , Xin Chenguang , Jin Li , Wang Zhibin , Wang Zhaoba , Li Mengwei , Zhao Hongbo 
Published: April 2021

We demonstrate a novel, to the best of our knowledge, micro-opto-electro-mechanical system (MOEMS) gyroscope based on the Talbot effect of a single-layer near-field diffraction grating. The Talbot effect of an optical grating is studied both theoretically and experimentally. A structure of grating–mirror combination, fabricated by the micro–nano processing method, is used for out-of-plane structure detection. The detection of a weak Coriolis force is realized by using the highly sensitive displacement characteristic of Talbot imaging of near-field diffraction with a mirror mass block and single-layer grating. The experimental results show that, the micro-displacement detection sensitivity can reach up to 0.09%/nm, and the MOEMS gyroscope can be moved in the driven direction, with a resonant frequency of 7048 Hz and a quality factor of 700, which indicates great potential of the Talbot effect in developing novel high-performance micro-gyroscopes.
2.4  kW 1045  nm narrow-spectral-width monolithic single-mode CW fiber laser by using an FBG-based MOPA configuration
Authors: Xu Yang , Sheng Quan , Wang Peng , Cui Xuelong , Zhao Yizhu , Xu Haixin , Ding Xiangdong , Fang Qiang , Shi Wei , Yao Jianquan 
Published: April 2021

A 24 kW narrow-spectral-width near-diffraction-limited monolithic fiber laser system at

∼

1045.2

n
m

in a fiber Bragg grating (FBG)-based master oscillator power amplifier (MOPA) configuration is demonstrated in this paper. The near-diffraction-limited beam quality (

M

2

∼

1.2

) and a spectral width of 0.35 nm (

∼

96

G
H
z

) are achieved. The stimulated Raman scattering (SRS) is theoretically and experimentally investigated. The SRS has been suppressed by carefully optimizing the length of the Yb-doped fiber and the pumping scheme, and a signal-to-noise ratio of

∼

33

d
B

between the laser signal and the Raman Stokes component is achieved. The stimulate Brillouin scattering and the transverse mode instability are not observed. To our best knowledge, this is the highest-output power for

104

×

n
m

single-mode fiber laser with

∼

96

G
H
z

spectral width by using an FBG-based MOPA configuration.