bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of chronic kidney disease on total knee arthroplasty outcomes: a meta-analysis of matched control studies
Authors: Cheng Chongjie , Yan Yan , Zhang Qidong , Guo Wanshou 
Published: July 2021

Abstract
Purpose
The purpose of this meta-analysis was to review the current evidence in the literature to find out whether the coexisting chronic kidney disease affected infection, revision, transfusion, readmission, mortality, and the length of hospital stay after total knee arthroplasty.

Methods
Medline, PubMed, Embase, and the Cochrane Library were searched from their dates of inception to June 30, 2020. The primary outcomes were postoperative infection, revision, and mortality. The secondary outcomes were transfusion, the length of hospital stay, and readmission. A P value of < 0.05 was deemed to be statistically significant.

Results
A total of 881 articles were identified, and 7 articles that met the inclusion criteria were identified to be eligible. The most important finding of our study was that the chronic kidney disease was associated with increased postoperative transfusion (P < 0.05) and mortality (P < 0.05). Meanwhile, the patients with chronic kidney disease were associated with a higher readmission rate, compared to the patients without chronic kidney disease (P < 0.05). However, chronic kidney disease was not associated with high risks for infection (P > 0.05), revision surgeries (P > 0.05), and a prolonged hospital stay (P > 0.05).

Conclusions
After total knee arthroplasty, the patients with coexisting chronic kidney disease carry higher risks of transfusion, mortality, and readmission. However, the chronic kidney disease may not be associated with the risk of infection or revision, nor the duration of hospitalization.
Science shines in a new virtual SY-Stem
Authors: Buecker Christa , Merkle Florian T. 
Published: July 2021

ABSTRACT
The third ‘Symposium for the Next Generation of Stem Cell Research’ (SY-Stem) was held virtually on 3-5 March 2021, having been cancelled in 2020 due to the COVID-19 pandemic. As in previous years, the meeting highlighted the work of early career researchers, ranging from postgraduate students to young group leaders working in developmental and stem cell biology. Here, we summarize the excellent work presented at the Symposium, which covered topics ranging from pluripotency, species-specific aspects of development and emerging technologies, through to organoids, single-cell technology and clinical applications.
The BMP antagonist gremlin 1 contributes to the development of cortical excitatory neurons, motor balance and fear responses
Authors: Ichinose Mari , Suzuki Nobumi , Wang Tongtong , Kobayashi Hiroki , Vrbanac Laura , Ng Jia Q. , Wright Josephine A. , Lannagan Tamsin R. M. , Gieniec Krystyna A. , Lewis Martin , Ando Ryota , Enomoto Atsushi , Koblar Simon , Thomas Paul , Worthley Daniel L. , Woods Susan L. 
Published: July 2021

ABSTRACT
Bone morphogenetic protein (BMP) signaling is required for early forebrain development and cortical formation. How the endogenous modulators of BMP signaling regulate the structural and functional maturation of the developing brain remains unclear. Here, we show that expression of the BMP antagonist Grem1 marks committed layer V and VI glutamatergic neurons in the embryonic mouse brain. Lineage tracing of Grem1-expressing cells in the embryonic brain was examined by administration of tamoxifen to pregnant Grem1creERT; Rosa26LSLTdtomato mice at 13.5 days post coitum (dpc), followed by collection of embryos later in gestation. In addition, at 14.5 dpc, bulk mRNA-seq analysis of differentially expressed transcripts between FACS-sorted Grem1-positive and -negative cells was performed. We also generated Emx1-cre-mediated Grem1 conditional knockout mice (Emx1-Cre;Grem1flox/flox) in which the Grem1 gene was deleted specifically in the dorsal telencephalon. Grem1Emx1cKO animals had reduced cortical thickness, especially layers V and VI, and impaired motor balance and fear sensitivity compared with littermate controls. This study has revealed new roles for Grem1 in the structural and functional maturation of the developing cortex.
The effects of triceps surae muscle stimulation on localized Achilles subtendon tissue displacements
Authors: Lehr Nathan L. , Clark William H. , Lewek Michael D. , Franz Jason R. 
Published: July 2021

ABSTRACT
The triceps surae muscle–tendon unit is composed of the lateral and medial gastrocnemius (MG) and soleus (SOL) muscles and three in-series elastic ‘subtendons’ that form the Achilles tendon. Comparative literature and our own in vivo evidence suggest that sliding between adjacent subtendons may facilitate independent muscle actuation. We aim to more clearly define the relationship between individual muscle activation and subtendon tissue displacements. Here, during fixed-end contractions, electrical muscle stimulation controlled the magnitude of force transmitted via individual triceps surae muscles while ultrasound imaging recorded resultant subtendon tissue displacements. We hypothesized that MG and SOL stimulation would elicit larger displacements in their associated subtendon. Ten young adults completed four experimental activations at three ankle angles (−20, 0 and 20 deg) with the knee flexed to approximately 20 deg: MG stimulation (STIMMG), SOL stimulation (STIMSOL), combined stimulation, and volitional contraction. At 20 deg plantarflexion, STIMSOL elicited 49% larger tendon non-uniformity (SOL–MG subtendon tissue displacement) than that of STIMMG (P=0.004). For STIMSOL, a one-way post hoc ANOVA revealed a significant main effect of ankle angle (P=0.009) on Achilles tendon non-uniformity. However, peak tendon non-uniformity decreased by an average of 61% from plantarflexion to dorsiflexion, likely due to an increase in passive tension. Our results suggest that localized tissue displacements within the Achilles tendon respond in anatomically consistent ways to differential patterns of triceps surae muscle activation, but these relations are highly susceptible to ankle angle. This in vivo evidence points to at least some mechanical independence in actuation between the human triceps surae muscle–subtendon units.
One-stage exchange should be avoided in periprosthetic joint infection cases with massive femoral bone loss or with history of any failed revision to treat periprosthetic joint infection
Authors: Slullitel Pablo A. , Oñativia José I. , Zanotti Gerardo , Comba Fernando , Piccaluga Francisco , Buttaro Martin A. 
Published: July 2021

Aims There is a paucity of long-term studies analyzing risk factors for failure after single-stage revision for periprosthetic joint infection (PJI) following total hip arthroplasty (THA). We report the mid- to long-term septic and non-septic failure rate of single-stage revision for PJI after THA. Methods We retrospectively reviewed 88 cases which met the Musculoskeletal Infection Society (MSIS) criteria for PJI. Mean follow-up was seven years (1 to 14). Septic failure was diagnosed with a Delphi-based consensus definition. Any reoperation for mechanical causes in the absence of evidence of infection was considered as non-septic failure. A competing risk regression model was used to evaluate factors associated with septic and non-septic failures. A Kaplan-Meier estimate was used to analyze mortality. Results The cumulative incidence of septic failure was 8% (95% confidence interval (CI) 3.5 to 15) at one year, 13.8% (95% CI 7.6 to 22) at two years, and 19.7% (95% CI 12 to 28.6) at five and ten years of follow-up. A femoral bone defect worse than Paprosky IIIA (hazard ratio (HR) 13.58 (95% CI 4.86 to 37.93); p < 0.001) and obesity (BMI ≥ 30 kg/m2; HR 3.88 (95% CI 1.49 to 10.09); p = 0.005) were significantly associated with septic failure. Instability and periprosthetic fracture were the most common reasons for mechanical failure (5.7% and 4.5%, respectively). The cumulative incidence of aseptic failure was 2% (95% CI 0.4 to 7) at two years, 9% (95% CI 4 to 17) at five years, and 12% (95% CI 5 to 22) at ten years. A previous revision to treat PJI was significantly associated with non-septic failure (HR 9.93 (95% CI 1.77 to 55.46); p = 0.009). At the five-year timepoint, 93% of the patients were alive (95% CI 84% to 96%), which fell to 86% (95% CI 75% to 92%) at ten-year follow-up. Conclusion Massive femoral bone loss was associated with greater chances of developing a further septic failure. All septic failures occurred within the first five years following the one-stage exchange. Surgeons should be aware of instability and periprosthetic fracture being potential causes of further aseptic revision surgery. Cite this article: Bone Joint J 2021;103-B(7):1247–1253.
Cemented femoral stem fixation through the anterior approach has fewer early complications than cementless fixation
Authors: Ennin Kwame A. , Elsharkawy Karim A. , Dasgupta Shuvalaxmi , Emerson Roger H. 
Published: July 2021

Aims To achieve the functional benefits of the direct anterior (DA) approach and the fixation benefits of cemented replacement, this study combined the two techniques posing the following questions: does the limited access of the DA approach adversely affect the cement technique?; and does such a cementing technique reduce the incidence of cementless complications? Methods A consecutive series of 341 patients (360 hips) receiving the DA approach between 2016 and 2018 were reviewed. There were 203 cementless stems and 157 cemented stems. Mean age was 75 years (70 to 86) in the cementless group and 76 years (52 to 94) in the cemented group, with 239 (70%) females in the whole series. Femoral complications were compared between the two groups. Mean follow-up was 1.5 years (0.1 to 4.4) for patients in the cementless group and 1.3 years (0.0 to 3.9) for patients in the cemented group. Results The cementless group had a higher rate of femoral complications (8 vs 0; p = 0.011). There were two loose stems and six fractures, all requiring revision. Fractures occurred a mean 14.5 days (2 to 31) postoperatively and loosening at 189 days and 422 days postoperatively. Femoral cementing can be done using the DA approach safely and reduces the number of complications compared with a contemporary cementless series. Conclusion A higher rate of early fractures and loosening occurred with cementless stems. This was not observed in our cemented stem cohort and cementing was safely accomplished through the DA approach. The modern femoral cementing process with the DA approach does not add to surgical complexity or time, has fewer early complications, and is a safer option for older patients compared to cementless femoral arthroplasties. Cite this article: Bone Joint J 2021;103-B(7 Supple B):33–37.
Outcomes of operatively treated interprosthetic femoral fractures
Authors: Tibbo Meagan E. , Limberg Afton K. , Gausden Elizabeth B. , Huang Phil , Perry Kevin I. , Yuan Brandon J. , Berry Daniel J. , Abdel Matthew P. 
Published: July 2021

AimsThe prevalence of ipsilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA) is rising in concert with life expectancy, putting more patients at risk for interprosthetic femur fractures (IPFFs). Our study aimed to assess treatment methodologies, implant survivorship, and IPFF clinical outcomes.MethodsA total of 76 patients treated for an IPFF from February 1985 to April 2018 were reviewed. Prior to fracture, at the hip/knee sites respectively, 46 femora had primary/primary, 21 had revision/primary, three had primary/revision, and six had revision/revision components. Mean age and BMI were 74 years (33 to 99) and 30 kg/m2(21 to 46), respectively. Mean follow-up after fracture treatment was seven years (2 to 24).ResultsOverall, 59 fractures were classified as Vancouver C (Unified Classification System (UCS) D), 17 were Vancouver B (UCS B). In total, 57 patients (75%) were treated with open reduction and internal fixation (ORIF); three developed nonunion, three developed periprosthetic joint infection, and two developed aseptic loosening. In all, 18 patients (24%) underwent revision arthroplasty including 13 revision THAs, four distal femoral arthroplasties (DFAs), and one revision TKA: of these, one patient developed aseptic loosening and two developed nonunion. Survivorship free from any reoperation was 82% (95% confidence interval (CI) 66.9% to 90.6%) and 77% (95% CI 49.4% to 90.7%) in the ORIF and revision groups at two years, respectively. ORIF patients who went on to union tended to have stemmed knee components and greater mean interprosthetic distance (IPD = 189 mm (SD 73.6) vs 163 mm (SD 36.7); p = 0.546) than nonunited fractures. Patients who went on to nonunion in the revision arthroplasty group had higher medullary diameter: cortical width ratio (2.5 (SD 1.7) vs 1.3 (SD 0.3); p = 0.008) and lower IPD (36 mm (SD 30.6) vs 214 mm (SD 32.1); p < 0.001). At latest follow-up, 95% of patients (n = 72) were ambulatory.ConclusionInterprosthetic femur fractures are technically and biologically challenging cases. Individualized approaches to internal fixation versus revision arthroplasty led to an 81% (95% CI 68.3% to 88.6%) survivorship free from reoperation at two years with 95% of patients ambulatory. Continued improvements in management are warranted. Cite this article: Bone Joint J 2021;103-B(7 Supple B):122–128.
Half-life of surgical truth in general surgery
Authors: James OP , Smith L , Locker D , Hopkins L , Robinson DBT , Abdelrahman T , Barry J , Codd R , Egan R , Harries R , Jayamanne H , Jones HG , Pollitt J , Powell AGMT , Stephens M , Thippeswamy KM , Williams G , Williams IM , Williamson J , Lewis WG 
Published: July 2021

Introduction Karl Popper’s hypothetico-deductive model contends that an assertion is true if it agrees with the facts, and that science progresses via paradigms held to be true until replaced by better approximations of reality. Our study aimed to estimate the half-life of surgical dogma. Methods The first 15 general surgery articles at 5-year intervals were extracted from the British Journal of Surgery since its inception in 1913. A statement summarising each article’s conclusion was formatted, and non-conducive articles were excluded (n=22). A total of 293 article statements were reviewed and marked as true or false by a cohort of 15 senior general surgeons, with a majority positive response denoting a true statement. Regression analysis of the relationship between perceived truth and time was performed. Results Median reviewer positive response rate was 49.5% (range 35.8–64.2%), with over 80% of responders in total agreement regarding 151 statements (51.5%) and deeming 137 (46.8%) currently true. Publication year correlated with percentage of true responses (rho 0.647, p=0.002). Linear modelling of true responses related to 5-year intervals (R2=0.398, p=0.002) estimated the annual rate of loss of truth to be 0.25%, equating to a half-life of 200.0 years. Conclusions Contrary to popular belief, it appears THAT surgical dogma does not lose its lustre for some seven generations. Regression line extrapolation is contentious but would suggest that the current era of surgical knowledge extends from 1769 – the days of John Hunter, the ‘father of modern surgery’ – to 2176, although relative rates of innovation may accelerate and move the nexus point.
Paediatric dentists’ views on the use of silver diammine fluoride: a UK perspective
Authors: Timms Laura , Graham Anna , Gallacher Nicola , Large Jessica , Simpson Sarah , Johnson Rosamund , Gallichan Nathalie , Oliver Rachel , Morgan Emma , Hardwick Constance , Gormley Alexander , Dixon Carly 
Published: July 2021

Introduction Silver diamine fluoride (SDF) is an option for biologic caries management that is not well utilised in the United Kingdom (UK). Caries in the primary dentition is common in the UK, and despite current treatment options many children require invasive treatment and multiple extractions. SDF could provide an alternative and due to their clinical expertise paediatric dentists are well placed to discuss this. Methods Fourteen semi-structured interviews were carried out with paediatric dentists across the UK. This was a heterogeneous sample including working across different settings, with differing levels of experience and both academic and NHS primary employment. Thematic analysis was undertaken with respondent validation. Results Participants felt SDF could be useful where patients have caries in their primary dentition, are asymptomatic and cannot manage other treatment options. The five themes influencing their views were child factors, parental influence, external influences, the clinician’s knowledge, experience and beliefs and the properties of SDF. Conclusion Paediatric dentists interviewed feel that there is a role for SDF in caries management in the UK. They believe case selection and communication with families is important.
July 2021 Critical Care Case of the Month: When a Chronic Disease Becomes Acute
Authors:   Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado, Denver, CO USA, Calhoun Kara 
Published: July 2021

No abstract available. Article truncated after 150 words. History of Present Illness A 32-year-old woman with no known past medical history presented with progressive shortness of breath for 2 weeks. She denied having a cough, fever, or chills, but she did have a one-month history of fatigue, weakness, and painful rashes on her hands. PMH, SH, and FH •	No known past medical history •	Former tobacco user (quit 2 years prior to admission) •	No drug use •	Worked as an office assistant •	Has two pet dogs and four pet macaws •	No family history of lung disease •	Not taking any prescription medications Physical Exam •	BP: 116/65, Pulse: 105, T: 37°C, RR: 28, SpO2: 89% on HHFNC (60L; 100%) •	Pulmonary: Tachypneic, in respiratory distress, crackles throughout •	Cardiovascular: Tachycardic but regular, no murmurs •	Extremities: No edema •	Skin: Palms with purplish discoloration and erythematous papules Which of the following should be done next? 1.	CT Chest 2.	COVID-19 testing 3.	Sputum gram stain and …
On Unconditional Hos(ti)pitality: Thinking-doing Strategies for Dis/Abling Arts Education
Authors: Trento Francisco B. 
Published: July 2021

Hospitality and diplomacy are understood as universal hosting parameters. However, they fail to address non-neurotypical perception, jeopardising the inclusiveness of arts education environments. By bringing hospitality, inclusiveness, neurotypicality, and more-than-human wildness into conversation, I argue for developing pedagogical spaces oriented to deconstructing normalcy. This article emerges at the intersection of disability studies and neuroqueerness and it is further developed through KarenBarad’s take on non-human agency and Deleuzoguattarian schizoanalysis. Jacques Derrida conceptualises hostipitality to problematise how hospitality cannot enable radical difference. I discuss this notion in dialogue with anecdotes from The Spaze, which is a schizoanalytical experiment and a procedural architecture oriented to non- neurotypicality developed at the Senselab. There, relationality is understood as always more-than-human. In this article, I furthermore examine how diplomacy’s rhetoricexcludes non-neurotypical perception by enacting what Félix Guattari names normopathy, namely, the privileging of linguistic patterns, human-to-human relationalities, and typical socialities. By discussing non-neurotypicality, I aim to queer rhetoric in arts education, diffracting Derrida’s notion of hospitality to foreground the more-than-human relationality developed by Deleuzoguattarian and Baradian perspectives.
Análisis ético y jurídico del turismo médico en Colombia. Riesgos en la instrumentalización comunicativa
Authors: Bastidas-Goyes Luis Guillermo , Méndez-Castillo Efraín , Bonilla-Estévez Claudia Marina 
Published: July 2021

En un contexto globalizado, donde el mundo convencional se expande a lo virtual, se desarrolla un análisis ético y jurídico del turismo médico en Colombia mediante la identificación de riesgos potenciales en la instrumentalización comunicativa. La oferta y demanda de cirugía estética acompañada del marketing, como un reflejo del deseo, lo bello y el maquillaje, promueven tensiones éticas latentes. La incertidumbre jurídica que gravita alrededor del flujo transfronterizo e indeterminación de los distintos sistemas jurídicos exterioriza varios frentes susceptibles de abordaje y que a su vez se erigen como desafíos. El trasfondo de las reflexiones que se divisan hace imprescindible reivindicar prerrogativas fundamentales, inherentes a los seres humanos, que parecen desvanecerse ante inserciones cada vez más frecuentes y penetrantes provenientes de realidades construidas y enraizadas en el vaivén de los precios.
Polarization-resolved second-harmonic generation imaging through a multimode fiber
Authors: Cifuentes Angel , Pikálek Tomáš , Ondráčková Petra , Amezcua-Correa Rodrigo , Antonio-Lopez José Enrique , Čižmár Tomáš , Trägårdh Johanna 
Published: July 2021

Multimode fiber-based endoscopes have recently emerged as a tool for
minimally invasive endoscopy in tissue, at depths well beyond the
reach of multiphoton imaging. Here, we demonstrate label-free
second-harmonic generation (SHG) microscopy through such a fiber
endoscope. We simultaneously fully control the excitation polarization
state and the spatial distribution of the light at the fiber tip, and
we use this to implement polarization-resolved SHG imaging, which
allows imaging and identification of structural proteins such as
collagen and myosin. We image mouse tail tendon and heart tissue,
employing the endoscope at depths up to 1 mm, demonstrating that we
can differentiate these structural proteins. This method has the
potential for enabling instant and in
situ diagnosis of tumors and fibrotic conditions in sensitive
tissue with minimal damage.
Achieving high-responsivity near-infrared detection at room temperature by nano-Schottky junction arrays via a black silicon/platinum contact approach
Authors: Hu Fei , Wu Li , Dai Xiyuan , Li Shuai , Lu Ming , Sun Jian 
Published: July 2021

A room temperature sub-bandgap near-infrared (

λ
>
1100

nm

) Si photodetector with high responsivity is achieved. The Si photodetector features black Si made by wet etching Si (100), Si/PtSi nano-Schottky junction arrays made from black Si/Pt contacts, and chemical and field-effect passivation of black Si. Responsivities are 147.6, 292.8, and 478.2 mA/W at reverse voltages of

−
1.0
,
−
1.5

, and

−
2.0

V

for 1550 nm light, respectively, with corresponding specific detectivities being

9.79
×

10

8

,

1.88
×

10

9

, and

2.97
×

10

9

cm
·

Hz

1
/
2

/
W

. This work demonstrates a practical room temperature sub-bandgap near-infrared Si photodetector that can be made in a facile and large-scale manner.