bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Preoperative Breast MRI on Surgical Margin Status in Breast Cancer Patients Recalled at Biennial Screening Mammography: An Observational Cohort Study
Authors: Gommers Jessie J. J. , Duijm Lucien E. M. , Bult Peter , Strobbe Luc J. A. , Kuipers Toon P. , Hooijen Marianne J. H. , Mann Ritse M. , Voogd Adri C. 
Published: April 2021

Abstract
Background
This study aimed to examine the association between preoperative magnetic resonance imaging (MRI) and surgical margin involvement, as well as to determine the factors associated with positive resection margins in screen-detected breast cancer patients undergoing breast-conserving surgery (BCS).

Methods
Breast cancer patients eligible for BCS and diagnosed after biennial screening mammography in the south of The Netherlands (2008–2017) were retrospectively included. Missing values were imputed and multivariable regression analyses were performed to analyze whether preoperative MRI was related to margin involvement after BCS, as well as to examine what factors were associated with positive resection margins, defined as more than focally (>4 mm) involved.

Results
Overall, 2483 patients with invasive breast cancer were enrolled, of whom 123 (5.0%) had more than focally involved resection margins. In multivariable regression analyses, preoperative MRI was associated with a reduced risk of positive resection margins after BCS (adjusted odds ratio [OR] 0.56, 95% confidence interval [CI] 0.33–0.96). Lobular histology (adjusted OR 2.86, 95% CI 1.68–4.87), large tumor size (per millimeter increase, adjusted OR 1.05, 95% CI 1.03–1.07), high (>75%) mammographic density (adjusted OR 3.61, 95% CI 1.07–12.12), and the presence of microcalcifications (adjusted OR 4.45, 95% CI 2.69–7.37) and architectural distortions (adjusted OR 1.85, 95% CI 1.01–3.40) were independently associated with positive resection margins after BCS.

Conclusions
Preoperative MRI was associated with lower risk of positive resection margins in patients with invasive breast cancer eligible for BCS using multivariable analysis. Furthermore, specific mammographic characteristics and tumor characteristics were independently associated with positive resection margins after BCS.
Nitrogenization of Biomass-Derived Porous Carbon Microtubes Promotes Capacitive Deionization Performance
Authors: Sheng Xinran , Xu Xingtao , Wu Yue , Zhang Xiaojie , Lin Peng , Eid Kamel , Abdullah Aboubakr M , Li Zhengtong , Yang Tao , Nanjundan Ashok Kumar , Yamauchi Yusuke 
Published: April 2021

Abstract
Nitrogenization of porous carbon provides an effective methodology to promote capacitive deionization (CDI) performance. Exploring a new class of nitrogen-doped porous carbons from waste biomass over commercially available activated carbons is of significant interest in CDI. In this contribution, we present the preparation of nitrogen-doped porous carbon microtubes (N-CMTs) by pyrolyzing willow catkins, a naturally abundant biomass with urea as the nitrogen source. Due to the naturally occurring hollow microtube structure and the high nitrogen content, the as-prepared N-CMTs show an enhanced desalination performance compared to undoped samples. A high deionization capacity of 16.78 mg g−1 predicted by Langmuir isotherm and a stable cycling performance over ten cycles are observed. The result advocates the importance and significance of naturally developed architectures and chemistry for practical CDI application.
Effects of Systematic Changes in Commodity Arrangement on the Satisfaction of Supermarket Customers
Authors: Tošenovský Josef , Tošenovský Filip , Dočkalová Ivana 
Published: April 2021

Purpose: The paper investigates if relocation of goods at supermarkets, practised to boost sales, bothers customers and improves financial results of the stores. To explore this, a questionnaire-based poll was run, using questions, such as “Do you mind if commodity is not permanently in the same place?”, or “While searching, do you buy anything you did not indend to buy?”. Various relations are also observed. For instance, are opinions on product relocation related in any way to age of customers? The study suggests most customers are not satisfied with changes in product location, yet the practices lead to higher sales. It turns out the business principle – only satisfied customers spend more – may not be so true. In the study, some new questions also arose and were evaluated, such as the question “Which management activities have a positive effect on customers?”.
Methodology/Approach: The paper relies on statistical testing, specifically on the chi-square test of independence and a test of differences in the relative frequency of occurrence of diverse phenomena. Real, empirical data are utilized.
Findings: The analysis showed that most customers dislike looking for goods, and many of them buy items that they did not intend to purchase. Thus, a paradox occurs when entrepreneurs dissatisfy customers, yet they register higher profits.
Research Limitation/Implication: The results concern a specific scientific field – microeconomic behavioural patterns at supermarkets.
Originality/Value of paper: The research presented in this paper is focused on the Czech Republic where it has not been undertaken to date. Work of this kind is not cited in the scientific literature, however.
Maternal factors associated with stillbirth among women in Marsabit County, Kenya
Authors: Wako Badane Amina , Epiu Isabella , Otor Samuel 
Published: April 2021

Background/Aim Stillbirth refers to fetal death occurring at or after 28 weeks of gestation. Worldwide, 130 million babies are born every year and approximately 4 million are stillborn; more than 98% of these deaths occur in developing countries. The government of the Republic of Kenya has put in place several measures, such as the National Health Insurance Fund and Free Child Delivery Programmes for pregnant women, in order to meet the Sustainable Development Goals on health. However, the problem of stillbirth continues to prevail in the country. This study sought to determine maternal factors associated with occurrence of stillbirth in selected hospitals in Marsabit County, Kenya. Methods The study employed a cross-sectional descriptive study design, targeting 387 women who delivered in selected hospitals in Marsabit County, to collect qualitative and quantitative data. Quantitative data were analysed using the Statistical Package for Social Sciences version 24.0 while qualitative data were analysed using N-Vivo software version 11. Inferential statistics were calculated using Chi Square and Fisher's Exact Tests at 95% confidence interval and P<0.05 was considered significant. Results The rate of stillbirth occurrence was 5.9%. Maternal factors significantly associated with the occurrence of stillbirth included antenatal attendance (P=0.031), use of illicit drugs (P=0.041), low maternal weight (P=0.043) and tough domestic work (P=0.004). Conclusions The respondents from Marsabit County experienced relative high rates of stillbirth compared to the national figure. The outcome of delivery was significantly influenced by maternal factors. These results may help address the high rate of stillbirth across the country and improve the delivery outcomes of pregnancies among mothers delivering in public hospitals.
Does chronic kidney disease affect implant survival after primary hip and knee arthroplasty?
Authors: Jämsä Pyry , Reito Aleksi , Oksala Niku , Eskelinen Antti , Jämsen Esa 
Published: April 2021

Aims To investigate whether chronic kidney disease (CKD) is associated with the risk of all-cause revision or revision due to a periprosthetic joint infection (PJI) after primary hip or knee arthroplasty. Methods This retrospective cohort study comprised 18,979 consecutive hip and knee arthroplasties from a single high-volume academic hospital. At a median of 5.6 years (interquartile range (IQR) 3.5 to 8.1), all deaths and revisions were counted. To overcome the competing risk of death, competing risk analysis using the cumulative incidence function (CIF) was applied to analyze the association between different stages of CKD and revisions. Confounding factors such as diabetes and BMI were considered using either a stratified CIF or the Fine and Gray model. Results There were 2,111 deaths (11.1%) and 677 revisions (3.6%) during the follow-up period. PJI was the reason for revision in 162 cases (0.9%). For hip arthroplasty, 3.5% of patients with CKD stage 1 (i.e. normal kidney function, NKF), 3.8% with CKD stage 2, 4.2% with CKD stage 3, and 0% with CKD stage 4 to 5 had undergone revision within eight years. For knee arthroplasty, 4.7% with NKF, 2.7% with CKD stage 2, 2.4% with CKD stage 3, and 7% of CKD stage 4 to 5 had had undergone revision. With the exception of knee arthroplasty patients in whom normal kidney function was associated with a greater probability of all-cause revision, there were no major differences in the rates of all-cause revisions or revisions due to PJIs between different CKD stages. The results remained unchanged when diabetes and BMI were considered. Conclusion We found no strong evidence that CKD was associated with an increased risk of all-cause or PJI-related revision. Selection bias probably explains the increased amount of all-cause revision operations in knee arthroplasty patients with normal kidney function. The effect of stage 4 to 5 CKD was difficult to evaluate because of the small number of patients. Cite this article: Bone Joint J 2021;103-B(4):689–695.
Total ankle arthroplasty
Authors: Clough Timothy M. , Ring Joseph 
Published: April 2021

Aims We report the medium-term outcomes of a consecutive series of 118 Zenith total ankle arthroplasties (TAAs) from a single, non-designer centre. Methods Between December 2010 and May 2016, 118 consecutive Zenith prostheses were implanted in 114 patients. Demographic, clinical, and patient-reported outcome measures (PROMs) data were collected. The endpoint of the study was failure of the implant requiring revision of one or all of the components. Kaplan-Meier survival curves were generated with 95% confidence intervals (CIs) and the rate of failure calculated for each year. Results Eight patients (ten ankles) died during follow-up, but none required revision. Of the surviving 106 patients (108 ankles: rheumatoid arthritis (RA), n = 15; osteoarthritis (OA), n = 93), 38 were women and 68 were men, with a mean age of 68.2 years (48 to 86) at the time of surgery. Mean follow-up was 5.1 years (2.1 to 9.0). A total of ten implants failed (8.5%), thus requiring revision. The implant survival at seven years, using revision as an endpoint, was 88.2% (95% CI 100% to 72.9%). There was a mean improvement in Manchester-Oxford Foot and Ankle Questionnaire (MOXFQ) from 85.0 to 32.8 and visual analogue scale (VAS) scores from 7.0 to 3.2, and overall satisfaction was 89%. The three commonest complications were malleolar fracture (14.4%, n = 17), wound healing (13.6%, n = 16), and superficial infection (12.7%, n = 15). The commonest reason for revision was aseptic loosening. No patients in our study were revised for deep infection. Conclusion Our results show that Zenith survival rates are comparable with those in the literature for other implants and in the National Joint Registry (NJR). Overall patient satisfaction was high as were functional outcomes. However, the data highlight potential complications associated with this surgery. The authors believe that these figures support ankle arthroplasty as an option in the treatment of ankle arthritis. Cite this article: Bone Joint J 2021;103-B(4):696–703.
Factors which predict adverse events following surgery in adults with cervical spinal deformity
Authors: Varshneya Kunal , Jokhai Rayyan , Medress Zachary Adam , Stienen Martin Nikolaus , Ho Allen , Fatemi Parastou , Ratliff John Kevin , Veeravagu Anand 
Published: April 2021

Aims The aim of this study was to identify the risk factors for adverse events following the surgical correction of cervical spinal deformities in adults. Methods We identified adult patients who underwent corrective cervical spinal surgery between 1 January 2007 and 31 December 2015 from the MarketScan database. The baseline comorbidities and characteristics of the operation were recorded. Adverse events were defined as the development of a complication, an unanticipated deleterious postoperative event, or further surgery. Patients aged < 18 years and those with a previous history of tumour or trauma were excluded from the study. Results A total of 13,549 adults in the database underwent primary corrective surgery for a cervical spinal deformity during the study period. A total of 3,785 (27.9%) had a complication within 90 days of the procedure, and 3,893 (28.7%) required further surgery within two years. In multivariate analysis, male sex (odds ratio (OR) 0.90 (95% confidence interval (CI) 0.8 to 0.9); p = 0.019) and a posterior approach (compared with a combined surgical approach, OR 0.66 (95% CI 0.5 to 0.8); p < 0.001) significantly decreased the risk of complications. Osteoporosis (OR 1.41 (95% CI 1.3 to 1.6); p < 0.001), dyspnoea (OR 1.48 (95% CI 1.3 to 1.6); p < 0.001), cerebrovascular accident (OR 1.81 (95% CI 1.6 to 2.0); p < 0.001), a posterior approach (compared with an anterior approach, OR 1.23 (95% CI 1.1 to 1.4); p < 0.001), and the use of bone morphogenic protein (BMP) (OR 1.22 (95% CI 1.1 to 1.4); p = 0.003) significantly increased the risks of 90-day complications. In multivariate regression analysis, preoperative dyspnoea (OR 1.50 (95% CI 1.3 to 1.7); p < 0.001), a posterior approach (compared with an anterior approach, OR 2.80 (95% CI 2.4 to 3.2; p < 0.001), and postoperative dysphagia (OR 2.50 (95% CI 1.8 to 3.4); p < 0.001) were associated with a significantly increased risk of further surgery two years postoperatively. A posterior approach (compared with a combined approach, OR 0.32 (95% CI 0.3 to 0.4); p < 0.001), the use of BMP (OR 0.48 (95% CI 0.4 to 0.5); p < 0.001) were associated with a significantly decreased risk of further surgery at this time. Conclusion The surgical approach and intraoperative use of BMP strongly influence the risk of further surgery, whereas the comorbidity burden and the characteristics of the operation influence the rates of early complications in adult patients undergoing corrective cervical spinal surgery. These data may aid surgeons in patient selection and surgical planning. Cite this article: Bone Joint J 2021;103-B(4):734–738.
Incidence and clinical outcome of lateral femoral cutaneous nerve injury after periacetabular osteotomy
Authors: Doi Nobunao , Kinoshita Koichi , Sakamoto Tetsuya , Minokawa Ayumi , Setoguchi Daisuke , Yamamoto Takuaki 
Published: April 2021

Aims Injury to the lateral femoral cutaneous nerve (LFCN) is one of the known complications after periacetabular osteotomy (PAO) performed using the anterior approach, reported to occur in between 1.5% and 65% of cases. In this study, we performed a prospective study on the incidence of LFCN injury as well as its clinical outcomes based on the Harris Hip Score (HHS), Short-Form 36 Health Survey (SF-36), and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ). Methods The study included 42 consecutive hips in 42 patients (three male and 39 female) who underwent PAO from May 2016 to July 2018. We prospectively evaluated the incidence of LFCN injury at ten days, three months, six months, and one year postoperatively. We also evaluated the clinical scores, including the HHS, SF-36, and JHEQ scores, at one year postoperatively. Results LFCN injury was observed in 31 of 42 (74%) patients at ten days, of which 11 resolved completely by one year. Incidence decreased gradually, to 25 of 42 (60%) patients at three months, 24 of 42 patients (57%) at six months, and 20 of 42 (48%) patients at one year postoperatively. There was no significant difference in the HHS between patients with and without LFCN injury at one year postoperatively. Regarding the SF-36 and JHEQ, a significant difference in the mental score was recognized between patients with and without LFCN injury, but there were no significant differences in the other clinical scores. Conclusion The incidence of LFCN injury was 74% at ten days after PAO, and subsequently decreased to 48% at one year. LFCN injury did not influence the hip function as assessed by the HHS, but had a negative impact on mental health at one year. Cite this article: Bone Joint J 2021;103-B(4):659–664.
Evidence for the validity of a patient-based instrument for assessment of outcome after revision knee arthroplasty
Authors: Sabah Shiraz A. , Alvand Abtin , Beard David J. , Price Andrew J. 
Published: April 2021

Aims To estimate the measurement properties for the Oxford Knee Score (OKS) in patients undergoing revision knee arthroplasty (responsiveness, minimal detectable change (MDC-90), minimal important change (MIC), minimal important difference (MID), internal consistency, construct validity, and interpretability). Methods Secondary data analysis was performed for 10,727 patients undergoing revision knee arthroplasty between 2013 to 2019 using a UK national patient-reported outcome measure (PROM) dataset. Outcome data were collected before revision and at six months postoperatively, using the OKS and EuroQol five-dimension score (EQ-5D). Measurement properties were assessed according to COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) guidelines. Results A total of 9,219 patients had complete outcome data. Mean preoperative OKS was 16.7 points (SD 8.1), mean postoperative OKS 29.1 (SD 11.4), and mean change in OKS + 12.5 (SD 10.7). Median preoperative EQ-5D index was 0.260 (interquartile range (IQR) 0.055 to 0.691), median postoperative EQ-5D index 0.691 (IQR 0.516 to 0.796), and median change in EQ-5D index + 0.240 (IQR 0.000 to 0.567). Internal consistency was good with Cronbach’s α 0.88 (baseline) and 0.94 (post-revision). Construct validity found a high correlation of OKS total score with EQ-5D index ( r = 0.76 (baseline), r = 0.83 (post-revision), p < 0.001). The OKS was responsive with standardized effect size (SES) 1.54 (95% confidence interval (CI) 1.51 to 1.57), compared to SES 0.83 (0.81 to 0.86) for the EQ-5D index. The MIC for the OKS was 7.5 points (95% CI 5.5 to 8.5) based on the optimal cut-off with specificity 0.72, sensitivity 0.60, and area under the curve 0.66. The MID for the OKS was 5.2 points. The MDC-90 was 3.9 points. The OKS did not demonstrate significant floor or ceiling effects. Conclusion This study found that the OKS was a useful and valid instrument for assessment of outcome following revision knee arthroplasty. The OKS was responsive to change and demonstrated good measurement properties. Cite this article: Bone Joint J 2021;103-B(4):627–634.
Platelet-rich plasma: a narrative review
Authors: Collins Thomas , Alexander Dinesh , Barkatali Bilal 
Published: April 2021

The aim of this article was to synopsize platelet-rich plasma (PRP) use in musculoskeletal pathologies through evidence-based assessment of the preparation, classification, mechanism of action and applications of PRP, thereby answering which PRP type is best for each clinical indication. The literature search was performed using Medline, EMBASE and Cochrane Reviews databases for papers containing the key terms “platelet-rich plasma” AND “orthopaedics” AND (“classification” OR “mechanism of action” OR “preparation” OR “clinical application”). Generated papers were evaluated for pertinence in following areas: preparation, classification, mechanism of action, clinical application within orthopaedics. Non-English papers were excluded. Included studies were evaluated for quality. Sixty studies were included in our review. There are many commercial PRP preparation kits with differing component concentrations. There is no consensus on optimal component concentrations. Multiple PRP classifications exist but none have been validated. Platelet-rich plasma acts via growth factors (GFs) released from α-granules within platelets. Growth factors have been shown to be beneficial in healing. Grossly elevated concentrations of GFs may have inhibitory effects on healing. Multiple systematic reviews show efficacy of PRP in tendinopathies, early osteoarthritis, acute muscle injuries and in combination with rotator cuff repair and anterior cruciate ligament reconstruction. The literature suggests leukocyte-rich PRP (L-PRP) is more beneficial in tendinopathies and pure PRP (P-PRP) is more beneficial in cartilage pathology. However, different PRP preparations have not been directly compared in any pathology. Classification of PRP type is frequently not stated in research. Standardization of PRP research parameters is needed to streamline findings and generate clear indications for PRP types to yield maximum clinical benefit.Cite this article: EFORT Open Rev 2021;6:225-235. DOI: 10.1302/2058-5241.6.200017
Dental care for children with selective mutism
Authors: Agel Mona , Hipolito Gino 
Published: April 2021

Selective mutism (SM) is an anxiety disorder that is characterised by a consistent failure to speak in certain social settings where the individual is expected to speak while in other situations, speech is normal. It often starts in childhood and is thought to affect around 1 in 140 children in the UK. If recognised and treated early, SM can be overcome but left untreated, it can lead to long-term problems. It is thought to be caused by a complex interaction between various vulnerabilities such as genetics, temperament, environment and neurodevelopmental factors. Treatment methods are variable and can include non-medication-based therapies (eg behavioural therapy) or pharmacotherapy. This paper specifically addresses the child with SM. Few professionals are trained in dealing with SM and many have little knowledge of the condition. SM awareness for parents and professionals along with appropriate information and intervention techniques are vital. For children with SM, dental visits can prove challenging. Each child is unique in how they present with their difficulties. A child attending the dentist for a dental problem or a routine examination may not yet be diagnosed with SM, and so knowledge of the condition and what appropriate services are available is important. The dental team should understand the possible modes of therapy that the child is receiving and work with these principles during dental appointments. Simple strategies such as asking the parent how best to communicate with the child, understanding what makes the child feel at ease and whether the child has any other phobias or anxieties can help.
In-vivo imaging of melanoma with simultaneous dual-wavelength acoustic-resolution-based photoacoustic/ultrasound microscopy
Authors: Wang Congcong , Guo Lili , Wang Guan , Ye Tong , Wang Bo , Xiao Jiaying , Liu Xinli 
Published: April 2021

Melanoma is a common, highly fatal skin cancer. Photoacoustic imaging
can achieve highly sensitive and high-contrast detection of melanin
molecules in tissues, also inheriting the high penetration depth and
high spatial resolution characteristics of ultrasound imaging, thus it
is a very promising non-invasive diagnostic tool for early melanoma.
In this work, we built an acoustic-resolution-based photoacoustic
microscopy system, using 1064 nm/532 nm pulsed light to observe
melanoma in the back of a mouse with simultaneous
photoacoustic/ultrasound imaging. Through the fusion of multi-modal
images, accurate positioning of melanoma and its surrounding normal
tissues were realized. This work will further promote the application
of photoacoustic imaging in the clinical diagnosis of early
melanoma.