bluuebunny/crossref_metadata_2025_split huggingface dataset:
SONICATION FLUID INCUBATION IN BLOOD CULTURE BOTTLES IS MORE SENSITIVE FOR PERIPROSTHETIC JOINT INFECTION THAN CLASSICAL CULTIVATION OF SONICATION FLUID
Authors: Roskar Samo , Rak Mitja , Mihalic Rene , Trebse Rihard 
Published: November 2024

AimPeriprosthetic joint infection (PJI) is one of the most devastating complications after joint replacement. It is associated with high morbidity and economic burden when misdiagnosed as an aseptic failure. Among all cases of PJI, up to 25% could yield negative cultures. Conversely, among cases of aseptic failures, up to 30% may actually be undiagnosed PJIs. In PJIs microbiological diagnosis is a key step for successful treatment. Sonication of the removed prosthesis is more sensitive than conventional periprosthetic-tissue culture, especially in patients who received antimicrobial therapy before surgery. This study aimed to compare the diagnostic value of classic sonication fluid cultures (SF-C) and sonication fluid incubation in blood culture bottle (SF-BCB).MethodBetween 2016 and 2018 we analysed 160 revision procedures of joint arthroplasties. For each procedure, at least 5 microbiological and multiple histopathological samples were harvested, and explant sonication was performed which was further analysed by SF-C and SF-BCB. For SF-C classical cultivation of sonication fluid was performed. While for SF-BCB, 10 mL of sonication fluid was inoculated into aerobic and anaerobic lytic blood culture bottles. The definite diagnosis of PJI was based on the EBJIS definition.ResultsAmong 160 revisions, 59 PJIs were identified, 15 patients were treated with the debridement and implant retention, 7 patients with the one-stage and 35 with the two-stage exchange, remaining 2 were partial revisions. The sensitivity of SF-C and SF-BCB were 81.5% and 94.9%, respectively. The mismatch of microbe identification was observed in 5 cases. We observed positive SF-C while negative SF-BCB in 4 cases, among them having 2 positive histology. While 12 patients have negative SF-C and positive SF-BCB, among them 3 have positive and 6 negative histology. Among these 12 patients, typical low-grade microbes were identified in 9 cases (5 cases of C. acnes, 3 cases of S. epidermidis, and 1 case of S. capitis).ConclusionsThe weakest point in all PJI diagnostic criteria is their sensitivity. SF-BCB demonstrates higher sensitivity in diagnosing PJI compared to SF-C. Therefore, it appears prudent to incorporate SF-BCB into the diagnostic protocol for all patients exhibiting either low-grade PJI symptoms or experiencing undiagnosed, presumably aseptic failures, where the likelihood of misdiagnosing infection is greatest.
SEPTIC ORTHO-PLASTIC RECONSTRUCTION SURGERY: OUTCOMES FROM A SIX-YEAR COLLABORATIVE STUDY
Authors: Lentini Audrey , Djoko Joseph , Putineanu Dan , Tribak Karim , Coyette Maude , Yombi Jean-Cyr , Cornu Olivier 
Published: November 2024

AimBone infections often manifest with soft tissue complications such as severe scarring, fistulas, or ulcerations. Ideally, their management involves thorough debridement of infected bone and associated soft tissues, along with achieving stable bone structure, substantial tissue coverage, and long-term antibiotic therapy. The formation of a multidisciplinary team comprising orthopedic surgeons, plastic surgeons, and infectious disease specialists is essential in addressing the most complex cases.MethodWe conducted a retrospective study during six years (2018-2023) at our university center. Focusing on the most challenging cases, we included patients with bone infections in the leg and/or foot requiring free flap reconstruction. Each patient underwent simultaneous bone debridement and reconstruction by the orthopedic team, alongside soft tissue debridement and free flap reconstruction by the plastic surgery team. Targeted antibiotic therapy for either 6 weeks (acute) or 12 weeks (chronic osteitis) was initiated based on intraoperative cultures. Additional procedures such as allografts, arthrodesis, or autografts were performed if necessary. We analyzed the rates of bone union, infection resolution, and limb preservation.ResultsForty-five patients were enrolled. Twenty-four patients (53.3%) had urgent indications (e.g., open infected fractures, osteitis, acute osteoarthritis, or wound dehiscence), while 21 (46.7%) underwent elective surgery (e.g., septic pseudarthrosis or chronic osteitis). Two patients underwent amputation due to flap failure (4.4%), and one patient was lost to follow-up. Follow-up of the remaining 42 patients averaged 28 months (range: 6–60 months). During this period, 35 patients (83.4%) experienced no recurrence of infection. Similarly, 35 patients (83.4%) achieved bone union. Overall, the rate of lower limb preservation was 93.3%.ConclusionsManaging bone infection coupled with soft tissue defects brings significant challenges. Although the majority of patients treated here belong to a complex framework based on the BACH classification, the outcomes achieved here appear to align with those of the simpler cases, thanks to optimal care with a dedicated septic ortho-plastic team. Our study demonstrates a notable success rate in treating infection, achieving bone consolidation, and preserving lower limb function.
VANCOMYCIN ELUTION KINETICS FROM ANTIBIOTIC AUGMENTED ALLOGRAFT AND RESORBABLE SYNTHETIC BONE FILLER SUPERIOR TO ANTIBIOTIC AUGMENTED BONE CEMENT: AN IN VITRO STUDY OVER 42 DAYS
Authors: Glehr Mathias , Smolle Maria , Murtezai Hana , Amerstorfer Florian , Hörlesberger Nina , Leitner Lukas , Klim Sebastian , Hauer Georg , Leithner Andreas 
Published: November 2024

AbstractBackgroundThe aim of the present experimental study was to analyse vancomycin elution kinetics of nine bone fillers used in orthopaedic and trauma surgery over 42 consecutive days.MethodsTwo allograft bone chips (carriers 1 and 2), a calcium-sulfate matrix (carrier 3), a hydroxyapatite/calcium-sulphate composite (carrier 4), four bone cements (carriers 5-8) and a pure tricalcium phosphate matrix (carrier 9), either already contained vancomycin, or were mixed with it following manufacturer's recommendations. Over 42 days, half of elution medium was substituted by the same amount of PBS at 9 distinct time points. Vancomycin concentration in obtained samples were measured with a kinetic microparticle immunoassay, and masses consecutively calculated. To enhance comparability between carriers analysed, vancomycin mass released related to overall mass within each probe was determined. Notably, elution kinetics of carriers 1 to 4 have been published previously.ResultsAll carriers initially released high vancomycin masses, followed by constant reduction later into the experiment. Mean initial vancomycin masses released after 4 hours were highest for carriers 1 (337.7 ± 76.2 mg), 9 (68.4 ± 4.9 mg), and 2 (49.0 ± 54.6 mg). From prefinal (35 days) to last measurement (42 days) carriers 2 (8.6 ± 4.8 mg), 1 (2.4 ± 1.0 mg), and 5 (0.1 ± 0.1 mg) had released highest vancomycin masses. Notably, all five bone cements tested only released a small percental amount of their total mass up to the last measurement (42 days; 2.1% – 9.3%), whilst allografts and resorbable synthetic bone fillers discarded high percental values (22.5% – 79.2%).ConclusionsElution kinetics differ between 9 antibiotic-loaded bone fillers, with high vancomycin masses released by allografts and resorbable bone fillers over time. Transferred to clinical practice, these may be favoured over bone cements in case prolonged and high antibiotic release is warranted rather than mechanical stability.
Assessing a behavioral nudge on healthcare leaders’ intentions to implement evidence-based practices
Authors: Crawford Maia , O’Malley A. James , Meara Ellen , Fraze Taressa K. , Barnato Amber E. 
Published: November 2024

Importance
Leaders of healthcare organizations play a key role in developing, prioritizing, and implementing plans to adopt new evidence-based practices. This study examined whether a letter with peer comparison data and social norms messaging impacted healthcare leaders’ decision to access a website with resources to support evidence-based practice adoption.

Methods
Pragmatic, parallel-group, randomized controlled trial completed from December 2019 –June 2020. We randomized 2,387 healthcare leaders from health systems, hospitals, and physician practices in the United States, who had previously responded to our national survey of healthcare organizations, in a 1:1 allocation ratio to receive one of two cover letter versions via postal mail (all) and email (for the 60.6% with an email address), accompanying a report with their survey results. The “nudge” letter included messaging that highlighted how an organization’s results compared to peers using text, color, and icons. Both nudge and control letters included links to a resource website. We interviewed 14 participants to understand how the letter and report impacted behaviors.

Results
Twenty-two of 1,194 leaders (1.8%) sent the nudge letter accessed online resources, compared to 17 of 1193 (1.4%) sent the control letter (p = 0.424). Nine of the 14 interviewed leaders stated that viewing the letter (regardless of version) and accompanying report influenced their decision to take a subsequent action other than accessing the website. Seven leaders forwarded the report or discussed the results with colleagues; two leaders stated that receiving the letter and report resulted in a concrete practice change.

Conclusions
Receiving cover letters with a behavioral nudge did not increase the likelihood that organizational leaders accessed a resource website. Qualitative results suggested that the survey report’s peer comparison data may have been a motivator for prioritizing and delegating implementation activities, but leaders themselves did not access our online resources.
Physical activity levels, agility skills and speed among female basketball players compared to non-basketball players in Saudi Arabia: A cross-sectional study
Authors: Albishi Alaa M. 
Published: November 2024

Background
Research findings indicate a concerning prevalence of physical inactivity among Saudi females, which has been associated with low physical performance levels. To address this challenge, it is crucial to promote sports participation, particularly in activities such as basketball. However, despite its potential benefits, the specific effects of basketball engagement among Saudi females remain largely unexplored. Therefore, this study investigated the relationship between physical performance and basketball playing among female collegiate players compared to non-basketball players in Saudi Arabia. Also, this study examined the effect of years of playing basketball on the basketball players group’s speed, agility, and physical activity levels.

Methods
The participants were divided into two groups: a non-athletic control group of 20 participants (age: 22 ± 2.0 years; weight: 55.6 ± 7.7 kg; height: 157.7 ± 5.5 cm) and a basketball group of 18 participants (age: 20 ± 3.3 years; weight: 60.6 ± 12 kg; height: 163.8 ± 6.3 cm).To examine the relationship between playing basketball and physical performance levels, this study included 38 female participants divided into a non-athletic control group (N = 20) and a basketball group (N = 18). To evaluate physical performance, the 10-Meter Walk Test (10MWT), Modified Agility T-Test (MAT), and International Physical Activity Questionnaire (IPAQ) were used.

Results
Basketball players demonstrated significantly superior performance in the 10-MWT (Mann-Whitney-test = 1.7, p < .05) and MAT (Mann-Whitney-test = 9.6, p < .001) compared to the non-athletic participants. Furthermore, IPAQ scores were significantly correlated with speed and agility (p < 0.05).

Conclusion
Women who regularly played basketball exhibited superior physical activity levels and higher physical performance in speed and agility compared to those who were less active. However, no significant differences between the years of playing and any other variables were found. Nevertheless, these findings seek to contribute valuable insights into the potential benefits of basketball playing among Saudi women.
Cost-effectiveness of an oral cholate challenge test for the management of patients at risk for large esophageal varices
Authors: Chavan Shailesh , McRae Michael P. , Pitts Kelly R. , Everson Gregory T. 
Published: November 2024

Aims
The dual oral cholate challenge test (DuO) quantifies liver function and portal-systemic shunting. Herein we report the economic impact of the use of the DuO Disease Severity Index (DSI) in the clinical management of patients with chronic liver disease suspected of having large esophageal varices.

Methods
A Markov health state transition model of 100,000 patients with chronic liver disease suspected of having varices was populated with previously reported epidemiological, utility, and price data to assess the cost-effectiveness of employing the DuO test against the standard of care. The model examined the clinical and economic impact of healthcare management decisions all centered around the DSI score and given fixed prices of the DuO test.

Results
In the target population, the combined strategy of healthcare management decisions based on DSI results would be highly cost-effective within two years for a price of $3,250 per DuO test. These same management decisions would save 2,740 lives over five years. For a price of ≤$3,213 per test, this intervention would be cost-saving within two years, and for ≤$4,100 per test it would be cost-saving within five years.

Conclusions
Clinical decisions based on DSI from DuO are cost-effective in the management of patients with chronic liver disease suspected of having large esophageal varices. Future studies of direct comparison of DuO with other noninvasive tests are warranted. The DuO test offers a simplified approach that could enhance the clinical and research utility of liver function testing.
Effects of the Alexander technique on pain and adverse events in chronic non-specific neck pain: A systematic review and meta-analysis
Authors: Qin Di , Qin Yaxuan , Wang Yudi , Xue Lian , Peng Yong 
Published: November 2024

Objective
Self-care-oriented positive approach are very important for the management of chronic neck pain. To evaluate the clinical efficacy of the Alexander Technique (AT) courses on pain and adverse events in chronic non-specific neck pain (CNSNP), compared to the conventional therapy.

Methods
We evaluated the effects of the AT in the treatment of the CNSNP according to PICO (participant, intervention, comparison, outcome) elements. In this paper, we have utilized some English databases. Totally 140 records are included in the Cochrane Library (43), PubMed (18), Web of Science (27), EBSCO (21), EMBESE (31). The search dated from the day of the database’s inception to June, 2024. Those parameters like Weighted mean differences (WMD), Standardized mean difference (SMD) and 95% confidence intervals (Cis) are calculated. A random-effects model is applied to minimize the heterogeneity, and I2 test is used to assess heterogeneity, the risk of bias of RCTs studies included are assessed by the PEDro tools.

Results
A total of three studies (Two RCTs and a quasi-randomized trial) are included in this paper based on the predetermined eligibility criteria. Compared with the conventional therapy group, the included studies collectively show that the AT can provide a significant pain relief in CNSNP, whose effects can last for 2 months with a very low heterogeneity (immediate term pain score: SMD: -0.34, 95%CI: -0.87–0.19, P = 0.208, I2 = 0.0%; short term pain score: SMD: -0.33, 95%CI: -0.55–0.10, P = 0.005, I2 = 0%). In addition, compared with the conventional therapy group, the AT does not significantly increase the incidence of adverse events (AE: RR = 1.690, 95% CI: 0.67–4.27, P = 0.267, I2 = 44.3%).

Conclusion
This meta-analysis preliminarily indicated that the Alexander Technique courses may not have a significant pain relief effective in patients with chronic Non-specific neck pain, which is related to the follow-up time of the post-intervention. However, it’s necessary to interpret and apply the outcome of this research cautiously.

Systematic review registration
PROSPERO, CRD420222361001.
Effects of pharmacist-led home visit services and factors influencing medication adherence improvement
Authors: Ahn Hwayoung , Byun Bo-Kyung , Lee Tae-Hoon , Kang Dong-Won , Park Sun-Kyeong 
Published: November 2024

Background
The use of medicines is crucial in treatment, but nonadherence poses an important challenge, particularly when managing polypharmacy and long-term conditions. Pharmacist-led home visit services offer a promising solution to enhance the outcomes associated with medication use. However, the effects and the factors contributing to this improvement remain unclear.

Objective
This study assessed the effects of pharmacist-led home visit services on medication adherence and general medication knowledge. Additionally, we analyzed the factors associated with improved medication adherence.

Methods
Face-to-face, pharmacist-led home visit services were conducted via opportunistic sampling in community settings. Data were collected between 2017 and 2019. The program included participants aged ≥65 years or taking ten or more medications, in need of care, and who were willing to participate. We estimated the effects of the program by improved medication adherence and general knowledge about taking medications. Medication adherence was measured using the Morisky Scale. We used McNemar’s test to evaluate the statistical differences in outcomes before and after consultation. To identify factors influencing improvements in medication adherence, odds ratios (OR) with 95% confidence intervals (CI) were calculated using multivariate logistic regression with adjustments for covariates.

Results
Among the 1,194 participants in the program, 874 were included in the analysis. Pharmacist-led home visit services improved both medication adherence (from 69.2% to 85.8%) and mean scores for general knowledge of taking medications (from 65.3% to 89.5%). Participants aged ≥70 years showed less improvement in overall adherence than those aged <70 years (OR = 0.51; 95% CI = 0.317–0.817). The program was significantly more effective at improving adherence for participants with higher level of medication knowledge (OR = 2.93; 95% CI = 1.78–4.81) compared to those with lower level of knowledge.

Conclusion
These quantitative findings highlight the importance of pharmacist-led interventions and suggest a framework for future programs about medication management.
Uniqueness and nondegeneracy of ground states for
−
Δ
u
+
u
=
(
I
α
⋆
u
2
)
u
-\Delta u+u=\left({{\rm{I}}}_{\alpha }\star {u}^{2})u
in
R
3
{{\mathbb{R}}}^{3}
when
α
\alpha
is close to 2
Authors: Luo Huxiao , Zhang Dingliang , Xu Yating 
Published: November 2024

Abstract
In this article, we study the following Choquard equation:

−
Δ
u
+
u
=

(

I

α

⋆

u

2

)

u
,

x
∈

R

3

,

-\Delta u+u=\left({{\rm{I}}}_{\alpha }\star {u}^{2})u,\hspace{1.0em}x\in {{\mathbb{R}}}^{3},

where

I

α

{{\rm{I}}}_{\alpha }

is the Riesz potential and

α

\alpha

is sufficiently close to 2. By investigating the limit profile of ground states of the equation as

α
→
2

\alpha \to 2

, we prove the uniqueness and nondegeneracy of ground states.
Philosophizing the Indefensible: Reply to Critics
Authors: Nili Shmuel 
Published: November 2024

Abstract
This essay responds to the central critiques of Philosophizing the Indefensible advanced by Nuti, Kapelner, and Garcia-Gibson. Nuti and Kapelner pose general challenges to the strategic method driving the book. Garcia-Gibson focuses on this method’s application to green energy policies. I explain why I believe that both the general account of strategic theorizing presented in the book and its specific green-energy arguments withstand the critics’ scrutiny.
Evaluation of double-bottom structure performance under fire accident using nonlinear finite element approach
Authors: Satriatama Muhammad Affan , Pratama Anandito Adam , Muttaqie Teguh , Prabowo Aditya Rio , Kusharjanta Bambang , Firdaus Himma 
Published: November 2024

Abstract
This study was conducted to evaluate the response of the double-bottom structure on a ship when a fire phenomenon involves temperature elevation and depreciation. Fire accidents on ships can be very detrimental, especially since ships are the main transportation for export and import activities. Therefore, this research is needed to reduce the risk of fire accidents on ships, especially on double-bottom structures. This study used the finite element modeling method in ABAQUS software. The research results found that the Von Mises stress contour, strain, and displacement values were influenced by the type of material, temperature, and plate thickness. Based on the results evaluated using the multi-attribute decision-making method, model 32 is the best model, while model 95 is the worst. Concurrently, from sensitivity analysis, it was found that temperature plays a significant role in the results of Von Mises Stress, Strain, and Displacement. The results indicated that the main factor influencing the Von Mises stress, strain, and displacement is the loading in the form of temperature, followed by material properties and plate thickness.
High school students’ perceived performance and relevance of chemistry learning competencies to sustainable development, action competence, and critical thinking disposition
Authors: Ramirez Hazel Joyce , Paderna Edwehna Elinore 
Published: November 2024

Abstract
Chemistry is deeply interconnected with various aspects of sustainability. However, enabling students to analyze these interconnections requires adequate support in learning. Moreover, few studies have explored the connection between students’ perceptions of chemistry learning competencies and their sustainability competencies that could be the basis for improving pedagogical practices. Therefore, this research investigated Filipino Grade 12 students’ perceived performance and relevance of chemistry learning competencies to sustainable development. Moreover, this study explored the students’ sustainability competencies, specifically action competence and critical thinking disposition. The Performance-Relevance Grid Analysis categorized the learning competencies based on the extent of perceived performance and relevance. Furthermore, the analysis also showed a correlation between students’ perceived performance and relevance (p = 0.015). Additionally, critical thinking disposition was found to be correlated with students’ perceived performance (p = 0.002) and relevance of chemistry learning competencies (p = 0.036) as well as with action competence (p < 0.001). Research findings provide crucial insights for future research and practice that could drive the integration of sustainability in chemistry education. This integration not only enhances the relevance of chemistry, but also encourages students to see the broader implications of their studies in the context of sustainable practices and societal impact.