bluuebunny/crossref_metadata_2025_split huggingface dataset:
The pre-operative levels of haemoglobin in the blood can be used to predict the risk of allogenic blood transfusion after total knee arthroplasty
Authors: Maempel J. F. , Wickramasinghe N. R. , Clement N. D. , Brenkel I. J. , Walmsley P. J. 
Published: April 2016

AimsThe pre-operative level of haemoglobin is the strongest predictor of the peri-operative requirement for blood transfusion after total knee arthroplasty (TKA). There are, however, no studies reporting a value that could be considered to be appropriate pre-operatively. This study aimed to identify threshold pre-operative levels of haemoglobin that would predict the requirement for blood transfusion in patients who undergo TKA.Patients and MethodsAnalysis of receiver operator characteristic (ROC) curves of 2284 consecutive patients undergoing unilateral TKA was used to determine gender specific thresholds predicting peri-operative transfusion with the highest combined sensitivity and specificity (area under ROC curve 0.79 for males; 0.78 for females).ResultsThreshold levels of 13.75 g/dl for males and 12.75 g/dl for females were identified. The rates of transfusion in males and females, respectively above these levels were 3.37% and 7.11%, while below these levels, they were 16.13% and 28.17%. Pre-operative anaemia increased the rate of transfusion by 6.38 times in males and 6.27 times in females. Blood transfusion was associated with an increased incidence of early post-operative confusion (odds ratio (OR) = 3.44), cardiac arrhythmia (OR = 5.90), urinary catheterisation (OR = 1.60), the incidence of deep infection (OR = 4.03) and mortality (OR = 2.35) one year post-operatively, and increased length of stay (eight days vs six days, p < 0.001).ConclusionUncorrected low pre-operative levels of haemoglobin put patients at potentially modifiable risk and attempts should be made to correct this before TKA. Target thresholds for the levels of haemoglobin pre-operatively in males and females are proposed. Take home message: Low pre-operative haemoglobin levels put patients at unnecessary risk and should be corrected prior to surgery. Cite this article: Bone Joint J 2016;98-B:490–7.
Assessing the comparability of hip arthroplasty registries in order to improve the recording and monitoring of outcome
Authors: Lacny S. , Bohm E. , Hawker G. , Powell J. , Marshall D. A. 
Published: April 2016

Aims We aimed to assess the comparability of data in joint replacement registries and identify ways of improving the comparisons between registries and the overall monitoring of joint replacement surgery. Materials and Methods We conducted a review of registries that are full members of the International Society of Arthroplasty Registries with publicly available annual reports in English. Of the six registries which were included, we compared the reporting of: mean age, definitions for revision and re-operation, reasons for revision, the approach to analysing revisions, and patient-reported outcome measures (PROMs) for primary and revision total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA). Results Outcomes were infrequently reported for HRA compared with THA and all hip arthroplasties. Revisions were consistently defined, though re-operation was defined by one registry. Implant survival was most commonly reported as the cumulative incidence of revision using Kaplan-Meier survival analysis. Three registries reported patient reported outcome measures. Conclusion More consistency in the reporting of outcomes for specific types of procedures is needed to improve the interpretation of joint registry data and accurately monitor safety trends. As collecting additional details of surgical and patient-reported outcomes becomes increasingly important, the experience of established registries will be valuable in establishing consistency among registries while maintaining the quality of data. Take home message: As the volume of joint replacements performed each year continues to increase, greater consistency in the reporting of surgical and patient-reported outcomes among joint replacement registries would improve the interpretation and comparability of these data to monitor outcomes accurately. Cite this article: Bone Joint J 2016;98-B:442–51.
The surgical approach for hemiarthroplasty does not influence patient-reported outcome
Authors: Leonardsson O. , Rolfson O. , Rogmark C. 
Published: April 2016

AimsHemiarthroplasty of the hip is usually carried out through either a direct lateral or posterior approach. The aim of this prospective observational study was to determine any differences in patient-reported outcomes between the two surgical approaches.Patients and MethodsFrom the Swedish Hip Arthroplasty Register we identified patients of 70 years and above who were recorded as having had a hemiarthroplasty during 2009. Only patients who had been treated with modern prostheses were included. A questionnaire was posted to those who remained alive one year after surgery. A total of 2118 patients (78% of those available) with a mean age of 85 years (70 to 102) returned the questionnaire.ResultsPatients who had undergone surgery through a posterior approach reported a higher health-related quality of life (HRQoL, EQ-5D mean 0.52 versus 0.47, p = 0.009), less pain (visual analogue scale mean 17 versus 19, p = 0.02) and greater satisfaction with the result of surgery (visual analogue scale mean 22 versus 24, p = 0.02) than those who had a direct lateral approach. However, after adjusting for age, gender, cognitive impairment and American Society of Anesthesiologists grade, no association was found between surgical approach and HRQoL, residual pain or patient satisfaction. Take home message: The surgical approach for hemiarthroplasty does not seem to affect the patient-perceived HRQoL, residual pain or patient satisfaction one year after surgery on elderly patients. The choice of approach should be based on other factors, such as the risk of dislocation. Cite this article: Bone Joint J 2016;98-B:542–7.
Epidemiology of periprosthetic fracture of the femur in 32 644 primary total hip arthroplasties
Authors: Abdel M. P. , Watts C. D. , Houdek M. T. , Lewallen D. G. , Berry D. J. 
Published: April 2016

Aim and Methods The goals of this study were to define the risk factors, nature, chronology, and treatment strategies adopted for periprosthetic femoral fractures in 32 644 primary total hip arthroplasties (THAs). Results There were 564 intra-operative fractures (1.7%); 529 during uncemented stem placement (3.0%) and 35 during cemented stem placement (0.23%). Intra-operative fractures were more common in females and patients over 65 years (p < 0.001). The majority occurred during placement of the femoral component (60%), and involved the calcar (69%). There were 557 post-operative fractures (20-year probability: 3.5%; 95% confidence interval (CI) 3.2 to 3.9); 335 fractures after placement of an uncemented stem (20-year probability: 7.7%; 95% CI 6.2 to 9.1) and 222 after placement of a cemented stem (20-year probability: 2.1%; 95% CI 1.8 to 2.5). The probability of a post-operative fracture within 30 days after an uncemented stem was ten times higher than a cemented stem. The most common post-operative fracture type was a Vancouver AG (32%; n = 135), with 67% occurring after a fall. In all, 36% (n = 152) were treated with revision arthroplasty. Conclusion In summary, intra-operative fractures occur 14 times more often with uncemented stems. Female patients over 65 years of age are at highest risk. Post-operative fractures are also most common with uncemented stems, but are independent of age or gender. Cumulative risk of post-operative periprosthetic femur fracture was 3.5% at 20 years. Take home message: Intra-operative fractures occur 14 times more often with uncemented stems, particularly with female patients over 65 years of age, while post-operative fracture risk is independent of age or gender, but still increased with uncemented stems. Cite this article: Bone Joint J 2016;98-B:461–7.
Epidemiology of periprosthetic femoral fractures in 5417 revision total hip arthroplasties
Authors: Abdel M. P. , Houdek M. T. , Watts C. D. , Lewallen D. G. , Berry D. J. 
Published: April 2016

AimsThe goals of this study were to define the risk factors, characteristics, and chronology of fractures in 5417 revision total hip arthroplasties (THAs).Patients and MethodsFrom our hospital’s prospectively collected database we identified all patients who had undergone a revision THA between 1969 and 2011 which involved the femoral stem. The patients’ medical records and radiographs were examined and the relevant data extracted. Post-operative periprosthetic fractures were classified using the Vancouver system. A total of 5417 revision THAs were identified.ResultsThere were 668 intra-operative fractures, giving an incidence of 12%. Fractures were three times more common with uncemented stems (19%) than with cemented stems (6%) (p < 0.001). The incidence of intra-operative femoral fracture varied by uncemented stem type: fully-coated (20%); proximally-coated (19%); modular fluted tapered (16%) (p < 0.05). Most fractures occurred during the insertion of the femoral component (35%). One-third involved the diaphysis and 26% were of the calcar: 69% were undisplaced. There were 281 post-operative fractures of the femur (20-year probability = 11%). There was no difference in risk for cemented and uncemented stems. Post-operative fractures were more common in men < 70 years (p = 0.02). Periprosthetic fractures occurred earlier after uncemented revision of the femoral component, but later after a cemented revision. The most common fracture type was a Vancouver B1(31%). Of all post-operative fractures, 24% underwent open reduction and internal fixation and 15% revision arthroplasty.ConclusionIn revision THA, intra-operative fractures occurred three times more often with an uncemented stem. Many were undisplaced diaphyseal fractures treated with cerclage fixation. While the risk of post-operative fracture is similar between uncemented and cemented components, they occur at notably different times depending on the type of stem fixation. Take home message: In revision THA, intra-operative periprosthetic femoral fractures occur three times more often with uncemented stems. Many are non-displaced diaphyseal fractures treated with cerclage fixation. While postoperative fracture risks are equivalent between uncemented and cemented components, they occur at notably different time periods based on stem fixation type. Cite this article: Bone Joint J 2016;98-B:468–74.
A New Hilbert-type integral inequality with a non-homogeneous kernel and its extension
Authors: Wu Weiliang 
Published: April 2016

By introducing some parameters , using the weight function and the technique of real analysis, a new Hilbert-type integral inequality with a non-homogeneous kernel as \(\frac{1}{|1-axy|^{\lambda_2}}(a\geq1)\) and its equivalent form are established. As application, the constant factor on the plane is the best value and its extension form with some parameters is also considered.
Female murderers: Examination of the relationship between childhood traumatic experiences and anger expression
Authors: Akduman İrem , Çelik Dilek , Tiftik Nurhan 
Published: April 2016

Adverse childhood period and abuse experiences may lead to some problems later in life. One of these problems is aggressive behavior, which is thought to be a reflection of the child’s increasing anger (Page, 2004; Olive, 2007). Based on the fact that negative childhood experiences can lead to aggressive emotions, investigating the relationship between traumatic childhood experiences and female convicts’ aggression expression styles was considered important.Sample of the research consists of 77 females who are homicide convicts selected from correctional institutes in three different cities. Data gathered from the participants were examined by using the Turkish versions of The Childhood Trauma Questionnaire and The State-Trait Anger Scale.A positive and meaningful relationship between childhood trauma experiences and trait anger levels of participants was observed. In addition, there was a significant relationship between childhood trauma experiences and domestic violence as well as perceived problematic relationship with family members during childhood. Trait anger and internal anger were also found to be significantly related to perceived problematic relationship with family members during childhood. Results of the analyses were discussed in detail.
Impact of Obesity on Clinical Outcomes in Urban Children Hospitalized for Status Asthmaticus
Authors: Aragona Elena , El-Magbri Eussra , Wang Justin , Scheckelhoff Tessa , Scheckelhoff Trevor , Hyacinthe Assata , Nair Suja , Khan Amina , Nino Gustavo , Pillai Dinesh K. 
Published: April 2016

BACKGROUND AND OBJECTIVE:
The prevalence of both childhood asthma and obesity remain at historically high levels and disproportionately affect urban children. Asthma is a common and costly cause for pediatric hospitalization. Our objective was to determine the effect of obesity on outcomes among urban children hospitalized with status asthmaticus.

METHODS:
A retrospective cohort study was performed by using billing system data and chart review to evaluate urban children admitted for asthma. Demographics, asthma severity, reported comorbidities, and outcomes were assessed. Obesity was defined by BMI percentile (lean &lt;85%, overweight 85%–95%, obese ≥95%). Outcomes were length of stay, hospitalization charges, ICU stay, repeat admissions, and subsequent emergency department (ED) visits. Bivariate analysis assessed for differences between overweight/obese and lean children. Multivariable regression assessed the relationship between overweight status and primary outcomes while controlling for other variables. Post hoc age-stratified analysis was also performed.

RESULTS:
The study included 333 subjects; 38% were overweight/obese. Overweight/obese children admitted with asthma were more likely than lean children to have subsequent ED visits (odds ratio 1.6, 95% confidence interval 1.0–2.6). When stratified by age, overweight/obese preschool-age children (&lt;5 years) were &gt;2 times as likely to have repeat ED visits than lean preschool-age children (odds ratio 2.3, 95% confidence interval 1.0–5.6). There were no differences in the other outcomes between overweight/obese and lean individuals within the entire cohort or within other age groups.
A Meta-analysis of the Rates of Listeria monocytogenes and Enterococcus in Febrile Infants
Authors: Leazer Rianna , Perkins Amy M. , Shomaker Kyrie , Fine Bryan 
Published: April 2016

CONTEXT:
A change in the epidemiology of pathogens causing serious bacterial infection (SBI) has been noted since original recommendations were made for the empirical antibiotic choices for young infants with fever.

OBJECTIVE:
To assess the prevalence of SBI caused by Listeria monocytogenes and Enterococcus species.

DATA SOURCES:
A literature search was conducted on keywords related to SBI, L. monocytogenes, and Enterococcus spp. infections.

STUDY SELECTION:
Eligible studies were those conducted in the United States and published between January 1998 and June 2014 focusing on SBI in infants ≤90 days of age.

DATA EXTRACTION:
The rates of urinary tract infection, bacteremia, and meningitis for each pathogen were recorded for each study. Meta-analysis was performed to calculate the prevalence for each pathogen in a random effects model with 0.5 continuity correction added to studies with zero events.

RESULTS:
Sixteen studies were included. A total of 20 703 blood cultures were included, with weighted prevalences for L. monocytogenes and Enterococcus spp. bacteremia of 0.03% and 0.09%, respectively. A total of 13 775 cerebrospinal fluid cultures were included with event rates (unweighted prevalences) for L. monocytogenes and Enterococcus spp. meningitis of 0.02% and 0.03%, respectively. A total of 18 283 urine cultures were included, with no cases of L. monocytogenes and a weighted prevalence for Enterococcus spp. urinary tract infection of 0.28%.

LIMITATIONS:
There may have been reporting bias or incomplete retrieval or inadvertent exclusion of relevant studies.

CONCLUSIONS:
SBI caused by L. monocytogenes and Enterococcus spp. in febrile infants is rare, and therefore clinicians may consider a change in empirical antibiotic choices.
The Impact of Reduced Pulse Oximetry Use on Alarm Frequency
Authors: Schondelmeyer Amanda C. , Brady Patrick W. , Sucharew Heidi , Huang Guixia , Hofacer Kelsey E. , Simmons Jeffrey M. 
Published: April 2016

BACKGROUND:
Concerns about alarm fatigue prompted The Joint Commission to issue a Sentinel Event Alert urging hospitals to minimize alarms. We previously conducted a quality improvement project on a single unit that reduced time on continuous pulse oximetry, a common source of physiologic monitor alarms, for patients with wheezing (ie, asthma and bronchiolitis, wheezing-associated respiratory infections).

OBJECTIVE:
To study the impact of our improvement work on overall physiologic monitor alarm frequency for these patients.

METHODS:
This was a retrospective cohort study at a freestanding children’s hospital over an 8-week period. We compared alarm count, including respiratory, cardiac, and pulse oximetry alarms, for patients admitted to the intervention unit with the alarm count for similar patients on a control unit by using the Wilcoxon rank sum test. We used negative binomial regression to evaluate differences in alarm count between the units, adjusting for age, medical comorbidity, and length of stay.

RESULTS:
There were 101 patients on the intervention unit and 46 patients on the control unit. The percentage of patients with medical comorbidities was significantly higher on the intervention unit (P = .01). Median alarm count per day for patients on the intervention unit was lower; however, this difference was not statistically significant (71 vs 76 alarms per patient-day, P = .29). The multivariable model estimated a nonsignificant 6.4-count decrease in alarms for patients on the intervention unit.

CONCLUSIONS:
Reducing continuous pulse oximetry use alone may not make substantial reductions in overall alarm counts. Even on our intervention unit, alarm burden remained quite high.
The tomb of Queen Gertrude
Authors: Takács Imre 
Published: April 2016

The burial site and fragments of the tomb of Queen Gertrude of Andechs-Meran, first wife of King Andrew II (1205–1235) and a victim of assassination in 1213, were discovered during the excavations carried out in the Cistercian church of Pilis between 1967 and 1982. Her tomb was found along the central axis of the church, in the crossing. The present study, which includes the complete catalogue of the known fragments, attempts to establish the typology, iconography, and stylistic context of the artwork. New reconstructions are proposed for the two short sides of the sarcophagus-shaped tomb, which each bore distinct forms: one contained a wide, shallow niche, while the other depicted two standing figures under a double arcade. The figural ornaments on the sides of the tomb and the gisant with angels on the lid occupy an important place in the history of funerary art. In fact, the tomb displays one of the first examples of this type of decoration. The seated figures on the side relief probably represent the choir of saints in heaven, who provided companionship for the soul of the deceased queen. Gertrude herself is represented not only on top of the tomb, but also appears as a donor in one of the reliefs.
Stylistic analysis of the figures proves that their master came from the workshop responsible for the Last Judgment and Callixtus portals of the cathedral of Reims. He must have left the workshop around 1220, before the portals were completed and installed in the façade of the northern transept. At about this time, Villard de Honnecourt also embarked on his travels that took him from Reims to Hungary. The style of Gertrude’s tomb bears similarities to the Villard’s drawings, even if we do not wish to attribute the sculptures to him. A team of masons from Reims also arrived in Pannonhalma during this time frame and worked on the abbey church there. Their most important work in Pannonhalma is the southern portal of the new church, the Porta Speciosa. The complicated nature of these construction histories reminds us of the need for caution when attributing one work of art to one person.
Both Gertrude’s tomb and the Porta Speciosa are prime examples of the cultural and artistic period that began in the late 12th century, when the Kingdom of Hungary was a leader in the region in the reception of French Gothic.
Resurgence and rejection: Lajos Kassák’s self-financed exhibition in Fényes Adolf Showroom, Budapest
Authors: Sasvári Edit 
Published: April 2016

Lajos Kassák’s exhibition in the Fényes Adolf Showroom in 1967 was to be the last exhibition during the lifetime of that emblematic figure of the historic avant-garde in Hungary. It also serves as a window into the emergence of self-financed exhibitions at that time. There were two mutually contradictory phenomena connected with Kassák and his art in the Sixties: resurgence and rejection. Mounting demands for Kassák’s art to be put on show were set against the banishment of such exhibitions to the periphery. Kassák fought hard for acceptance as a painter. The contradictions typified by this simultaneous resurgence and rejection beset all kinds of intellectual accomplishment in the Kádár era, and more accurately characterize the period than the — nowadays somewhat worn-out – concept of ‘prohibition.’
After 1956, the cultural authorities’ relations with artists and cultural intellectuals were decidedly cold. After reaching a low point in 1957, cultural relations began to improve in the 1960s through a process that may be most simply described as a gradual widening of dialogue or attempts at dialogue, with both the authorities and those involved in cultural life putting out feelers to each other at varying levels of intensity. They sought a broader set of partners, on one side in the hope of a more rewarding pursuit of culture, and on the other in hope of justification. This process continued to unfold until the events of 1968, after which it stagnated and began to deteriorate. Set against this simple schema, Kassák’s exhibition in 1967 took place as optimistic dialogue was reaching its peak. But even in that brightest phase of compromise-seeking between the system and the cultural sphere, there was to be no prestigious, publicly-funded life’s-work exhibition for Kassák; only a modest, ‘off-site’ self-financed show in the Fényes Adolf Showroom.
This period saw an extension of the ‘tolerated art’ category. The regime could not — or did not want to — maintain its division into friends and enemies. By the end of the period, the passively-tolerated category had completely displaced the active, judgemental thrust of cultural policy and with the emergence of the self-financing exhibition system it became firmly established.