bluuebunny/crossref_metadata_2025_split huggingface dataset:
Failure mechanisms and influencing factors on orthopaedic knee implant failure – A comprehensive review
Authors: Jeyalakshmi P. , Ramkumar P. 
Published: October 2024

BackgroundTotal knee replacement (TKR) is an effective orthopaedic surgical procedure to confront osteoarthritis and restore bone joint mobility, relieve pain, and enhance the quality of life. The improvements in implant design and the use of high-wear resistance polyethylene bearings improve the survival of implants. Despite the advancements, the implants still failed and required revision surgery. Also, with an increase in the trend of young patients getting knee replacements, there is a possibility of a higher revision rate. Thus, understanding the failure cause, failure mechanisms and the influencing factors is pertinent.MethodsA systematic review of the available literature was performed for different modes of failure. All the observations are collated and found the more predominant failure modes. Also, the data pertaining to the failure mechanisms, and the influencing factors of the failure mechanisms are collected from various literature and provided comprehensively.ResultsInfection (30%) becomes the primary cause of implant failure followed by loosening (20%) and instability (18%). The types of wear on knee implants are polyethylene wear, backside wear, impingement wear, and corrosive wear. The factors influencing these wear are material processing, shelf age, implant design, surface topography, and activity level.ConclusionsModerately cross-linked, and sequentially processed polyethylene has better wear resistance. Less conformal contact with minimum shelf age provides less wear at articulation and backside. A polished tibial tray with a sophisticated locking mechanism reduces the backside wear of PE, and proper design consideration could reduce impingement wear.
Relationship Between Hip and Groin Pain and Hip Range of Motion in Amateur Soccer and Australian Rules Football Players
Authors: Mosler Andrea B. , Heerey Joshua J. , Kemp Joanne L. , Semciw Adam I. , King Matthew G. , Agricola Rintje , Lawrenson Peter R. , Scholes Mark J. , Mentiplay Benjamin F. , Crossley Kay M. 
Published: October 2024

Background: The relationship between hip/groin pain and hip range of motion (ROM) is unclear. Purpose: To explore the relationship between hip/groin pain and hip joint ROM and examine the influence of sex and cam morphology on this relationship. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included were 184 amateur soccer and Australian Rules football players (276 hips; 20% women; median age, 26 years; interquartile range, 24-30 years) with hip/groin pain >6 months and a positive flexion-adduction-internal-rotation (FADIR) test, and 50 matched asymptomatic control players (98 hips; 28% women, median age, 26 years; interquartile range, 23-31 years). Hip ROM measures were flexion, internal and external rotation at 90° of hip flexion, total rotation (internal and external), and bent-knee fall out (BKFO). Cam morphology was determined from anteroposterior pelvis or 45° Dunn radiographs, defined by an alpha angle ≥60°. Linear regression models with generalized estimating equations were used to examine the relationship between group (symptomatic and asymptomatic) and each ROM measure. Interaction terms (group × cam morphology or group × sex) were included to examine if relationships between group and hip ROM were influenced by cam morphology or sex. Where appropriate, models were adjusted for sex, age, and cam morphology. Results: An interaction between the relationship between group × cam and internal rotation ROM was found. Symptomatic players with cam morphology had lower internal rotation ROM than controls with cam morphology (adjusted mean difference [AMD] = −4.5°; 95% CI, −7.4° to −1.6°). Hip/groin pain was not associated with internal rotation ROM if cam morphology was absent. A significant interaction was also found for group × sex and BKFO and total rotation ROM. Symptomatic women had lower total rotation ROM than control women (AMD = −8.2°; 95% CI, −14.1° to −2.2°), but no difference was seen in men. BKFO range was lower in men with hip/groin pain compared with control men (AMD = 1.6 cm; 95% CI, 0.3-3.0 cm), but no difference was seen in women. Flexion and external rotation ROM did not differ between symptomatic and control hips. Conclusion: Cam morphology was an effect modifier of the relationship between hip/groin pain and internal rotation ROM. Sex-related differences were also observed in the relationship between hip/groin pain and hip ROM.
An early economic evaluation of WireSafe™ to prevent guidewire retention in central venous catheter procedures
Authors: Mattock R , Hanbury A , Morys-Edge M. , Corp A. , Lawton R 
Published: October 2024

Background Guidewire retention (GWR) poses a patient safety risk during Central Venous Catheter (CVC) insertions and is listed as a ‘Never Event’ by the National Health Service England (NHSE). WireSafe™ is an intervention to prevent GWR, but its cost-effectiveness is uncertain. This study is an early economic evaluation comparing WireSafe™ to standard care from a UK healthcare perspective. Methods We conducted (i) a primary analysis of GWR related NHSE Never Events data in England between 2016 and 2020; and (ii) a cost-utility analysis, including healthcare costs and quality-adjusted life years (QALYS) for populations receiving CVC-insertions. We applied a cost-effectiveness threshold of £30,000 per QALY and considered three WireSafe™ costing scenarios (£18.50, £4.50, and £2.50). Results NHSE Never Events data showed 61 GWR cases, averaging 1 per month. Most incidents (92%) were identified during hospital stays, with one serious adverse outcome reported (peri-arrest). In a population of 200,000, we estimate WireSafe™ would prevent 59.92 wire retentions, 5.61 procedural adverse events, 0.3 cardiac adverse events, and 0.19 deaths, improving QALYs by 4.87. In the base case analysis WireSafe™ was not cost-effective and had an economically justifiable price of £2.44. There were high levels of uncertainty in the lowest cost-scenario (ICER 95% credible interval: Dominant; £793,398). Conclusions The health benefits of WireSafe™ are limited due to low GWR rates and high identification rates, making WireSafe™ viable only at low costs. Future research should prioritise obtaining more precise estimates of these parameter values which are key determinants of cost-effectiveness.
Long-term real-world evidence of CPX-351 of high-risk patients with AML identified high rate of negative MRD and prolonged OS
Authors: Cluzeau Thomas , Guolo Fabio , Chiche Edmond , Minetto Paola , Rahme Ramy , Bertoli Sarah , Fianchi Luana , Micol Jean-Baptiste , Gottardi Michele , Peterlin Pierre , Galimberti Sara , Thomas Xavier , Rizzuto Giuliana , Legrand Olivier , Rondoni Michela , Raffoux Emmanuel , Bertani Giambattista , Caulier Alexis , D’Argenio Michelina , Bonmati Caroline , Billio Atto , Lejeune Caroline , Scappini Barbara , Pigneux Arnaud , Zappasodi Patrizia , Recher Christan , Grimaldi Francesco , Ades Lionel , Lemoli Roberto M. 
Published: October 2024

Abstract
CPX-351 has been approved for patients with therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (MRC-AML). No extensive data are available on measurable residual disease (MRD) and long-term clinical outcome using CPX-351 in AML in real life. We retrospectively collected data from 168 patients in 36 centers in France and Italy who had received 1 or 2 cycles of induction with CPX-351. All patients were aged &gt;18 years and had newly diagnosed, untreated t-AML or MRC-AML. With a median follow-up of 3 years, the median overall survival (OS) was 13.3 months. The median OS was 20.4 months vs 12.9 months for patients with MRD below or above 10–3, respectively (P = .006). In a multivariate analysis, only MRD &gt;10–3 was associated with a poorer OS (hazard ratio, 2.6; 95% confidence interval, 1.2-5.5; P = .013). We also observed a trend toward a better median OS in patients who underwent hematopoietic stem cell transplantation with MRD &lt;10–3 (not reached vs 26.0 months; P = .06). Achievement of MRD negativity contributed to the improvement of OS in the overall population and, maybe, in patients receiving transplant. These data provide the rationale for the 2 ongoing studies evaluating CPX-351 vs 7+3 in non–MRC-AML and non–t-AML using MRD as the primary end point for ALFA-2101 phase 2 clinical trial and event-free survival for AMLSG 30-18 phase 3 clinical trial.
Ibrutinib for therapy of steroid-refractory chronic graft-versus-host disease: a multicenter real-world analysis
Authors: Pidala Joseph , Kim Jongphil , Kalos Denise , Cutler Corey , DeFilipp Zachariah , Flowers Mary E. D. , Hamilton Betty K. , Chin Kuo-Kai , Rotta Marcello , El Jurdi Najla , Hamadani Mehdi , Ahmed Gulrayz , Kitko Carrie , Ponce Doris , Sung Anthony , Tang Helen , Farhadfar Nosha , Nemecek Eneida , Pusic Iskra , Qayed Muna , Rangarajan Hemalatha , Hogan William , Etra Aaron , Jaglowski Samantha 
Published: October 2024

Abstract
To examine the activity of ibrutinib in steroid-refractory chronic graft-versus-host disease (SR-cGVHD) after the US Food and Drug Administration approval, we conducted a multicenter retrospective study. Data were standardly collected (N = 270 from 19 centers). Involved organs included skin (75%), eye (61%), mouth (54%), joint/fascia (47%), gastrointestinal (GI) (26%), lung (27%), liver (19%), genital (7%), and others (4.4%). The National Institutes of Health (NIH) severity was mild in 5.7%, moderate 42%, and severe 53%. Thirty-nine percent had overlap subtype. Karnofsky performance status (KPS) was ≥80% in 72%. The median prednisone was 0.21 mg/kg (0-2.27). Ibrutinib was started at a median of 18.2 months after cGVHD onset and in earlier lines of therapy (second line, 26%; third, 30%; fourth, 21%; fifth, 9.6%; sixth, 10%; seventh or higher, 1.2%). Among evaluable patients, the 6-month NIH overall response rate (ORR; complete response [CR]/partial response [PR]) was 45% (PR 42%; CR 3%). The median duration of response was 15 months (range, 1-46). Liver involvement had association with 6-month ORR (multivariate [MVA] odds ratio, 5.49; 95% confidence interval [CI], 2.3-14.2; P &lt; .001). The best overall response was 56%, with most (86%) achieving by 1 to 3 months. With a median follow-up for survivors of 30.5 months, failure-free survival (FFS) was 59% (53%-65%) at 6 months and 41% (36%-48%) at 12 months. On MVA, increased age (hazard ratio [HR], 1.01; 95% CI, 1.0-1.02; P = .033), higher baseline prednisone (HR, 1.92; 95% CI, 1.09-3.38; P = .032), and lung involvement (HR, 1.58; 95% CI, 1.1-2.28; P = .016) had worse FFS. Ibrutinib discontinuation was most commonly due to progressive cGVHD (44%) or toxicity (42%). These data support that ibrutinib has activity in SR-cGVHD, provide new insight into factors associated with response and FFS, and demonstrate the toxicity profile associated with discontinuation.
Engagement/Disengagement Characteristics of Pull-Type Diaphragm Spring Clutch for Heavy-Duty Commercial Vehicles
Authors: Yan Zhengfeng , Wu Bingbing , Gao Xinming , Bai Xianxu 
Published: October 2024

AbstractConsidering that the clutch cover assembly and driven disc assembly show common effect on the engagement/disengagement characteristics of the pull-type diaphragm spring clutches for heavy-duty commercial vehicles, the diaphragm spring, cushion plate, and friction plate, are thoroughly analyzed in this paper. The A-L method and the micro-element method are used to analyze the mechanical properties of diaphragm spring and cushion plate, respectively. The mechanical characteristics are obtained via numerical simulation, and the deformation and load mechanical characteristics of the cushion plate are verified by experimental tests. According to the relationship between the pressure plate temperature and the friction coefficient of the friction plate, the influence of the change of the friction coefficient on the transmission torque characteristics of the clutch is analyzed. In view of the torque fluctuation in the process of engagement/disengagement, the mathematical model of torsional characteristics is established with consideration of the torsional characteristics of torsional damper. Modeling and simulation of the handling characteristics are carried out to evaluate the influence of the boosting characteristics of the hydraulic operated pneumatic booster on the clutch pedal operating force separation characteristics. Specific tests are also conducted, and the effectiveness of the established models is verified.
Associations between genotype, phenotype and behaviours measured by the Rett syndrome behaviour questionnaire in Rett syndrome
Authors: Downs Jenny , Wong Kingsley , Leonard Helen 
Published: October 2024

Abstract
Introduction
Rett syndrome (RTT) is a rare neurodevelopmental disorder with developmental impairments, comorbidities, and abnormal behaviours such as hand stereotypies and emotional features. The Rett Syndrome Behaviour Questionnaire (RSBQ) was developed to describe the behavioural and emotional features of RTT. Little is known how RSBQ scores are associated with genetic and clinical characteristics in RTT. This study investigated relationships between genotype, age, walking, hand function, sleep, and RSBQ total and subscale scores in RTT.

Methods
This is a cross-sectional analysis of data collected in the Australian Rett Syndrome Database and the International Rett Syndrome Phenotype Database. Parent caregivers completed the RSBQ and Sleep Disturbance Scale for Children [subscales for disorders of initiating and maintaining sleep (DIMS), disorders of excessive somnolence (DOES)], and provided information on age, variant type, functional abilities (mobility, hand function), seizure frequency and gastrointestinal problems. Associations between the RSBQ scores and the independent variables were modelled using linear regression.

Results
Data were available for 365 individuals with RTT [median (range) age 17.8 (2.9–51.9) years, 2 males]. Compared to adults, 2- to 12-year-old children had higher mean Total, Night-time Behaviour and Fear/Anxiety scores. Compared to individuals with a C-terminal deletion, individuals with the p.Arg255* variant had higher mean Total and Night-time Behaviours scores, whereas the p.Arg294* variant had higher mean Mood scores. Individuals with intermediate mobility and hand function abilities had a higher mean Total score. Total RSBQ and subscale scores were similar across categories for seizures, constipation, and reflux, but were higher with abnormal DIMS and abnormal DOES scores.

Conclusion
Except for associations with sleep, the RSBQ measures the behavioural phenotype rather than clinical severity in RTT, as traditionally conceptualised in terms of functional abilities and comorbidities. When designing clinical trials, the RSBQ needs to be complemented by other outcome measures to assess specific core functions and associated comorbidities in RTT.
Diversity of attachment systems in heelwalkers (Mantophasmatodea) – highly specialized, but uniform
Authors: Büscher Thies H. , Gorb Stanislav N. , Eberhard Monika J. B. 
Published: October 2024

Abstract
Background
Heelwalkers possess a highly modified tarsal attachment system. All extant species lift the distalmost tarsomere permanently off the substrate and primarily use their euplantulae for locomotion. The combination of a smooth adhesive pad (arolium) on the pretarsus and fibrillary attachment pads on the euplantulae offers valuable insights for translational approaches, but its infra-order diversity remains unexplored.

Results
We explored the morphology of the tarsal attachment apparatus of Mantophasmatodea based on a representative taxon sampling spanning a large fraction of species of this group and compared morphological differences in the specialized morphology of this system across species and sexes. Our scanning electron microscope investigation of the tarsi of 11 species (52% of all described extant species) revealed an overall very consistent ground pattern and almost no specific adaptations. There are only minor, but mostly clade-specific differences in the shape of the adhesive setae on the tarsal euplantulae and in the morphology and density of the acanthae on the pretarsal arolium. Both features differ primarily between Austrophasmatidae in comparison to the remaining Mantophasmatodea taxa.

Conclusion
We conclude that the strong specialization of the mantophasmatodean tarsal attachment sufficiently copes with the diversity of substrates the insects are exposed to.
Women’s perspectives on the acceptability of risk-based cervical cancer screening
Authors: Remmel Maali-Liina , Suija Kadri , Raudne Riina , Tisler Anna , Ķīvīte-Urtāne Anda , Stankūnas Mindaugas , Nygård Mari , Aasbø Gunvor , Maļina Laura , Uusküla Anneli 
Published: October 2024

Abstract
Background
The increased knowledge of cervical cancer (CC) risk factors and suboptimal performance of present screening programs has generated interest in shifting from a universal screening approach to one based on individual risk assessment. To inform the future development of risk-based CC screening programs, it is crucial to gain insight into the factors influencing the acceptability of such approach among screening target group women. The aim of this study was to prospectively investigate the acceptability of risk-based CC screening and to identify potential barriers.

Methods
In this qualitative study, one-to-one semi-structured interviews were conducted with a purposeful sample including women aged 30–65 years to explore women’s perspectives on the acceptability of risk-based CC screening. The study was conducted in Estonia, and interviews were conducted from March to September 2023. Potential participants were approached in person by a member of the study team or by their healthcare providers at primary care or gynaecology clinics. The interview guides were developed based on the concept of acceptability of healthcare interventions.

Results
Twenty participants (mean age 44.5, SD = 8.6) with diverse backgrounds were interviewed. The seven components of acceptability (affective attitude, burden, ethicality, opportunity costs, perceived effectiveness, self-efficacy, and intervention coherence) were explored as key themes. Generally, women supported risk-based screening. However, we identified several factors that may compromise the acceptability of risk-based screening. The participants were reluctant to accept less intense screening for low-risk women and anticipated that if risk-based approach was implemented, more frequent testing would remain an option. Providing in-person clinician support was expected, requiring additional healthcare resources. Knowledge gaps in CC prevention highlighted the need for accessible information and education. Most women were unworried about sensitive data inclusion in risk score calculations. However, some participants were concerned about potential confidentiality breaches by healthcare workers.

Conclusion
This study indicates that risk-based CC screening is acceptable, except for testing low-risk women less frequently. Our findings underscore the necessity for comprehensive understanding of the needs and concerns of the target group women for program development. Healthcare organizations are required to proactively address these needs by implementing comprehensive information dissemination and efficient communication approaches.
Determinants of oral health among Iranian soldiers: a structural equation modeling study
Authors: Banakar Morteza , Ghannadpour Akram , Behbahanirad Arghavan , Joulaei Hassan , Lankarani Kamran Bagheri 
Published: October 2024

Abstract
Background
Military personnel often face unique challenges in maintaining optimal oral health. This study investigated the oral health status, caries experience, and associated factors among a sample of Iranian soldiers, employing a structural equation modeling (SEM) approach to explore the complex interplay of socioeconomic and behavioral determinants.

Methods
A cross-sectional study was conducted among 658 male soldiers aged 18–30 years from three military barracks in Fars province, Iran. Data were collected through a structured instrument and clinical oral examinations. The study employs the DMFT index, which measures caries experience based on decayed, missing, and filled teeth, along with the Simplified Oral Hygiene Index (OHI-S) to assess overall oral health status. Structural equation modeling was employed to analyze the complex relationships between socioeconomic factors, oral health behaviors, and oral health outcomes.

Results
The mean DMFT score was 3.57 ± 5.91, and the mean OHIS score was 0.56 ± 1.42. SEM analysis revealed that socioeconomic status (SES) indirectly influenced DMFT and oral hygiene scores, mediated by drug use, oral hygiene practices, dietary sugar consumption, and dental visit frequency. Lower toothbrushing frequency was significantly associated with higher DMFT (Estimate = -0.064, p < 0.001) and OHIS scores (Estimate = -0.637, p < 0.001). Drug use (smoking, qalyan, alcohol) was linked to poorer oral health outcomes, while more frequent dental visits were associated with lower DMFT and OHIS scores.

Conclusion
This study reveals the complex interplay between socioeconomic conditions, oral health behaviors, and oral health outcomes among Iranian soldiers. The findings highlight the need for targeted interventions to address modifiable risk factors and improve access to preventive dental care within military settings. Future longitudinal studies are warranted to elucidate further the causal pathways between these factors and oral health outcomes in military populations.
Assessment of inverse publication bias in safety outcomes: an empirical analysis
Authors: Xing Xing , Zhu Jianan , Shi Linyu , Xu Chang , Lin Lifeng 
Published: October 2024

Abstract

Background
The aims of this study were to assess the presence of inverse publication bias (IPB) in adverse events, evaluate the performance of visual examination, and explore the impact of considering effect direction in statistical tests for such assessments.

Methods
We conducted a cross-sectional study using the SMART Safety, the largest dataset for evidence synthesis of adverse events. The visual assessment was performed using contour-enhanced funnel plots, trim-and-fill funnel plots, and sample-size-based funnel plots. Two authors conducted visual assessments of these plots independently, and their agreements were quantified by the kappa statistics. Additionally, IPB was quantitatively assessed using both the one- and two-sided Egger’s and Peters’ tests.

Results
In the SMART Safety dataset, we identified 277 main meta-analyses of safety outcomes with at least 10 individual estimates after dropping missing data. We found that about 13.7–16.2% of meta-analyses exhibited IPB according to the one-sided test results. The kappa statistics for the visual assessments roughly ranged from 0.3 to 0.5, indicating fair to moderate agreement. Using the one-sided Egger’s test, 57 out of 72 (79.2%) meta-analyses that initially showed significant IPB in the two-sided test changed to non-significant, while the remaining 15 (20.8%) meta-analyses changed from non-significant to significant.

Conclusions
Our findings provide supporting evidence of IPB in the SMART Safety dataset of adverse events. They also suggest the importance of researchers carefully accounting for the direction of statistical tests for IPB, as well as the challenges of assessing IPB using statistical methods, especially considering that the number of studies is typically small. Qualitative assessments may be a necessary supplement to gain a more comprehensive understanding of IPB.